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Background:

Conventional 13C-urea breath testing (13C-UBT) includes a test meal to delay gastric emptying, which, theoretically, improves the accuracy of the test. Citric acid has been proposed as the best test meal. However, recent studies have suggested that a test meal may not be necessary.

Aim:

To investigate a new 13C-UBT protocol without a test meal in a Chinese population.

Methods:

Consecutive dyspeptic patients referred for upper endoscopy were recruited. 13C-UBT was performed on two separate days with or without a test meal (2.4 Gm citric acid) and compared with the ‘gold standard’ (CLO test and histology).

Results:

Two hundred and two patients were tested. Using receiver operating characteristics (ROC) analysis, the optimal delta-value and optimal measurement interval for UBT were 5% and 30 min, respectively, both with or without a test meal. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 13C-UBT with citric acid (96.5%, 97.7%, 98.2%, 95.6%, 97.0%) were similar to 13C-UBT without a test meal (94.7%, 97.7%, 98.2%, 93.5%, 96.0%).

Conclusion:

This simplified 13C-UBT protocol without a test meal produced highly accurate and reliable results in the Chinese population.