Confirmation of Helicobacter pylori eradication using ¹³C urea breath test: addressing the regional post-treatment outcomes.

BACKGROUND: As a major etiological factor of the gastrointestinal diseases, the presence of Helicobacter pylori (H. pylori) poses a serious concern to the clinical management; however, the confirmation of the eradication post-therapy is of utmost crucial. The purpose of this study was to use the 13C Urea Breath Test (UBT) in measuring the effectiveness of second-line quadruple therapy in assessing treatment failure due to the infection with resistant strains of H. pylori, particularly in the state of Odisha. METHODS: The study included 70 adult patients (mean age 42.5 ± 12.7 years) with H. pylori infection who participated in first-line eradication therapy. The 13C UBT was performed approximately 50.4 ± 14.4 days after therapy to determine the eradication success. Patients who have tested positive in the initial treatment were subjected to second-line quadruple therapy. The collected data in a designed proforma and excel sheet were analyzed using statistical software SPSS version 21. Descriptive statistics summarized demographic and clinical variables. RESULTS: Among the study participants, 75.75% had negative H. pylori in UBT, indicating successful eradication, and 24.29% were still positive and received second-line quadruple therapy. In situations where H. pylori was not eradicated, the likelihood of geographic fatal H. pylori strains that were also not eradicated using conventional methods was established. In more than two-thirds of the patients, an improvement in their symptoms was observed, and among their common complaints were bloating (61%) and heartburn (40%). A subset of the patients had comorbidities, such as diabetes and metabolic-associated steatohepatitis (MASLD), which were also noted. CONCLUSION: The 13C UBT is crucial and non-invasive test and is used to verify whether H. pylori has been eradicated after treatment. Since the efficacy of UBT has already been proven, it plays a significantly important role in cases of treatment failure, especially in regions resistant to strains. Regional variations in strain identification should be studied for more efficient treatment.