What’s New in April for Gastroenterology, Hepatology, and Endoscopy features: Urea Breath Testing for the Detection of Helicobacter Pylori, Magnetic Resonance Enterography in Inflammatory Bowel Diseases.
Edward A. Lew, MD, MPH
Staff Gastroenterologist, VA Boston Healthcare System, Brigham and Women’s Hospital, Assistant Professor of Medicine, Harvard Medical School, Boston, MA
Urea Breath Testing for the Detection of Helicobacter Pylori
Urea breath testing is an excellent noninvasive method for detecting Helicobacter pylori in the stomach. A baseline breath sample is obtained and then subjects ingest a solution of urea that has been labeled with carbon-13 or -14 (13C or 14C). If H. pylori is present in the stomach, the abundant H. pylori urease will convert the labeled urea to ammonia and 13C or 14C labeled carbon dioxide (13CO2 or14CO2), which is absorbed in the blood and excreted in the lungs. The exhaled labeled CO2 is subsequently detected in breath samples minutes after urea ingestion.
Francesco Alessandrino, MD
Division of Body MRI, Department of Radiology, Beth Israel Deaconess Medical Center,Harvard Medical School, Boston, MA, USA
Koenraad J. Mortelle, MD
Division of Body MRI, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
Magnetic Resonance Enterography in Inflammatory Bowel Diseases
Inflammatory bowel disease (IBD) patients are often young at diagnosis and require multiple assessments throughout their lives. Over the past 5 years, magnetic resonance enterography (MRE) has been increasingly used in the assessment of IBD. There are several advantages compared with other imaging techniques such as computed tomography enterography (CTE): MRE, unlike CTE, is a radiation-free technique that can be used even in pregnant patients, and it allows for differentiation between active disease and chronic fibrostenotic changes. MRE also provides multiple images of each bowel segment at different time points, allowing evaluation of peristalsis and avoiding misdiagnosis of strictures.