Calcium Carbonate Breath Test for Non-Invasive Estimation of Gastric Acid Secretion

Abstract

Gastric acid measurement is useful in assessing the effectiveness of antisecretory drugs, however, the conventional tests involve invasive nasogastric intubation. Orally administered 13 C-labeled calcium carbonate (Ca 13 CO 3 ) reacts with gastric acid to produce 13 C-labeled carbon dioxide ( 13 CO 2 ), which is then excreted in the breath. The objective of this study was to evaluate the suitability of Ca 13 CO 3 breath test for estimating gastric acid secretion in human noninvasively. First, the Ca 13 CO 3 breath test and the measurement of pooled gastric acid under a fasting condition were performed in 6 healthy volunteers to evaluate the correlation between the two parameters. Next, endoscopic gastric acid collection and the Ca 13 CO 3 breath test were performed on different days after pentagastrin injection in 20 subjects to evaluate the correlation between the tests and the reproducibility. Finally, the same studies were repeated in 4 subjects before and after 1-week rabeprazole, a proton pump inhibitor, administration. The maximum 13 CO 2 concentration (Cmax) correlated very well with the amount of pooled gastric acid (r = 0.95), suggesting that Ca 13 CO 3 breath test values well reflected the fasting intragastric acidity. The 13 CO 2 concentration after pentagastrin injection correlated well with pentagastrin-stimulated maximal acid output (r = 0.79 at 20 min). The reproducibility of the Ca 13 CO 3 breath test under pentagastrin-stimulation was good (coefficient of variation = 0.11). Rabeprazole administration markedly reduced the values of the Ca 13 CO 3 breath test, suggesting that it can sensitively assess the efficacy of rabeprazole. The Ca 13 CO 3 breath test can potentially be a useful method for non-invasive estimation for gastric acid secretion in human.

A Chronological Increase in Gastric Acid Secretion from 1995 to 2014 in Young Japanese Healthy Volunteers under the Age of 40 Years Old

“…In a series of our previous studies (Iijima et al 1998(Iijima et al , 2009Iwabuchi et al 2013;Shinkai et al 2014), we enrolled 95 healthy male volunteers to investigate their gastric acid secretion level with the endoscopic gastrin test (EGT) described below over the 20-year time period from 1995 to 2014. These healthy volunteers had been recruited mainly from Tohoku university students or post-graduate students, and they were not included in our preceding report comprising hospital outpatients (Iijima et al 2015).…”

Evaluation of gastric acid suppression with vonoprazan using calcium carbonate breath test

“…Interestingly, some studies have reported that the calcium carbonate breath test (CBT) is useful for estimating changes in gastric acid secretion. (23,24) CBT is a non-invasive test, as the subjects are administered 13 C-labeled calcium carbonate (Ca 13 CO 3 ) orally; subsequently, the amount of 13 C-labeled carbon dioxide ( 13 CO 2 ) in the breath (produced upon reaction with the gastric acid) is analyzed.…”

“…Inada et al (25) reported that a high correlation (r = 0.994) between the 13 CO 2 concentration (Cmax) and the total amount of gastric acid in rats with or without PPI. In addition, Shinkai et al (23) established that the maximum Cmax is correlated with the amount of pooled gastric acid in human (r = 0.95). The aim of this study was thus to evaluate the suppressed amount of gastric acid secretion using CBT.…”

Pulcandi a healing natural ash coal against gastric acidity: Scientific comprehension

“…Gastro-oesophageal reflux disease (GERD) is a common disease in Western countries and the number of patients with GERD is increasing in Japan as well (Shinkai et al, 2014). Gastric ulcer is common gastrointestinal tracts disorder that affect about 10% of the world population.…”