Effect of standard and high dose ranitidine on [ 13c]urea breath test results

Abstract

Objective: It has been suggested that standard dose H2 blockers will affect the [ 14−C]urea breath test. The aim of this study was to evaluate the effect of standard and high dose ranitidine on the [ 13C]urea breath test in a prospective cross-over study. Methods: Volunteers found to be positive for H. pylori by IgG serology and [ 13C]urea breath test were given either ranitidine 150 mg b.i.d. or 300 mg b.i.d. for 14 days. Repeat breath tests were completed on the last day of antisecretory dosing and study patients were immediately crossed over to the other ranitidine dose. The third breath test was performed at 14 days after initiation of the new dose. Results: A total of 20 volunteers were enrolled. Using the established cut-off of 2.4% for the commercial breath test, only one patient developed negative results on H2 blockers. This patient had negative breath tests on both ranitidine doses and remained test-negative off all medications 6 wk after study completion, suggesting either a false positive baseline test or an unexpected bacterial eradication. No specific trend in breath test results was observed for the group ( p = NS). On ranitidine 300 mg, six of 19 patients elevated their breath results from 23% to 112% (mean 76%) above baseline. Conclusion: Ranitidine at standard or high doses did not generate a reproducible decline in breath test results. Histamine 2 blockers do not need to be discontinued before urea breath testing.