BREATHTAKING TECHNOLOGY TAMES THE ULCER
03 March 2007 - ABB Automation Technologies

An ABB instrument detects the bacteria that can cause gastric or duodenal ulcers, providing effective weaponry against a bug present in about half the world’s population.

Not long ago, people believed ulcers were a matter of stress and lifestyle. ‘Diagnosis,’ meant an invasive scope in the stomach.

Now, it is believed that almost all duodenal ulcers and roughly 80 percent of gastric ulcers are triggered by bothersome Helicobacter Pylori bacteria, which lodge in the lining of the stomach and leave it vulnerable to normal gastric acids.

Marked for destruction
As it turns out, the key to detection is the fact that H. pylori absorbs highly-soluble urea from its host and converts it to carbon dioxide and ammonia.

A coating of ammonia protects the bug from the corrosive acids of the stomach. But the CO2 it produces marks it for destruction.

The detection tool is based on the ABB Infrared gas analyzer Uras and works by testing levels of CO2 in the breath of infected people. Everybody exhales CO2, but people with H. pylori bacteria give off different concentrations of it when they ingest urea.

Successful therapy usually involves little more than a seven-day course of two antibiotics and an acid blocker.

H. pylori undone
Thirty-million of Germany’s 80-million people have been infected with the bacteria, and at least one in 20 is expected to get an ulcer as a result.

So there was a big need to be addressed when German analytical technology company Hartman & Braun began a project with partners from a medical university looking for a simple instrument that doctors could use to detect H. pylori in the mid-1990s.

So-called ‘mass spectrometers’ were on the market and capable of measuring the specific CO2 emissions, but they were too expensive for most medical clinics.

World wide
Hartmann & Braun, which was bought by ABB in 1998, adapted its Uras analyzer to measure breath samples in two steps.

The Uras had a distinguished history in process measurement, but required a retrofit for use in clinics and this was devised with the help of medical instrumentation specialists and ABB sales partners.

The patient simply breathes into a respiratory bag and then takes an inexpensive dose of urea labeled with a carbon dioxide isotope, known as 13CO2. Twenty minutes later, the patient breathes into a second bag. A significant difference in the ratio of 13CO2 carbon dioxide versus the naturally occurring 12CO2 signals the presence of the Helicobacter, and treatment can begin.

Sold under names like HeliFAN plus or IRIS, the ABB instrument is now in use all over the world. Breath tests are covered by health insurance in many parts of Europe.

Gastroscopy clinics remain the primary market, but there are more than 20 other diagnostic tests that rely on the Uras system, and the instrument is also used in veterinary medicine and biochemical research.

Efforts are underway to adapt the method and associated software for other diagnostic tests, including liver function, amino acid metabolism and poor absorption of fat, and one German project is examining use of the technology in intensive care units under the title “Multi-organ function test”

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