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UW Health SMPH
American Family Children's Hospital

UW Hospital and Clinics Lab Test Directory

Test Name: Helicobacter pylori Urea Breath Test (if >= 18 years old)

Test Code(s): HPYBT / HCHPYBT

CPT Code(s): 83013, 83014

Methodology: Infrared Spectrometry

Clinical Significance: A non-invasive, non-radioactive method for detecting current H. pylori infection. Test is not acceptable for patients under the age of 18 yr. For patients under the age of 18, see H. pylori Ag, stool.

Days Performed: Mon-Fri, dayshift.

Turnaround Time: Stat: Not available stat.
Routine: Up to 72 hours.


Specimen Requirements

Patient Preparation: See Health Facts for You, "Urea Breath Test Instructions".

Inform the patient that the Pranactin-Citric Solution contains phenylalanine. Phenylketonurics need to restrict dietary phenylanalinine.

The patient should fast and abstain from smoking for at least one hour prior to and during administration of the Breath-Tek UBT.

Test is contraindicated for patients that have taken antimicrobials or bismuth preparations two weeks prior to administering the Breath-Tek UBT.

For test of cure, perform test at least 4 weeks after completion of therapy to avoid false negative tests.

Collection Instructions: Samples will be collected in the UWHC Outpatient lab, UHS lab, and clinic labs. For inpatients, call the UWHC Outpatient lab at (608)263-6033 to schedule the collection with a phlebotomist. A baseline breath sample is collected and then a post-dose breath sample is collected 15 minutes after ingestion of Pranactin®-Citric Solution.

Collection instructions are available from the laboratory. Contact phlebotomy at (608)263-6033.

Collection Container: Preferred: Breath-Tek BASELINE bag (blue) / POST-DOSE Pranactin®-Citric Solution bag (pink)

Sample Analyzed: See collection instructions.

Specimen Transport: Transport specimen to UWHC Microbiology (B4/231). Do not refrigerate or freeze the bags.

Unacceptable Criteria: Bags that are not fully inflated are not acceptable. If only one of the two bags is submitted the sample is not acceptable.

Test is not acceptable for patients under the age of 18 yr.
For patients under the age of 18 the H. pylori stool antigen is recommended.

Stability: Ambient: 7 days
Refrigerated: Not acceptable
Frozen: Not acceptable


Interpretation

Expected Results:

18 years and up: Negative

Test Limitations:

A set of pre/post-dose breath bags will be accepted once every 5 days.

 

The performance characteristics for patients under the age of 18 have not been established for this test.

 

Patient must be off these drug(s) for at least 2 weeks prior to testing: 

  • Antimicrobial agents (antibiotics) by oral, IV, or IM administration
  • Bismuth preparations such as Pepto-Bismol®, Kaopectate®, or Helidac®.

Other known causes of false negative results include administration of the breath test less than 4 weeks after completion of therapy to eradicate H. pylori and premature or late collection of the post-dose sample.

 

Test can be performed if patient is on proton pump inhibitors.  If a patient is on proton pump inhibitors, a positive test can be considered positive; however, a negative test should be repeated after patient has been off proton pump inhibitors for 2 weeks.

 

Known causes of false positive results include patients with achlorhydria, the presence of other gastric spiral organisms such as Helicobacter heilmanii, and rinsing the Pranactin®-Citric Solution in the mouth which allows contact of the solution with other urease positive bacteria.

Additional Information:

The H. pylori breath test is considered the gold standard for the diagnosis of H. pylori infection.

 

Unlike serology, the breath test is positive only with active infection and can also be used to monitor response to therapy. A negative result does not rule out the possibility of H. pylori infection.

 

If clinical signs are suggestive of H. pylori infection, retest with a new sample or alternate method.

 

UBT
h. pylori
h pylori
stool

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