Helicobacter pylori Urea Breath Test

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Category:

Turnaround Time: 1 - 4 days
CPT Code:

83013

Test Type: One pre- and one post-ingestion breath sample
Reference Range:

Negative

Overview:

The urea breath test can be used to aid in the diagnosis of H pylori infection. The test can also be used to assess therapy when it is administered more than a month after completion of therapy.

The present standard of care includes testing for and treatment of Helicobacter pylori in patients with documented ulcer disease or recurrent dyspepsia. Although serologic assays have been widely used for the diagnosis of H pylori, the increasing availability of direct tests in the form of stool antigen and urea breath test provide diagnostic alternatives with higher positive predictive values. Use of “direct” tests leads to a reduction in unnecessary treatment, which is important because of the continuing concern regarding antimicrobial treatment and the emergence of antibiotic resistance. These tests each have the added feature of being able to be used as a test of cure when administered a month or more after completion of eradication therapy.

Bravo LE, Realpe JL, Campo C, Mera R, Correa P. Effects of acid suppression and bismuth medications on the performance of diagnostic tests for Helicobacter pylori infection. Am J Gastroent. 1999 Sep; 94(9):2380-2383. PubMed 10483995

Chey WD, Fendrick AM. Noninvasive Helicobacter pylori testing for the "test-and-treat" strategy: A decision analysis to assess the effect of past infection on test choice. Arch Int Med. 2001 Sep 24; 161(17):2129-2132. PubMed 11570943

Childs S, Roberts A, Meineche-Schmidt V, et al. The management of Helicobacter pylori infection in primary care. Fam Pract. 2000; 17(Suppl 2):S6-11. PubMed 10960429 NIH Consensus Conference. Helicobacter pylori in peptic ulcer disease. NIH Consensus Development Panel on Helicobacter pylori in Peptic Ulcer Disease. JAMA. 1994 Jul 6; 272:65-69. PubMed 8007082

Collection Details:

Patient Preparation:

The patient should fast for at least one hour prior to testing. The patient should not take antimicrobials, proton pump inhibitors, or bismuth preparations within two weeks prior to testing. Note: Solution contains phenylalanine. Phenylketonurics should be warned.

Collection Instructions:

One blue sample bag labeled “baseline” and one "postdose" sample bag.

 

Blue sample bag (baseline) must be collected as follows:

• Remove the blue breath collection bag from the kit.

• Remove the pulloff cap from mouthpiece of the breath collection bag.

• Instruct the patient to breathe normally, then take a deep breath, pause holding their breath for a full second (counting one, one thousand) then exhale into the mouthpiece of the bag.

• Replace the cap in the mouth piece of the bag.

Prepare the fruit-flavored powder solution, containing 13C-urea diagnostic component as detailed in the kit instructions

Postdose sample bag is collected as follows:

• Instruct the patient to drink all the solution without “rinsing” mouth before swallowing.

• Have the patient sit quietly for 15 minutes. Set timer for 15 minutes.

• After 15 minutes, collect the pink or gray sample bag as outlined for the baseline specimen above.

All sample bags must be labeled according to LabCorp specimen labeling policies.

Maintain specimen at room temperature.