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Test Code UBT Helicobacter pylori Breath Test

Reporting Name

H. pylori C Urea Breath Test

Useful For

Diagnostic testing for Helicobacter pylori infection in patients suspected to have active H pylori infection

 

Monitoring response to therapy

 

This test is not appropriate for asymptomatic people.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Breath


Ordering Guidance


An alternative test for the diagnosis of active Helicobacter pylori infection in patients is the HPFRP / Helicobacter pylori with Clarithromycin Resistance Prediction, Molecular Detection, PCR, Feces, which requires a different collection.



Specimen Required


Patient Preparation:

1. Patient should be fasting for 1 hour.

2. Patients should not have taken bismuth/Tritec, antimicrobials, proton-pump inhibitors (eg, Prilosec, Prevacid, Aciphex, Protonix, and Nexium) or bismuth preparations (eg, Pepto-Bismol) for 2 weeks prior to testing. If these instructions are not followed, test results may be inaccurate. Do not administer this test.

3. Histamine 2-receptor antagonists (H2RA) such as Pepcid, Tagamet, Axid, or Zantac should be discontinued for 24 to 48 hours before the BreathTek UBT test is administered. If these instructions are not followed, test results may be inaccurate. Do not administer this test.

4. Carafate (sucralfate) does not interfere with the test. Use of antacids does not affect the accuracy of this assay.

Supplies: H. Pylori Breath Kit - Meridian Breath ID (T906: fees apply)

Collection Instructions:

1. Do not collect if patient is younger than 3 years of age.

2. Follow instructions included with kit.

3. Mixing the (13)C-Urea Tablet

a. Dissolve the Citrica and the (13)C-enriched urea tablet in 150 to 200 mL (5.1 to 6.8 oz.) of tap water in the provided drinking cup.

b. Close the lid firmly using both hands. Place fingers over lid and shake thoroughly for a few minutes, until the Citrica Powder and the urea tablet are completely dissolved.

Note: Tiny particles may remain visible after thorough mixing. However, if more substantial particulate matter is still present after five minutes of mixing, discard the solution and repeat the procedure with a new kit.


Specimen Minimum Volume

Bag of ’’breath’’ must be full

Testing Algorithm

For more information see Helicobacter pylori Diagnostic Algorithm.

Specimen Stability Information

Specimen Type Temperature Time Special Container
Breath Ambient 14 days BREATH TEST BAG

Reference Values

Negative

Reference values apply to all ages.

Day(s) Performed

Monday through Friday, Sunday

Test Classification

This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information

83013

LOINC Code Information

Test ID Test Order Name Order LOINC Value
UBT H. pylori C Urea Breath Test 29891-9

 

Result ID Test Result Name Result LOINC Value
81590 H. pylori C Urea Breath Test 29891-9

Clinical Reference

1. Talley NJ, Vakil NB, Moayyedi P: American gastroenterological association technical review on the evaluation of dyspepsia. Gastroenterology. 2005 Nov;129(5):1756-1780

2. Chey WD, Leontiadis GI, Howden CW, Moss SF: ACG Clinical Guideline: Treatment of Helicobacter pylori infection. Am J Gastroenterol. 2017 Feb;112(2):212-239. doi: 10.1038/ajg.2016.563

3. Talley NJ, Ford AC: Functional dyspepsia. N Engl J Med. 2015 Nov 5;373(19):1853-1863. doi: 10.1056/NEJMra1501505

Method Description

In the Helicobacter pylori urea breath test, 75 mg (13)C-urea tablet and 4.3 g Citrica powder are dissolved in water, and the resulting solution is ingested by the patient. The presence of the Citrica creates an acidic environment in the stomach and delays the transfer of the ingested solution to the duodenum. These 2 characteristics facilitate the decomposition of the urea by H pylori, if present. Thus, in the presence of urease associated with gastric H pylori, (13)C-urea is decomposed to (13)CO2 and ammonia.

 

The (13)CO2 is absorbed into the blood and then exhaled in the breath. Absorption and distribution of (13)CO2 is fast. Therefore, the cleavage of urea by the H pylori urease that produces the (13)CO2 occurs immediately after the solution is ingested and enables immediate detection of increased (13)CO2 in the exhaled breath of H pylori-positive patients. In the case of H pylori-negative patients, the (13)C-urea does not produce (13)CO2 in the stomach because there are no human enzymes that can decompose the urea in the stomach.(Package insert: IDkit Hp Two for Exalenz BreathID Hp Lab System. Exalenz Bioscience Ltd; Revision 07, 07/2022)

Report Available

Same day/1 to 2 days

Reject Due To

No specimen should be rejected.

Method Name

Qualitative Spectrophotometry (SP)

Forms

If not ordering electronically, complete, print, and send 1 of the following forms with the specimen:

-Infectious Disease Serology Test Request (T916)

-Gastroenterology and Hepatology Client Test Request (T728)

-Microbiology Test Request (T732)

Secondary ID

81590