Helicobacter pylori Breath Test
Ordering Recommendation
Order this test to diagnose H. pylori infection.
Qualitative Spectrophotometry
1-4 days
New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
Patient Preparation
The patient should fast and abstain from smoking for 1 hour prior to test administration. The patient should not have taken antibiotics, proton pump inhibitors (e.g., Prilosec, Prevacid, Aciphex, Nexium), or bismuth preparations (e.g., Pepto-Bismol) within the previous 14 days. When used to monitor treatment, the test should be performed four weeks after cessation of definitive therapy. The patient should be informed that the Pranactin-Citric drink that will be administered contains phenylalanine. Phenylketonurics restrict dietary phenylalanine.  
BreathTek UBiT Kit. (ARUP Supply #33396 ) Available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787. Kits are provided at a cost of $50 each.  
Specimen Preparation
1) Label breath collection bags with patient name, MRN, date and time of collection, and designate Pre (blue) or Post (pink).
2) Collect the baseline breath specimen:
-Remove cap from collection bag (blue).
-Have patient take a deep breath, pause momentarily then exhale into the mouthpiece of the bag filling it completely.
-Replace cap on the bag.
3) Prepare Pranactin-Citric solution:
-Empty packet from test kit into the cup provided.
-Add drinking water up to the fill line (raised ridge).
-Replace lid; swirl for up to two minutes until completely dissolved. Solution should be clear. The solution is stable up to 60 minutes at room temperature.
4) Instruct patient to drink the solution without stopping using the straw provided. Advise the patient not to "rinse" the mouth with the solution before swallowing.
5) Set timer for 15 minutes. Start timer as soon as the patient has completed drinking. Patient should sit quietly without eating, drinking, or smoking.
6) Prepare the post specimen collection (pink) bag. At exactly 15 minutes, have the patient take a deep breath, pause momentarily and then exhale to fill the second sample collection bag (pink). Note: for a valid result, the post specimen must be collected within 13 to 18 minutes after administration of the Pranactin-Citric Solution.
Do not freeze.
Storage/Transport Temperature
Unacceptable Conditions
Bags not fully inflated or only one of the two bags submitted. Breath collected in tubes. Pediatric specimens from persons 17 years or younger.  
Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable  
Reference Interval
Reference intervals for pediatric patients have not been established.
Interpretive Data
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 specimen or an alternate method. Known causes of false negative results include:
1. Use of antimicrobials, proton pump inhibitors, and bismuth preparations within the two weeks preceding the test.
2. Administration of the breath test less than 4 weeks after completion of therapy to eradicate H. pylori.
3. Premature or late collection of the post-dose specimen.

Known causes of false positive results include:
1. Patients with achlorhydria.
2. Rinsing the Pranactin citric in the mouth allowing contact with urease positive bacteria.
3. The presence of other gastric spiral organisms such as Helicobacter heilmanii.
The post-dose sample must be collected within 13 to 18 minutes post dose to prevent false negatives.
CPT Code(s)
Component Test Code*Component Chart Name
0020646H. pylori Breath Test
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, contact interface support at interface.support@aruplab.com.
Cross References
  • 13C Urea Breath Test
  • H. Pylori Urea Breath Test
  • Pylori, Helicobactor Breath Test
  • Ulcer Breath Test
  • Urea Breath Test