Ordering Recommendation
Use to diagnose H. pylori infection in children and adolescents (3 to 17 years of age). For adults, refer to Helicobacter pylori Breath Test, Adult (2010476).
Mnemonic
Methodology
Qualitative Spectrophotometry
Performed
Sun-Sat
Reported
1-4 days
New York DOH Approval Status
Specimen Required
This test requires the pediatric patient (3-17 years old) to fast 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. The effect of histamine 2-receptor antogonists (e.g., Axid, Pepcid, Tagamet, Zantac) may reduce urease activity on urea breath tests and should be discontinued for 24-48 hours before the sample is collected. 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 UBT Kit. (ARUP Supply #51124) available online through eSupply using ARUP Connect™ or contact ARUP Client Services at (800) 522-2787.
1) Label breath collection bags with patient name, MRN, date and time of collection, and indicate Pre (blue) or Post (pink).
2) Collect the baseline (Pre) breath specimen according to the instructions in the BreathTek UBT kit.
3) After the allotted time, collect the Post breath specimen according to the instructions in the kit.
CRITICAL ROOM TEMPERATURE. Do not freeze.
Underinflated bags. Specimens from patients younger than 3 years.
Submit with Order: Weight (in pounds), height (in inches), sex, and age.
Ambient: 1 week; Refrigerated: Unacceptable; Frozen: Unacceptable
Reference Interval
Negative
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 antibiotics, proton pump inhibitors, and bismuth preparations during the preceding 2 weeks.
2. Administration of the breath test less than 4 weeks after completion of definitive 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 testing solution in the mouth or not using the straw provided in the kit, which can allow contact with urease-positive bacteria.
3. The presence of other gastric spiral organisms such as Helicobacter heilmanii.
FDA
Note
The post-dose sample must be collected between 15 and 30 minutes post-dose to prevent a false- negative result.
Hotline History
CPT Codes
83013
Components
Component Test Code* | Component Chart Name | LOINC |
---|---|---|
0020646 | H. pylori Breath Test | 29891-9 |
2010926 | Patient height at time of collection | 8302-2 |
2010927 | Patient weight at time of collection | 3141-9 |
Aliases
- 13C Urea Breath Test
- H. Pylori Urea Breath Test
- Helicobactor Breath Test
- Pylori
- Ulcer Breath Test
- Urea Breath Test