Testing kits are available from Specimen Control, 6240 RCP. 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 or bismuth preparations within the previous 14 days. These include: Prilosec, Prevacid, Aciphex, Nexium, and Pepto-Bismol. 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. Test administration: 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 sample: a) Remove cap from collection bag (blue). b) Have patient take a deep breath, pause momentarily then exhale into the mouthpiece of the bag filling it completely. c) Replace cap on the bag. 3) Prepare Pranactin-Citric solution: a) Empty packet from test kit into the cup provided. b) Add drinking water up to the fill line (raised ridge). c) 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 sample 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 sample must be collected within 13 to 18 minutes after administration of the Pranactin-Citric Solution. Return kit to Specimen Control, 6240 RCP. Sample stability: 1 week only-must reach reference laboratory within a week of collection. Critical ambient.

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 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 four weeks after completion of therapy to eradicate H. pylori. 3. Premature or late collection of the post-dose sample. 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.