1. Use of antibiotics, 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.

Note: The post-dose sample must be collected between 15 and 30 minutes 
post-dose to prevent a false negative result.

Order this test to diagnose H. pylori infection. 

Testing kits are available from Specimen Control, 6240 RCP.

Patient preparation:
This test requires the adult patient (>17 years of age) to 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. 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.

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 15 
to 30 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.