H. pylori Breath Test
Label Mnemonic: UBT
Epic Lab Code: LAB947
Downtime Form: A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery
Commercial Mail-out Laboratory
5231 RCP
Specimen Instructions:
Specimen Preparation:
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.

For a valid result, the post breath specimen must be collected between 15 and 30 minutes after the patient drinks the Pranactin- Citric solution.
Collection Medium:
H. pylori Breath Test Kit
Rejection Criteria:
Underinflated bags. Pediatric specimens.
Pediatric specimens from persons 17 years or younger.
Delivery Instructions:
Critical ambient temperature. Do not refrigerate or freeze.
Turn Around Time:
1-4 days upon receipt at reference laboratory
Reference Range:
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 sample or an alternate method. Known causes of false negative results include:
  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. 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.
Qualitative Spectrophotometry
CPT Code:
See Additional Information:
Fasting Specimen Requirements