The urea breath test is a non-invasive, fast, and extremely accurate (95% sensitivity and specificity) to detect the presence of active H. pylori infection. Peer reviews consistently rank the urea breath test as the best method to detect H. pylori infection for differential diagnosis of peptic ulcer disease and chronic active gastritis. The test is also ideal for monitoring therapeutic outcomes and confirmation of cure.
Helicobacter pylori (H. pylori) and Urea Breath Testing
The urea breath test (UBT) is a test for diagnosing the presence of a bacterium, Helicobacter pylori (H. pylori) infection in the stomach.
While these bacteria live in your stomach lining, H. pylori make urea, a natural compound in the body. As the bacteria make urea, they create ammonia and bicarbonate. Traces of these can be found in your breath. The presence of Urea indicates that you are infected with H. pylori. H. pylori causes inflammation, ulcers, and atrophy of the stomach. H. pylori bacteria are spread through contact with feces from an infected person. If the urea breath test is positive and the isotope is detected in the breath, it means that H. pylori is present in the stomach. If the isotope is not found in the breath, the test results are negative for the infection.
When the H. pylori is effectively treated (eradicated) with treatment, the test changes from positive (isotope present) to negative (isotope absent).
BreathTesting For H.Pylori is:
- Convenient — Can be done in your doctor’s office or at a lab
- Easy — Simple to do, no invasive procedures, no messy collection cups, no painful needles
- Fast — The entire test process takes about 20 minutes
There are other testing options available to diagnose and confirm the cure of an H. pylori infection. Urea breath tests and stool tests both diagnose active infections in the stomach, while a blood test can only identify antibodies that could be from an active or previous infection.
ACG guidelines recommend a test-and-treat strategy and also recommend to confirm eradication testing of H. pylori infection using UBT, fecal antigen test, and endoscopy methods.
- Test to detect the underlying cause of the condition
- Treat the patient if infection is detected
- Test again to confirm eradication at least 4 weeks after completing treatment
H. pylori testing should be performed by a test of active infection, such as 13C-urea breath test or stool antigen test (non-endoscopic tests).
What other tests might I have along with this test?
Testing For H Pylori Infections:
1) Stool Testing: Stool testing is useful when a doctor suspects a lower GI infection of H.pylori. You can learn more about testing for H.Pylori using a stool test here
2) Blood Tests: While these are still done the American Council of Gastroenterology. ACG guidelines no longer include serology in H. pylori testing recommendations since it is not a test for active infection2
The other issue with H Pylori antibodies is they may be present even when the infection is under control. This means you will test positive even when you are actually negative and the organisms are in their proper numbers.
3) H Pylori Breath Test: The H Pylori organism produces urease which breaks down urea in the stomach into ammonia and carbon dioxide. The breath test measures for elevated CO2 that is produced from this reaction.
4) Endoscopy: This is a highly invasive procedure where a scope is inserted into the esophagus and stomach. This is stressful on the body and does a poor job of analyzing for the presence of this infection but it can see the results of the infection such as irritation, ulcerations and cancer in the stomach.
- Chey WD, Leontiadis GI, Howden CW, Moss SF. ACG clinical guideline: treatment of helicobacter pylori infection. Am J Gastroenterol. 2017;112(2):212-238. https://acgcdn.gi.org/wp-content/uploads/2018/04/ACG-H.-pylori-Guideline-Summary.pdf. Accessed October 1, 2019.
- Chey WD, Wong BCY; Practice Parameters Committee of the American College of Gastroenterology. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol. 2007;102(8):1808-1825.
- Mayo Clinic. Mayo Laboratories. Hot topic. Helicobacter pylori — an update on diagnostic testing. Published February 1, 2016. https://news.mayomedicallaboratories.com/2016/02/01/helicobacter-pylori-an-update-on-diagnostic-testing-hot-topic/. Accessed March 12, 2019.
- Quest Diagnostics. Helicobacter pylori Infection: Laboratory Support of Diagnosis and Management. http://www.questdiagnostics.com/testcenter/testguide.action?dc=CF_Hpylori. Accessed March 12, 2019.
- Ore L, Hagoel L, Lavi I, Rennert G. Screening with faecal occult blood test (FOBT) for colorectal cancer: assessment of two methods that attempt to improve compliance. Eur J Cancer Prev. 2001;10(3):251-256.
- Cullen KP, Broderick BM, Jayaram J, Flynn B, O’Connor HJ. Evaluation of the Helicobacter pylori stool antigen (HpSA) test in routine clinical practice—is it patient-friendly? Ir Med J. 2002;95(10):305-306.