Helicobacter pylori Urea Breath Test, Pediatric

CPT: 83013
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Test Details

Synonyms

  • BreathTek™ UBT
  • Ubit
  • Urea Breath Test

Use

The urea breath test can be used to aid in the diagnosis of H pylori infection. The test can also be used to assess therapy when it is administered more than a month after completion of therapy.

Limitations

The performance characteristics for this test have not been established for individuals younger than three years.

Methodology

Infrared (IR) spectroscopy to assess the presence of 13CO2

Additional Information

The present standard of care includes testing for and treatment of Helicobacter pylori in patients with documented ulcer disease or recurrent dyspepsia. Although serologic assays have been widely used for the diagnosis of H pylori, the increasing availability of direct tests in the form of stool antigen and urea breath tests provides diagnostic alternatives with higher positive predictive values. Use of "direct" tests lead to a reduction in unnecessary treatment, which is important because of the continuing concern regarding antimicrobial treatment and emergence of antibiotic resistance. These tests each have the added feature of being able to be used as a test of cure when administered a month or more after completion of eradication therapy.

Specimen Requirements

Specimen

Breath samples pre- and postingestion of Pranactin®.

Volume

One pre- and one postingestion breath sample.

Patient Preparation

The patient should fast for at least one hour prior to testing. The patient should not take antimicrobials, proton pump inhibitors, or bismuth preparations within two weeks prior to testing. Note: Solution contains phenylalanine. Phenylketonurics should be warned.

Collection

Blue sample bag (baseline) must be collected as follows:

• Remove the blue breath collection bag from the trifold wallet.

• Remove the pulloff cap from mouthpiece of the breath collection bag.

• Instruct the patient to breathe normally, then take a deep breath, pause holding the breath for a full second (counting one, one thousand) then exhale into the mouthpiece of the bag.

• Replace the cap on the mouthpiece of the bag.

Prepare the Pranactin®-Citric solution as follows (Solution must be administered within 60 minutes of preparation.):

• Cut top off packet and dispense contents into drinking cup.

• Add drinking water to fill line of cup.

• Cover cup and swirl for two minutes. If not completely dissolved, the solution should not be used.

Pink sample bag must be collected as follows:

• Instruct patient to drink all the solution without "rinsing" mouth before swallowing.

• Have patient sit quietly for 15 minutes. Set timer for 15 minutes.

• After 15 minutes, collect the pink sample bag as outlined for the baseline specimen above.

All sample bags must be labeled according to LabCorp specimen labeling policies.

Storage Instructions

Maintain specimen at room temperature. Stable at room temperature for seven days.

Causes for Rejection

Prolonged transport >7 days; specimens collected from persons under the age of three years.

Clinical Information

Special Instructions

This test can only be performed on pediatric patients between the ages of 3 and 17. The following information must be provided to interpret the test results: age, gender, weight, and height. For adult patients, order Helicobacter pylori Urea Breath Test [180836].

References

Bravo LE, Realpe JL, Campo C, Mera R, Correa P. Effects of acid suppression and bismuth medications on the performance of diagnostic tests for Helicobacter pylori infection. Am J Gastroent. 1999 Sep; 94(9):2380-2383. 10483995
Chey WD, Fendrick AM. Noninvasive Helicobacter pylori testing for the "test-and-treat" strategy: A decision analysis to assess the effect of past infection on test choice. Arch Int Med. 2001 Sep 24; 161(17):2129-2132. 11570943
Childs S, Roberts A, Meineche-Schmidt V, et al. The management of Helicobacter pylori infection in primary care. Fam Pract. 2000; 17(Suppl 2):S6-11. 10960429
NIH Consensus Conference. Helicobacter pylori in peptic ulcer disease. NIH Consensus Development Panel on Helicobacter pylori in Peptic Ulcer Disease. JAMA. 1994 Jul 6; 272:65-69. 8007082

LOINC® Map

Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
180840 H pylori Breath Test, Peds 180842 Interpretation 29891-9
180840 H pylori Breath Test, Peds 180837 Age 30525-0
180840 H pylori Breath Test, Peds 180839 Weight in Pounds 29463-7
180840 H pylori Breath Test, Peds 180841 Height in Inches 8302-2

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