Urea Breath Test

Aka: Urea Breath Test, Urease Breath Test, Helicobacter pylori Breath Test

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II. Indications

  1. Dyspepsia evaluation
  2. Initial diagnosis of H. pylori
  3. Confirmation of cure after H. Pylori Management (test 6 weeks after)

III. Mechanism

  1. Measures urease activity
  2. Detected via nonradioactive isotope carbon 13 or carbon 14

IV. Efficacy: Accurate for Diagnosis for H. pylori

  1. Test Sensitivity: 97%
  2. Test Specificity: 100%
  3. Test Sensitivity: 96 to 100%
  4. Test Specificity: 93 to 100%
  5. Likelihood: LR+ 12, LR- 0.05
  6. Requires Fasting for 6 hours, no PPI for 2 weeks before test, and expensive

V. Advantages

  1. In-office test with high accuracy
  2. Noninvasive test of H. pylori cure

VI. Disadvantages

  1. Stop Proton Pump Inhibitors 2 weeks before test
  2. Patient must fast for 6 hours before test
  3. More expensive than stool Antigen testing (averages $133)

VII. References

  1. Calvet (2009) Clin Infect Dis 48(10): 1385-91 +PMID:19368506 [PubMed]
  2. Cutler AF (1995) Gastroenterology 109:136-41 +PMID:7540995 [PubMed]
  3. Ferwana (2015) World J Gastroenterol 21(4): 1305-14 [PubMed]

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