Helicobacter pylori; breath test analysis for urease activity, non-radioactive isotope (eg, C-13)
CPT4 code
Name of the Procedure:
Helicobacter Pylori Breath Test
Common name(s): Urea Breath Test
Technical term: Breath Test Analysis for Urease Activity, Non-Radioactive Isotope (e.g., C-13)
Summary
The Helicobacter pylori breath test is a simple, non-invasive procedure used to detect the presence of H. pylori bacteria in the stomach. These bacteria are known to cause stomach ulcers and other gastrointestinal issues. The test measures urease activity, a chemical process specific to H. pylori, by detecting a non-radioactive isotope, typically C-13, in the patient's breath.
Purpose
The primary purpose of the test is to diagnose H. pylori infection in patients experiencing symptoms of gastrointestinal distress. Goals of the procedure include confirming the presence of the bacteria, guiding appropriate treatment, and monitoring the effectiveness of therapy.
Indications
- Symptoms of gastrointestinal issues such as stomach pain, bloating, nausea, and indigestion.
- Persistent peptic ulcers.
- Ongoing dyspepsia (indigestion) without a clear cause.
- Follow-up after treatment for H. pylori to ensure eradication of the bacteria.
Preparation
- Fast for at least one hour before the test.
- Avoid antibiotics and bismuth-containing medications for at least four weeks before the test.
- Avoid proton pump inhibitors and H2 blockers for at least two weeks before the test.
- No specific diagnostic tests are required beforehand, but a medical history review may be conducted.
Procedure Description
- The patient breathes into a collection device, typically a balloon-like bag, to obtain a baseline sample.
- The patient ingests a urea-containing substance labeled with the non-radioactive C-13 isotope.
- After a fixed period (usually 15-30 minutes), the patient breathes into another collection device to obtain the post-ingestion sample.
- The samples are analyzed to detect the presence of C-13, which indicates the breakdown of urea by the urease enzyme produced by H. pylori.
Duration
The entire procedure typically takes about 30-60 minutes.
Setting
The H. pylori breath test is usually performed in an outpatient clinic or doctor’s office.
Personnel
- The test is often administered by a nurse, medical assistant, or a trained technician.
Risks and Complications
- The procedure is very safe with minimal risks.
- Rare complications may include nausea from the ingested substance, but this is uncommon.
- False-positive or false-negative results can occur but are relatively rare with proper preparation.
Benefits
- Non-invasive and generally well-tolerated.
- Quick results, often available the same day.
- Accurate diagnosis of H. pylori infection, guiding appropriate treatment.
Recovery
- No recovery time needed; patients can resume normal activities immediately.
- No specific post-procedure care or instructions are necessary.
- Follow-up might involve discussing results with the healthcare provider to determine the next steps in treatment.
Alternatives
- Stool antigen test: Examines stool samples for H. pylori antigens.
- Blood antibody test: Detects antibodies to H. pylori (less accurate for current infection).
- Upper gastrointestinal endoscopy with biopsy: More invasive but allows direct visualization and sampling.
Patient Experience
- The procedure is generally comfortable and painless.
- Patients might feel slight discomfort or a sensation of fullness after ingesting the urea solution.
- No anesthesia or sedation is required, and pain management is typically unnecessary.