Urea Breath Test

A test in which breath samples are analysed after the patient drinks a labelled urea solution by mouth, detecting the gastric bacterium with high accuracy.

Indication

• Active diagnosis when Helicobacter pylori infection is suspected
• Confirming the success of eradication therapy after treatment
• Recurrent stomach pain and indigestion (dyspepsia)
• Investigating infection in patients with a history of peptic ulcer
• Patients who are not suitable for, or do not prefer, endoscopy
• When non-invasive screening is needed in children and young patients

Preparation

• Fast for at least 6 hours before the test (water is allowed)
• Proton pump inhibitors (PPIs) and H2 blockers should be stopped at least 14 days before the test
• Antibiotics and bismuth-containing medications should be stopped at least 4 weeks before the test
• No smoking or chewing gum on the morning of the test
• Inform the physician of all current medications

How it's performed

1. A first breath sample is collected in a special bag (baseline measurement)
2. A sweet solution containing labelled urea is swallowed
3. A 15-30 minute waiting period allows the solution to spread in the stomach
4. A second breath sample is collected in the same way
5. Breath samples are analysed in a dedicated device; the test is positive when the urease enzyme produced by the bacterium is detected
6. Results are usually available the same day or the next working day

Post-procedure

• If positive, eradication therapy (typically a 14-day quadruple regimen) is planned
• A follow-up test is performed at least 4-8 weeks after treatment is completed
• If the result is negative but symptoms persist, further investigations are considered
• The breath test does not replace gastric cancer screening; endoscopy is recommended when needed

Risks

• Mild heartburn or transient nausea
• Very rare allergic reaction to the solution
• Risk of false-negative results if medication-stopping rules are not followed
• Accuracy may be reduced in patients who have undergone gastric surgery

FAQ

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