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Urea breath test
- 1. S S NA S L I N A UREA BREATH TEST
- 2. WHAT IS THEUREA BREATH TEST? • The urea breath test is a rapid diagnostic procedure used to identify infections by Helicobacter pylori, a spiral bacterium implicated in gastritis, gastric ulcer, and peptic ulcer disease. It is based upon the ability of H. pylori to convert urea to ammonia and carbon dioxide.
- 3. WHAT IS THEBASIS OF THIS TEST? • The urea breath test is based on the ability of H. pylori to break down urea, a chemical made up of nitrogen and carbon, into carbon dioxide which then is absorbed from the stomach and eliminated in the breath. (Urea normally is produced by the body from excess or "waste" nitrogen-containing chemicals and then eliminated in the urine.)
- 4. Feature & Benefitsof the Urea Breath Test Otsuka's UBT Serology (ELISA) Stool (HpSA) Endoscopy Accuracy 98% sensitivity 98% specificity 85% sensitivity 79% specificity 93% sensitivity 93% specificity 90-95% sensitivity 100% specificity Administration Non invasive Requires drawing blood Inconvenient, requires handling of faecal sample Requires invasive procedure Consistent Results Tests for active infection reducing the chance of false positives Serological test (for H. pylori) is not accurate enough for use in routine clinical Considerable lot-to-lot variation in tests Careful sample preparation is necessary for optimal results Scope of Test Tests the entire gastric mucosa for active H. pylori infection Inactive antibody testing is 17 times more likely to cause unnecessary treatment Second patient consultation is required Endoscopic biopsies only targets small areas of the stomach Eradication Monitoring Indicated for the post-treatment monitoring of H. pylori infection to confirm eradication 4 weeks following completion of therapy Cannot confirm eradication Must wait 6-8 weeks after therapy to confirm eradication Requires second invasive procedure to confirm eradication t
- 5. PREPARATION • Fast forat least 6 hours prior to test • No smoking for 2 hours prior to testing • Ensure compliance with drug therapy – see below: Antibiotics / Antibacterial These drugs must be stopped at least 4 weeks before Urea Breath testing: Amoxicillin (Amoxil, Moxam),Bismuth tricitrate (Denol), Clarithromycin (Klacid), Fasigyn (Trinidazole), Metronidazole (Flagyl), Tetracycline (Tetrex, Mysteclin, Achromycin), and any other antiobiotics. Proton Pump Inhibitors These drugs must be stopped at least 1 week before Urea Breath testing: Losec (Omeprazole), Somac (Pantoprazole Sodium Sesquihydrate), Zoton (Lansoprazole) and Nexiam. H2 Receptor Antagonists These drugs must be stopped at least 24 hours before Urea Breath testing. Cimetidine (Tagamet, Sigmetadine, Magicul), Famotidine (Amfarnax, Pepcid, Pepcidine), Nizatidine (Tazac) and Quick EzeRanitidine (Zantac, Rani 2). •
- 6. HOW IS THISBREATH TEST DONE? • Easy & Safe for Your Patients • 4 simple steps • Non-radioactive • If samples are analyzed in clinics, results can be obtained within 25 minutes • Please always instruct the patient to exhale into the mouthpiece of the bag until it is BLOATED. Sufficient amount of air sample is crucial to obtain valid results. Insufficient air in the bag may produce invalid results which require a repeat collection. This will lead to reagent wastage and inconvenience to your patient.
- 8. CONT… *Patient in afasting condition to promptly (within 5 sec) swallow one UBIT Tablet with 100mL of water without being crushed or chewed
- 9. 3C-UREA BREATH TEST •3C-Urea Breath Test is widely recognized as the easiest, safest and most reliable non-invasive diagnostic test by many gastroenterologists. Unlike 14C, 13C is a stable, non-radioactive isotope. About 1.1% of our body contains naturally occurring 13C. A normal daily food intake of an adult will contain about 3g of 13C. During the test, patient takes 100mg 13C-Urea, which only represents a further intake of 13C. The amount of urea (100 mg) taken during a breath test is only a small percentage of the average total body urea pool of 10g.