Name of test: Urea Breath Test
Principle:
-This test is carried out for diagnosis of Helicobacter pylori (H pylori) infection
-H pylori is a gram-negative bacillus which is highly motile due to its multiple unipolar flagella
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-They produce the enzyme urease which converts urea to ammonium and bicarbonate
-Some of the diseases caused by H pylori infection are:
1. Gastritis and dyspepsia
2. Stomach ulcers
3. Duodenal ulcers
4. Stomach cancer
5. Lymphoma
-The UBIT Tablet taken by the patient contains 100 mg of 13 C-Urea
-If the patient has Helicobacter pylori infection, H. pylori will produce the enzyme urease. The enzyme urease will convert the 13 C-Urea to 13 CO2 and NH4+
-The 13 CO2 is then absorbed in the blood, diffused into the blood and exhaled
-In our laboratory, we use the 13 CO2 Urea Breath Analyzer UBiT-IR300 by Otsuka electronics to analyse our UBT samples
-The machine will measure the 13 CO2 in both the *pre-dose and post dose breath samples
-The difference of the 13 CO2 levels in both breath samples will also be calculated
-This measurement is done via infrared spectroscopy
Materials:
2 UBT bags
1 UBIT tablet
100mL of water
Method:
Preparation for the test:
Patient must:
1.Fast for 8-9 hours before the test
2.Stop taking Proton Pump Inhibitors one week before the test
3.Stop taking antibiotics 4 weeks before the test
During the test:
1. The patient has to breathe into the “Pre-dose” bag without taking the UBIT tablet.
2. Within 5 sec, the patient has to swallow the UBIT tablet on an empty stomach with 100 mL of water. The tablet is not to be chewed, crushed or dissolved.
3. After taking the tablet, the patient has to lie down on his left side for 5 minutes.
4. Then, he has to remain seated for another 15 minutes.
5. After that, the patient has to breathe into the “Post-dose” bag.
6. These two bags with the request form will be sent our lab for analysis.
In the lab:
The medical technologists will:
1.Check the labels
2.Insert “Pre-dose” bag into the “Pre-dose” inlet
3.Insert “Post-dose” bag into the “Post-dose” inlet
4.Verify results
Results:
A value of 2.5% or higher indicates that the patient is positive for H.pylori infection
*pre-dose: sample before taking tablet
*post-dose:sample after taking tablet
Nur Farhana
0604834B
15 comments:
HELLO NUR!
I'd like to ask you about the PROTON INHIBITION thing. Is it a must always. And how do doctors know when to order the test?
THANKS!
LESLIE
Hi I would like to ask if you could furthur explain unipolar flagella and how it aids in the high motility of the bacteria.
Thanx
Johan
0606637G
Hello leslie!=p
yupz its a must for the patients to stop taking the proton pupm inhibitors as they have inhibiting action on gastric urease activity thus it can give false-negative results. I think the doctors order this test when the patients have symptoms of the infection like nausea, vomitting and abdominal pain.
thanks for the qn =)
Nur Farhana
0604834B
Hi Johan,
flagella is actually a thread-like appendages made up of protein which is the organ for locomotion. it can be arranged in a few ways. i will post a pic of H pylori.
thanks for the qn =)
Nur Farhana
0604834B
Hi Nur Farhana,
Why is so that after taking the UBIT Tablet tablet, the patient has to lie down on his left side for 5 minutes and following that he has to remain seated for another 15 minutes? Does this ensure that optimum level of carbon dioxide is produced?
Thanks!
From: Benjamin Ma
Class;Tg01
0606181F
Hi Nur Farhana,
1)why must patient fast for 8-9 hours before the test? If patients do not fast, how do you know and how will it affect the outcome of the test?
2)What is dyspepsia?
3)'This measurement is done via infrared spectroscopy'
What is the wavelength used?
4)How will the “Pre-dose” bag and “Post-dose” bag be processed before being sent for analysis?
5)How long does the entire Urea Breath Test take?
Thankz!
Han Yang
TG01
Hello Fana!!
Can you elaborate more on infrared spectoscopy?
Btw how is the QC done for the 13 CO2 Urea Breath Analyzer UBiT-IR300?
Thanks
AmiR
TG02
Hi Benjamin,
Yupz i think so too. This will allow the urea tablets to react more with the H pylori (by lying down) and to allow the carbon dioxide produced to be exhaled through the lungs properly (by sitting up).
thanks for the qn =)
Nur Farhana
0604834B
Hello Han Yang,
1. Most probably with food in the stomach, it will affect the reaction of the urea tablets with H pylori.
2. dyspepsia is a digestive disorder in which you feel pain and discomfort in ur stomach. some of the symptoms are: bloating, heart burn, nausea and vomiting.
3. im not sure of this. will get back to you soon
4. Both bags do not need to be processed. they will be sent up for analysis immediately.
5. analysis itself will take about 5-6 mins.
thanks for the qns =)
Nur Farhana
0604834B
Hi Amir,
infrared spectrosopy is actually a technique used to identify substances by analyzing the spectrum produced when a substance absorbs certain wavelengths of infrared radiation.
for QC, there are commercially-available control bag which will be run 10 times.
thanks for the qns =)
Nur Farhana
0604834B
Hello. I am writing to let you know that if you have medical questions, please ask your doctor. Also, there is a telephone line to talk to doctors about the test. Call 1-888-MERETEK and say you have a question for a doctor.
hi farhana
Have you come across positive results? what happens after that? Is this a confirmatory test?
thank you. C:
Nur Azeimah
0607060A
TG 02
Hi Aziemah..
yupz i have..for results exceeding 2.5%, we will just repeat the test again. let the samples run one more time. nopez..i believe this is not a confirmatory test. confirmatory tests include endoscopy and biopsy which are however invasive.
thanks for the qns =)
Nur Farhana
Hi Farhana, can i ask how does H.pylori causes cancer like lymphoma?because i only heard of the bacteria causing diseases linked to the GI tract?thanks
Rachael
Tg01
Hi..
referring to han yang's qn abt the wavelength of the machine..im sorry but i cannot find the info even after reading the manual of the machine..
rachael,
lymphoma here is more specifically known as Gastric Mucosa Associated Lymphoid Tissue. so it is still GIT related ;)
thanks for the qns =)
Nur Farhana
0604834B
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