H. pylori C13 Urea Breath Test

If you often experience stomach pain, bloating, nausea or acid reflux after meals, late at night or when your stomach is empty, it may be related to Helicobacter pylori (H. pylori) infection.

According to the classification by the International Agency for Research on Cancer (IARC) of the World Health Organization, H. pylori is classified as a Group 1 carcinogen. It is an important contributing factor in chronic gastritis, peptic ulcers and gastric cancer.

Symptoms that may be associated with H. pylori infection

Testing may be considered if you experience one or more of the following symptoms:

Persistent bad breath and frequent burping
Heartburn caused by acid reflux
Recurrent nausea; in more serious cases, vomit may contain blood or appear dark brown
Abdominal bloating or a tight feeling in the abdomen
Upper abdominal pain after meals or at night when the stomach is empty

If you experience the above symptoms, an H. pylori breath test may be considered. The C13 urea breath test is a non-invasive and painless test with high reported accuracy. It is simple, comfortable and allows results to be obtained relatively quickly.

This test may be suitable for individuals who:

Have stomach-related symptoms, such as persistent stomach pain, bloating, nausea, indigestion or frequent burping

Have a history of gastric or duodenal ulcers

Have a family history of gastric cancer

Require follow-up testing after H. pylori treatment

Are not suitable for, or prefer to avoid, invasive investigations
Registration and brief medical enquiry

First breath sample collection to obtain the baseline reading

Drinking the carbon-13 labelled urea solution

Waiting for approximately 30 minutes

Second breath sample collection

The result will be explained by clinical staff, with advice on whether further treatment or follow-up may be required.
Fast for at least 4 hours before the test. Plain water is allowed.

Antibiotics and bismuth-containing medicines should be stopped for 4 weeks before the test.

Proton pump inhibitors should be stopped for 2 weeks before the test.

This test may not be suitable for individuals who have previously undergone stomach surgery.

Individuals with citrus fruit allergy should not undergo this test.

Avoid very oily or irritating foods on the day before the test.

If you have acute gastroenteritis, it is advisable to postpone the test.

Please consult healthcare professionals before the test if you are unsure whether any medicine you are taking may affect the result.
Q1. How long does the test take?

A: The whole process usually takes approximately 30–40 minutes, including drinking the test solution and the waiting time.

Q2. What does the test value mean?

A: The test value reflects the level of labelled carbon dioxide detected in the breath sample. This helps indicate whether there may be an active H. pylori infection and may also reflect the level of bacterial activity.

The result should be interpreted by healthcare professionals together with your symptoms and medical history.

Q3. Can children have an H. pylori breath test?

A: Yes. Children aged 5 or above may be able to undergo an H. pylori breath test. The test is generally considered safe and non-invasive.

Suitability should be assessed by healthcare professionals.

Q4. Are there any side effects?

A: Side effects are uncommon. Some sensitive individuals may experience mild stomach discomfort or a sour taste, which usually settles quickly.

Q5. Do I need to have a gastroscopy?

A: Not necessarily. The C13 urea breath test is a non-invasive test and is one of the simpler and more comfortable ways to assess for active H. pylori infection.

However, if you have persistent, severe or concerning symptoms, your doctor may recommend further investigation, which may include gastroscopy.