Quick Facts
- Sample: Breath samples (before and after urea solution)
- Fasting: Yes – several hours (often overnight) before test
- Turn-around: 3-4 days. May take longer based on weather, holiday, or lab delays.
Benefits
- Highly accurate – 96–97% sensitivity and specificity for active H. pylori infection (NIH PMC 2019)
- Completely noninvasive – no blood draw, stool sample, or endoscopy required
- Fast, convenient results – detects active infection within about one day
- Guideline-endorsed – first-line test recommended by American College of Gastroenterology (ACG 2024)
- Confirms eradication – verifies successful treatment after antibiotic therapy
- Reduces cancer risk – early detection helps prevent peptic ulcers and gastric cancer
Who Is This Test For?
- Adults with persistent upper-abdominal pain or unexplained dyspepsia
- Individuals with a history of peptic ulcers or suspected ulcer disease
- People on long-term NSAID therapy at risk for ulcers
- Those needing confirmation of eradication after H. pylori treatment
- Anyone with unexplained iron-deficiency anemia or family history of stomach cancer
- Health-conscious consumers seeking to investigate stomach discomfort without invasive procedures
How It Works – Just 3 Steps
- Provide a baseline breath sample – blow into a collection bag before consuming anything.
- Drink the urea solution – wait 15–30 minutes after ingesting the labeled urea
- Collect final breath sample – exhale into a second bag; lab analyzes isotope ratios.
FAQ
What does this test detect? This test detects active Helicobacter pylori infection, a bacterium causing peptic ulcers and increasing gastric cancer risk.
Is it better than blood or stool tests? Yes – urea breath testing offers higher accuracy than antibody blood tests and comparable performance to stool antigen tests (NIH PMC 2019).
Can I take this test while on medication? Stop antibiotics and bismuth for 4 weeks, PPIs for 2 weeks before testing to avoid false negatives (MedlinePlus 2023).
How long until I get results? Most clinical labs provide results within approximately one day of receiving your breath samples.
What if my result is positive? A positive result indicates active infection; consult a healthcare provider to discuss guideline-recommended antibiotic eradication therapy.
When should I retest after treatment? Wait at least 4 weeks after finishing antibiotics and 2 weeks after stopping PPIs to confirm eradication (ACG 2024).
More Details
What is the purpose of this test?
The H. pylori urea breath test detects active infection with Helicobacter pylori, a bacterium linked to peptic ulcer disease and gastric cancer. During the test, you ingest urea labeled with a carbon isotope. If H. pylori is present, its urease enzyme breaks down the urea, producing labeled carbon dioxide measurable in your exhaled breath (NIH PMC 2019). This noninvasive approach lets you evaluate persistent stomach discomfort or confirm eradication after treatment without invasive endoscopy.
Who would benefit from this test?
Adults with persistent upper-abdominal pain, dyspepsia, or reflux-like symptoms are typical candidates for noninvasive H. pylori testing. The urea breath test is also recommended for individuals with a history of peptic ulcers, unexplained iron-deficiency anemia, or those undergoing long-term NSAID therapy (Premera 2026). Additionally, anyone needing confirmation that H. pylori treatment was successful should consider this test, as it documents active infection with very high accuracy.
When should I order an H. pylori Urea Breath Test?
Order this test when a clinician recommends H. pylori testing for ongoing dyspepsia or ulcer history. If you're confirming eradication after treatment, wait at least 4 weeks after finishing antibiotic therapy and 2 weeks after stopping proton pump inhibitors to ensure accurate results (Mayo Clinic 2022). Common symptoms prompting testing include abdominal pain, nausea, loss of appetite, bloating, frequent burping, weight loss, fatigue, or dark stools.
How do I interpret the results?
Negative
- Meaning: No evidence of active H. pylori infection under proper pre-test conditions
- Typical action: Infection ruled out with high confidence; investigate other causes if symptoms persist
Positive
- Meaning: Active H. pylori infection detected in the stomach
- Typical action: Discuss guideline-recommended eradication therapy with healthcare provider
Laboratories report results based on a predefined cutoff in labeled carbon dioxide change, ensuring standardized interpretation across testing sites (Mayo Clinic 2022).
A negative result in a well-prepared patient generally rules out infection with high confidence. A positive result indicates active H. pylori and should prompt discussion of eradication regimens. Patients with persistent symptoms despite a negative test, or with alarm features such as weight loss, bleeding, or anemia, should be evaluated for additional testing such as endoscopy (NIH PMC 2019).
Disclaimer: Reference ranges may vary by laboratory. Listed ranges are general guidelines and may differ from those used by the performing lab. Always consult your healthcare provider for interpretation.
Pre-test preparation
Stop antibiotics and bismuth-containing medications for at least 4 weeks before testing to avoid false-negative results. Discontinue proton pump inhibitors for about 2 weeks prior to the test (MedlinePlus 2023). H2-receptor blockers may modestly affect sensitivity, so some labs recommend avoiding them for a shorter interval when feasible. Fast for several hours—often overnight—before the test to standardize conditions and ensure accurate results.
How often should I get tested?
- Initial diagnosis: once when symptoms warrant evaluation
- Post-treatment confirmation: at least 4 weeks after antibiotics, 2 weeks after stopping PPIs
- Persistent symptoms: retest or pursue endoscopy as directed by healthcare provider
- Routine screening (asymptomatic): not recommended unless high risk or family history warrants evaluation
After completing eradication therapy, guidelines recommend confirming cure with a urea breath test or stool antigen test. If symptoms recur after successful eradication, consult your provider to determine whether repeat testing or further evaluation is needed (ACG 2024).
Why early detection matters
H. pylori infection is a major contributor to peptic ulcer disease and gastric cancer burden worldwide. A 2024 guideline update noted that H. pylori is a prevalent infectious disease causing dyspepsia, peptic ulcers, and gastric cancer, underscoring the clinical and economic importance of effective diagnosis and eradication (PubMed 2024). Early detection allows timely treatment with antibiotic regimens, reducing ulcer complications and long-term cancer risk. Partnering with a primary care or gastroenterology provider after receiving results ensures appropriate treatment, monitoring, and long-term cancer-prevention strategies when indicated.
Related tests you may consider
Complete Blood Count (CBC) and Comprehensive Metabolic Panel (CMP-14) Blood Test Panel - Used to diagnose and monitor health conditions by evaluating blood cells, liver and kidney function, and detecting diabetes.
Helicobacter pylori ( H. Pylori) Antigen Stool Test – Checks for harmful bacteria in the stomach that can cause problems like ulcers and stomach pain, helping to find and treat the infection early.
Parietal Cell Antibody Blood Test, ELISA - Checks for antibodies that attack stomach cells, helping doctors diagnose autoimmune gastritis and prevent problems like vitamin B12 deficiency and anemia.
