Your doctor has scheduled you for a H. Pylori Breath Test to determine if you are infected with this bacterium.
Your test is set for:________________________
Test will be conducted at: __________________
If you have any questions regarding the following instructions, please call our office at 612-871-1145 and request to speak to ____________
This simple breath test to detect the bacteria helicobacter pylori takes approximately 15 min. First you will be asked to blow a breath of air into a small collection bag. Next, you will drink an 8 ounce citrus flavored solution. After 15 minutes you will blow a breath of air into a second collection bag. NOTE: If you have Phenylketonuria (PKU) and restrict dietary phenylalanine please call the number listed above.
If you have been treated for H-Pylori infection, treatment must be completed at least 4 weeks prior to the test. Patients need to be off all antibiotics for 4 weeks prior to the test and Proton Pump Inhibitors and/or Bismuth type medications 2 weeks prior to the test.
Note: Bismuth medications are Pepto-Bismol and all generic forms.
Antibiotics must be completed by: _____________________________
Stop taking Proton Pump Inhibitors and Bismuth on:________________
Proton Pump Inhibitors include:
Generic Name
Omeprazole
Lansoprazole
Rabeprazole Sodium
Pantoprazole Sodium
Esomeprazole Magnesium
US Brand Name
Prilosec
Prevacid
Aciphex
Protonix
Nexium
Note: You can continue to take H2 Blockers, such as Tagamet, Zantac, Axid and Pepcid as well as Antacids, such as Maalox, Rolaids, Tums, and Mylanta.
Day of Test: Patient must fast for 1 hour prior to the test. This means nothing to eat or drink after _____________am/pm.