Skip to main content

Evidence to Improve Care

Carbon-13 Urea Breath Test for Helicobacter Pylori Infection in Patients With Uninvestigated Ulcer-Like Dyspepsia


Ontario Health Technology Advisory Committee Recommendations

  • The Ontario Health Technology Advisory Committee recommends that serology remain the first-line diagnostic test for Helicobacter pylori in adults with dyspepsia who do not present with alarm features, for whom endoscopy is not indicated.

  • The Ontario Health Technology Advisory Committee recommends coverage for the carbon-13 urea breath test in patients who have been treated successfully for a previous episode of Helicobacter pylori infection and now have recurrent symptoms that could be due to reinfection.

Read the full OHTAC Recommendation report



Dyspepsia is a condition that causes long-term stomach pain or discomfort. Symptoms can include heartburn, bloating, nausea, or slow digestion. Dyspepsia can be caused by common bacteria called Helicobacter pylori. These bacteria also cause ulcers and stomach cancer.


Health Quality Ontario Reviews the Carbon-13 Urea Breath Test

The carbon-13 urea breath test detects Helicobacter pylori using a breath sample, rather than a blood test (serology). This review looked at whether the test is as accurate as a blood test in people who have ulcer-like symptoms.


Carbon-13 Urea Breath Test for Helicobacter Pylori Infection in Patients with Uninvestigated Ulcer-Like Dyspepsia: An Evidence-Based Analysis (PDF)
October 2013

Cost-effectiveness of the Carbon-13 Urea Breath Test for the Detection of Helicobacter Pylori: An Economic Analysis (PDF)
October 2013


Use of this site, and the interpretation of the information contained here, is subject to important terms and conditions. Use of this site and information except in accordance with these terms and conditions is expressly prohibited.


The Ministry of Health and Long-Term Care endorses this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: The Ministry agrees with this recommendation and encourages health care professionals to adhere to it. Public funding for the C13 Urea Breath Test is available to in- and out-patients of hospitals.




Let’s make our health system healthier

Join Our Patient, Family and Public Advisors Program

Patients, families and the public are central to improving health quality.


Man smiling

Sign up for our newsletter

Are you passionate about quality health care for all Ontarians? Stay in-the-know about our newest programs, reports and news.

Health Quality Connect - Health Quality Ontario's newsletter - on an iPad and a cell phone