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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


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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.




Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.



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