PYtest - urea breath test (3rd April 2012)

I've been ill for about a week since I came back from Wellington, feeling nauseous and throwing up whenever I ate any food - I'm actually afraid to eat because nothing seems to stay down. Pregnant? Hell no! Not possible when Auntie Flo is here on her monthly visit (and I'm not ready to be mummy just yet - I want the ring first!) plus the symptoms were a lot more than just morning sickness-like - my stomach felt bloated and the area sore as if I had been punched, giving me little sleep at night. Vomiting and having an empty stomach made me feel somewhat better and I was hardly enjoying any food even though I've been eating at new places. Not great to be sick like this when you're a foodie :( And worse, to be in this state when I'm travelling!

By the time I managed to get an appointment with my doctor, I was no longer vomiting but belching and still felt bloatedness and sore in the stomach. My doctor was uncertain of the cause of my illness ("Could be some bacterium or maybe stress," she said) and suggested that I take a urea breath test (since I've a family history of stomach ulcer) to see if I may have
Helicobacter pylori (H.pylori) bacterium in my stomach which was giving me grief. "But I'm not able to do the test with you - you'll need to schedule an appointment with the nurse to have it done," said my doctor. Great, more wait = more discomfort for me...

Five days later, I was back in the clinic for the urea breath test with the nurse. In preparation for the test, I was told to fast for 8 hours - this meant no food and not even a sip of water. I had my appointment first thing in the morning so that made fasting quite easy but the nurse was behind schedule for a good 30 minutes and I was in need of refuel. Grr...The nurse finally called me into her room and took out a flat reddish A4-sized box kit from the cabinet - the PYtest kit. The PYtest is a urea breath test and is a
 non-invasive diagnostic (as compared to an endoscopy) for determining the presence of a current infection of H.pylori in the human stomach. It is known to be highly accurate and extremely reliable for pre-treatment diagnosis and post-treatment evaluation of “proof-of-cure”. If H.pylori exists in the stomach, it produces large quantities of urease to protect it against the acidic conditions in the stomach. The PYtest detects and quantifies the amount of urease - if there is no urease present, then the patient has no H.pylori infection.

The PYtest kit comes with two paper cups, a balloon, a sulphur-coloured capsule, a straw and a courier box for the balloon to post the breath sample. I was given the capsule containing a small amount of urea to take with 30mls of water (roughly a mouthful) using the paper cup and waited 3 minutes before taking another cup of water, following by another 7 minutes wait for the urea to come into contact with the bacterium (or so the nurse good-humouredly said, "let it cook in your stomach"). As we waited, I was asked several times to verify my personal details (this is normal procedure to make sure the right treatment is given to the right patient) on the form and sticker she needed to complete and submit with the breath sample.


When the urea comes to contact with the H.pylori, it is hydrolyzed into carbon dioxide and ammonia - this carbon dioxide then enters the bloodstream and is carried to the lungs via the circulatory system and exhaled into the balloon. The nurse gave me a special metalised mylar 
balloon with the straw slid into the opening to blow into. "You have to fill up the balloon in one breath so take a deep breath before you start," advised the nurse. Ok...inhale...and blooooooowwwwwwwwww...The balloon was tied up securely and put into its box for shipping to the pathology laboratory for analysis. And that concluded the test - easy and painless (well, that is until I received a painful bill of $201.55 for the test a week later - ouch!). Finally, time for breakfast!

I rang up the clinic a couple of days later to find out the results of my test. Turned out, I have no H.pylori infection, which was great news though that meant we still did not know the cause for my vomiting and belching. The doctor could only suggest we monitor the recurrences and prescribed me with Nexium tablets (a proton pump inhibitor) to help ease the acid reflux. I can't say if I was already on the path of getting better or it was the tablets working its magic but the problems went away within a few days after starting the medication. And you can tell that I'm better because all I'm back to always thinking about is food! :)



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