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Epic Code LAB3295 Bacterial Overgrowth, Breath Test

Important Note

  • This test must be scheduled through a Spectrum Health provider office (via Epic) OR through the Spectrum Health App, MyChart. Order must be in Epic prior to scheduling. More Information.
  • This test is performed at the Butterworth Outpatient Lab (100 Michigan) (click on the link for directions)
  • There are 4 appointments daily Monday-Friday. 
  • Appointments last up to 3.5 hours.
  • Patients that wishes to cancel upccoming breath test appointments, please call 616.774.5600
  • Fasting specimen required

Test Name Alias

Bacterial Overgrowth Breath Test | H2 Breath Test for Bacterial Overgrowth | Hydrogen Breath Test | 4131

Interface Order Alias

11613

Clinical Information

This test was developed and its performance characteristics determined by Spectrum Health Laboratory. It has not been cleared or approved by the FDA. The laboratory is regulated under CLIA as qualified to perform high-complexity testing. This test is used for clinical purposes. It should not be regarded as investigational or for research.

Ordering Instructions

Test must be ordered prior to scheduling.

Collection Instructions

Improper specimen collection can adversely affect the outcome of the test. Specimen collection should only be performed by staff with experience in proper specimen collection procedures.

 

Patient will consume Lactulose (gluten free)

 

Specimen collection: Alveolar, air from properly prepared patient who ingested lactulose

Container(s): Collection bags (7 total)

Minimum volume: 40 mL

 

LINK: Patient Preparation

 

For pediatric patients weighing less than 44 pounds:

1. Pour 15 ml of LACTULOSE solution into 8 ounces of water.           

2. Measure 1 ounce of LACTULOSE solution per 5.5 pounds of the child’s weight and administer this amount for the Bacterial Overgrowth Breath Test.

Example: if a child weighs 28 pounds, you would give him/her 5 ounces of lactose solution. (28 lbs ÷ 5.5 = 5 oz)

Specimen Stability

Ambient: 6 hours

Test Frequency

By schedule only, test is available Monday – Friday. Usual TAT 1-2 days.

Reference Range

Bacterial overgrowth in the small intestine is suggested if the Breath H2 increases at least 20 ppm within the first 2 hours (due to bacterial breakdown in the small intestine) followed by a larger H2 breath increase once the lactulose reaches the colon. In some patients double peaks do not appear but the levels plateau instead.

Performing Department

IMMUNOCHEMISTRY

Performing Department Laboratory Location

Spectrum Health Regional Laboratory, Grand Rapids, MI

Methodology

Gas chromatograph

CPT

91065

CDM Code

4054133

Epic Test ID

1230100370

Beaker LOINC

FASTING BACTERIAL OVERGROWTH HYDROGEN BREATH: 33490-4

30 MINUTES BACTERIAL OVERGROWTH HYDROGEN BREATH: 50000-9
60 MINUTES BACTERIAL OVERGROWTH HYDROGEN BREATH: 50001-7
90 MINUTES BACTERIAL OVERGROWTH HYDROGEN BREATH: 50002-5

120 MINUTES BACTERIAL OVERGROWTH HYDROGEN BREATH: 50003-3
150 MINUTES BACTERIAL OVERGROWTH HYDROGEN BREATH: 50013-2
180 MINUTES BACTERIAL OVERGROWTH HYDROGEN BREATH: 50004-1

Bacterial Overgrowth Comment: 8251-1

Reviewed Date

12/13/2021

Beaker Names

Beaker Procedure Name: BACTERIAL OVERGROWTH BREATH TEST
Beaker Display Name: Bacterial Overgrowth, Breath Test
BEAKER TEST NAME: BACTERIAL OVERGROWTH BREATH TEST
BEAKER TEST REPORT NAME: Bacterial Overgrowth Breath Test

Beaker Synonyms

No synonym on file

Beaker Collection and Specimen Handling

BEAKER COLLECTION: Schedule before draw

Beaker Location, Container and Temperature

BW IMMUNOCHEM: HYDROGEN BREATH BAG (Preferred)-Ambient