Carbon 13 breath test

Name:

Hospital number:

Appointment date:

Time:

Your doctor has asked us to perform a simple breath test to check the success of your recent ulcer treatment.

This is a simple procedure, which requires you to take a small drink after which a sample of your breath will be collected.

You should expect to be in the department for about 1 hour.

There are no side effects from this examination.

Your GP may have given you advice about preparing for the test. Please make sure that you follow the instructions below.

1. If your breath test appointment is for the morning you must have nothing to eat after bedtime on the night before your test. You may have a glass of water on the morning of your test.
2. If you have an afternoon appointment you may take a light breakfast of tea/coffee and toast. You should take nothing within 6 hours of the test.
3. Please do not take any antacids/indigestion medicines on the day of your test. Please see attached list.
4. You should not take any H2 antagonist drugs, such as Tagamet or Zantac in the 2 days before your test.
5. For 2 weeks before the test avoid anti- ulcer medications such as Losec or Zoton.
6. The test should not be performed within 1 month of taking antibiotics.
7. If you are taking any other medicines, please try to avoid taking these in the 4 hours leading up to your breath test.
8. If you are diabetic, fasting for this test may be a problem. If you are concerned please contact us on tel: 01896 826430.

Please contact us if the list of medicines to be avoided before your test is not enclosed.

The results of this examination will be sent to the Doctor or Consultant who requested it.

Your appointment letter gives details of how to prepare. This is important for the success of your breath test. This includes withholding certain medicines.

Below is a full list of examples of medicines to be avoided and from when they should be withheld.

1. In the 4 weeks before your test you should not take the following:
   Antibiotics
2. In the 2 weeks before your test you should not take the following:
   Losec (Omeprazole)
   Zoton (Lansoprazole)
   Protium (Pentoprazole)
   Esomeprazole
   Other medicines ending ---"oprazole"
3. In the 2 days before your test you should not take the following:
   Tagamet (Cimetidine)
   Peptimax (Cimetidine)
   Dyspamet (Cimetidine)
   Algitec (Cimetidine)
   Axid (Nizatidine)
   Zinga (Nizatidine)
   Zantac (Ranitidine)
   Pylorid (Ranitididne)
   Pepcid (Famotidine)
4. On the day of the test please do not take antacids or indigestion medicine such as:
   Aluminium Hydroxide (Aludrox)
   Magnesium Trisilicate
   Maalox
   Gaviscon
   Mucaine
   Gastrocote
   Algicon
   Altacite
   Asilone
   Bisodol
   Pepto Bismol
   Milk of Magnesia
   Rennie
   Settlers
   Denol
   Sucralfate (Antepsin)