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The urease test is the most widely used respiratory test. It detects the presence of the bacterium Helicobacter pylori in the stomach. However, chronic infections with this bacterium are the cause of most gastric or duodenal ulcers. H. pylori is the bacterium in the digestive tract that contains the largest amount of a particular enzyme: urease, which converts urea into CO2 and water.
A defined amount of urea labeled with a tracer component (carbon 13) is ingested. If the bacteria are present, they will degrade urea and carbon 13 will be detected in the exhaled air. Otherwise, the marker is eliminated in the urine.
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