Recently, I’ve been getting a lot of inquiries from friends about H. pylori infections found during physical exams, so I’m asking what to do. Physical examination to detect H. pylori is generally a blood test for serum H. pylori antibodies. Serum H. pylori antibody can reflect the serum H. pylori infection over a period of time and is suitable for epidemiological investigation; it can be used as a diagnostic tool for presenting infection in peptic ulcer bleeding or gastric MALT lymphoma. For people with positive serum H. pylori antibodies, there are two possible scenarios: 1) previous infection, which does not require treatment; 2) current infection, which can be considered for H. pylori eradication treatment if eligible. Therefore, if the physical examination reveals positive serum H. pylori antibodies, further breath test is needed. If the breath test is negative, it means you have a previous infection and no treatment is needed; if the breath test is positive, it means you have a current infection and if you are eligible, H. pylori eradication treatment can be considered.