Helicobacter pylori breath positive, gastroscopy negative recommended to follow the doctor’s advice to take four bactericidal drugs for treatment. 1. H. pylori can cause a variety of gastric diseases, such as gastritis, peptic ulcer, gastric cancer, etc. Breath test is the gold standard for diagnosing H. pylori infection, while the detection rate of gastroscopy is not high, therefore, breath-positive is recommended to start radical treatment. 2. According to the guidelines for the treatment of H. pylori in adults, the recommended first-line treatment regimen is quadruple therapy, i.e., one proton pump inhibitor + one bismuth preparation + two antibiotics, and the commonly used medications include omeprazole, bismuth potassium citrate, metronidazole, and clarithromycin, etc. The medication is usually required to be used for 10-14 days for patients without contraindications. For patients with positive breath and negative gastroscopy, H. pylori infection can be diagnosed, and it is recommended to seek medical treatment in time, so that professional doctors can formulate a plan for eradicating the disease to avoid delays.