Recently in the clinic, many people come to me with their medical reports, “Doctor, I was found to be positive for H. pylori (blowing test), but I don’t have stomach discomfort now, is this serious? Is it serious? Do I need to do other tests? Do I need to be treated?” First of all, we need to understand what is Helicobacter pylori (Hp), a bacterium that grows in the stomach, is a unipolar, multi-flagellated, bluntly rounded, spiral-shaped curved bacteria. Because it is usually curved, we call it “Helicobacter pylori”. Does Hp cause disease? In fact, nearly 80% of infected people are asymptomatic, and only 10% to 15% of infected people may develop peptic ulcers, and fewer may develop gastric mucosa-associated lymphoma and gastric cancer. So is it true that if you are Hp negative, you won’t get these diseases? No, because the development of tumor is a complex mechanism, such as family history of gastric cancer, altered genetic polymorphism, environmental factors, genetic factors, etc. Therefore, it is not “reliable” for ordinary people to prevent gastric cancer by eradicating Hp. How common is Hp infection? The infection rate of adults is 40% to 60%, and the older you are, the higher the risk of infection. How is Hp infection detected? A breath test for H. pylori (HP), or what we clinically call the 13C and 14C breath tests, is a safe, simple, rapid and painless way to check for H. pylori without going through a gastroscopy. The breath test is currently one of the most accurate methods for diagnosing H. pylori infection, with a sensitivity and specificity of 95% and 93%, respectively, for the diagnosis of H. pylori infection. A positive breath test indicates that you are now infected with Hp and do not need other tests to confirm it. And a positive blood test for Hp antibodies does not mean that you are now infected with Hp. As long as you have been infected with Hp, the antibodies will be positive for 6 months, regardless of whether you have undergone Hp eradication treatment. Therefore, the blow test is the preferred method of Hp screening. Do I need treatment for my Hp infection? Only the following conditions require treatment: (1) peptic ulcer; (2) gastric mucosa-associated lymphoma; (3) early postoperative gastric cancer; (4) family history of gastric cancer; (5) atrophic gastritis, erosive gastritis; (6) planned long-term use of non-steroidal anti-inflammatory drugs, such as aspirin and fen-phen; (7) iron deficiency anemia; (8) significant indigestion symptoms such as acid reflux, belching, bloating and abdominal pain. Except for these indications that strongly require treatment for Hp, other patients may not require treatment for Hp.