It was not until 1982 that two Australian physicians, pathologists Robin Warren and Barry J. Marshall, successfully isolated and cultured in vitro an “unidentified Campylobacter” from a patient’s gastric mucosal tissue sample, a pathogenic bacterium that readily colonized the gastric sinus and was officially named Helicobacter pylori seven years later. This pathogenic microorganism, easily colonized in the gastric sinus and officially named Helicobacter pylori seven years later, may have been discovered for a century. As early as 1875, German scientists found a spiral-shaped microorganism in the stomach of dogs; decades later, “spirochetes” were also found in the human stomach, but further study was difficult because they could not be isolated and cultured in a container to survive. In 1994, the International Agency for Research on Cancer (IARC) of the World Health Organization (WHO) found for the first time, through scientific statistics, that H. pylori was closely related to the development of gastric cancer. Therefore, it was listed as the only microbial carcinogen at present. At this point, the bacteria, which has two to six long flagella at one or both ends and is spiral in the body but rod-shaped outside, started to become a little bit creepy. People quickly jumped into the battle against H. pylori, only to find that, like other disease-causing microbes, H. pylori can quickly become resistant to drugs. Triple therapy, quadruple therapy, remedial programs, some patients can still detect H. pylori after several treatments, and some are cured and then reinfected. Fear, worry, anxiety …… Is H. pylori really that scary? Perhaps the scariest thing in the world was originally fear itself. Marshall, who had drunk a culture containing H. pylori in one go because it was not taken seriously, was able to stand on the podium at Zhejiang University more than two decades later in good health despite being sick for a time, saying that H. pylori …… tasted like chicken that had gone bad. In 2005, two Australian academics, Warren and Marshall were finally awarded the Nobel Prize in Physiology/Medicine for their epoch-making and great contributions. Today, Mr. Marshall is in his dotage, and Mr. Warren should be well past his prime. You see, is H. pylori scary? What should be done to prevent and deal with H. pylori infection? As Mao Zedong stated in “On the Protracted War”, we should defy it strategically and pay attention to it tactically. We believe that mankind will be the winner in the battle against H. pylori after all! Now, let’s discover the ways to defend against and eliminate H. pylori from its biological characteristics and the distribution of infection. Helicobacter pylori (H. pylori), abbreviated as HP, is a microaerobic bacterium with many different strains and subgroups, some of which are more virulent and more harmful. The main source of transmission is humans, but animals such as rats, cats, dogs and pigs may also spread. The main route of infection is through oral intake, and can be contracted through close contact, contaminated water, poorly disinfected medical equipment, etc. H. pylori can be detected in saliva or dental plaque, gastric mucosal tissues, and feces of infected patients. 90% of infected patients can detect the corresponding antibodies produced after infection in the blood, but these antibodies are not completely protective. Studies have found that the prevalence of H. pylori infection is associated with regional economic status, population density, type of drinking water, and a number of factors such as population literacy, age, and occupation. The prevalence of infection is significantly higher in developing countries than in developed countries, and children under 10 years of age or middle-aged and older adults over 50 years of age are particularly susceptible. The prevalence of H. pylori infection in Chinese is about 40-90%, and the rate of presenting infection is about 55%. Therefore, it is very important to actively promote medical knowledge about the prevention and treatment of H. pylori infection. We should strengthen health education, raise the health awareness of the whole population, improve the sanitary conditions of living and drinking water, cultivate a healthy lifestyle and good hygiene habits, do not eat contaminated or spoiled food, set up a meal sharing system, promote the use of common chopsticks and spoons, wash hands before and after meals, and go to regular hospitals for examination and treatment. There are many ways to detect H. pylori, the following are a few common detection methods: serum anti-H. pylori IgM, IgG test: convenient, fast and inexpensive (70 yuan). Typically, anti-HP-IgM appears 2 weeks after HP infection and gradually decreases over the following 3 months, while anti-HP-IgG appears and persists 3 weeks after HP infection. These two tests have a specificity and sensitivity of about 90% and can be used as a screening test or in combination with one of the direct HP tests for diagnosis and for review after anti-HP treatment. Because it takes time for immune antibodies to develop or disappear, testing is more accurate 2 to 3 weeks after infection and 6 to 12 months after the end of anti-HP treatment. Carbon-14 urea breath test: It is inexpensive (90 RMB) and is done in the morning on an empty stomach. Carbon-14 is a radioactive isotope with a long half-life and cannot be cleared by rapid decay, so this test is not suitable for children and pregnant women. Although no cases of damage have been reported, it is prudent to say that it is also not recommended for patients in their reproductive years. Carbon-13 urea breath test: Carbon 13 is a naturally occurring, stable, non-radioactive isotope that does not cause radioactive damage. It is highly accurate and safe, and is widely available to a wide range of people, including pregnant women, children or the elderly, but it is more expensive (around $256). Gastroscopic gastric mucosal biopsy for urease testing or histology is slightly invasive and suitable for patients who happen to need gastroscopy or pathology at the same time. The sensitivity and specificity of the latter tests are theoretically 100%, but can be affected by changes in the pH of the stomach or other Helicobacter spp. bacteria and medications, and must be tested after 4 weeks off antibiotics and 2 weeks off medications such as proton pumps and bismuth. People with H. pylori infection can be treated with Chinese medicine, Western medicine or a combination of Western and Chinese medicine depending on the situation. Usually, simple H. pylori infection with no objective evidence of acute active inflammation or other lesions can be treated with TCM evidence-based treatment or compounded Chinese medicine. Those with poor constitution, re-infection after cure or intolerance to western drugs, bacterial resistance, and repeated anti-HP treatment failure can also be treated with TCM protocols. If H. pylori infection is accompanied by erosion, ulceration, atrophy, white spots, pox rash or granular or verrucous hyperplasia, and pathology is seen with massive intestinal epithelial hyperplasia or different degrees of heterogeneous hyperplasia, Barrett’s esophagus, etc., it is recommended to treat with appropriate sequential protocols of Chinese and Western medicine.