Helicobacter pylori (HP for short) is a major risk factor for gastritis, peptic ulcer, gastric malignancy, and may also be associated with diseases such as anemia, thrombocytopenia, and diabetes, and is now receiving increasing attention from the public and medical professionals. Friends often ask how did I get infected with H. pylori, will it come back after treatment, and what problems do I need to pay attention to in the future. Here, I make a brief answer. A. How did you get infected with H. pylori? More than 50% of people worldwide carry H. pylori, and the incidence is higher in developing countries such as China than in developed Western countries, which may be related to dietary habits and living hygiene. However, most people who become infected have no obvious symptoms and may not develop the disease. In most cases, the first H. pylori infections occur in infancy and childhood (mostly before the age of 10), and infections after adulthood are relatively rare (but do exist). The main source of infection may come from family members, such as parents, siblings, etc. The transmission route is generally oral-oral and fecal-oral, and intimate contact, consumption of contaminated food and drinking water are all possible routes of transmission. Foreign studies have found that the detection rate of H. pylori in urban drinking water is 4%, and it can also be detected on the surface of food such as vegetables. I have not seen Chinese research on this, but it is not expected to be much better than abroad. Once infected, if not treated, H. pylori may be with you for life. Second, will H. pylori recur after treatment? The answer is: it is possible. It is true that some people relapse after H. pylori eradication, and there are regional and ethnic differences in the relapse rate. In developed countries and developed regions in the West, the relapse rate is very low, with an average annual relapse rate of only about 2-3%, while in less developed regions, the relapse rate can be as high as 10-13% per year. The first is due to incomplete eradication and the resurgence of a small amount of bacteria remaining in the body, which mostly occurs within one year after successful treatment; the second is the re-infection with new H. pylori. Both cases exist, in developed countries, the former is dominant, in less developed regions, the latter is usually dominant. Third, how to prevent infection and recurrence? How to prevent infection and recurrence? The fundamental solution is to improve the living and sanitary conditions of the whole society, but this is a long process. First, as mentioned earlier, it is common for family members to infect each other, so if possible, family members should be tested and treated for H. pylori at the same time. Second, use effective drugs and protocols for initial treatment, and try to treat as thoroughly as possible. Third, studies have shown that H. pylori also exists in the human oral cavity, so H. pylori infection in the stomach should be tested and treated at the same time as H. pylori infection in the oral cavity (rinsing with mouthwash is sufficient). Fourthly, after treatment, H. pylori should be rechecked regularly and if it recurs, it can be treated again. There are still many unknown aspects of H. pylori, and some studies have even found that H. pylori has a protective effect on the body. If a series of conditions such as peptic ulcers or stomach cancer occur, then treatment is necessary. For a normal person, to treat or not to treat, that is the question.