Recurrence of H Pylori : Incidence and Influential Factors.

Inclusion Criteria: * Age: 18-75 years old. * H. pylori infection: Confirmed by endoscopy, biopsy, or non-invasive tests (e.g., urea breath test, stool antigen test). * Symptoms: Presence of dyspepsia, peptic ulcer disease, or other H. pylori-related symptoms. * Laboratory tests: Normal liver and kidney function, and no significant abnormalities in blood counts. Exclusion Criteria: * Patients receiving eradication therapy in the past taking proton pump inhibitors,, H2 blockers ,,bismuth ,, antibiotics or other medications that interfere with the result of the examination in the recent 4 weeks. * Gastrointestinal disorders: Severe gastrointestinal disorders (e.g., gastric cancer, inflammatory bowel disease ,gastric or duodenal ulcer with current or recent bleeding , or clinical significant gastrointestinal bleeding within 4 weeks of randomization). * Malignancies: Active or recent malignancies. * Severe comorbidities: Unstable or severe comorbidities (e.g., heart failure, liver cirrhosis).