From January 2011 to December 2014, a total of 70 patients with H. pylori infection were selected and diagnosed with upper gastrointestinal problems. Patients were excluded if they presented with any of the following: unwillingness to give written informed consent; bleeding tendency; and usage of H2-receptor antagonists or proton pump inhibitors within two weeks of enrollment . H. pylori status was assessed by [13C] urea breath test and bacterial culture was performed on biopsies before therapy . Among the enrolled patients, there were 9 patients with chronic gastritis, 21 with duodenal ulcer, 22 with gastric ulcer, and 18 with gastric carcinoma. The severity of gastroenterological disorders was evaluated using endoscopic examination and confirmed by histology as previously described . All the patients had completed a self-administered questionnaire prior to being enrolled in the study. This study was approved by the Clinical Research Committee of Taipei Medical University, Taipei, Taiwan.