HP and gastric adenocarcinoma: Helicobacter pylori (Hp) is a bacteria that causes inflammation of gastric mucosa and it is a key cause of peptic ulcer globally.1 It colonizes the gastric mucosa and is guilty for a number of gastric related diseases such as chronic gastritis, gastric adenocarcinoma, and gastric mucosa associated lymphoid tissue (MALT) lymphoma.2 Prevalence of Hp varies from 85-95% in developing countries and from 30-50% in developed countries.3 It is advised that all patients with evidence of active infection with Hp should be offered eradication therapy.