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Rationale for a Helicobacter pylori Test and Treatment Strategy in Gastroesophageal Reflux Disease. Conflicting data have been published on the effect of long-term proton pump inhibitor therapy on the gastric mucosa in Helicobacter pylori-infected subjects. In this article, the available data are reviewed and a rationale is offered for why infected patients who are about to commence long-term proton pump inhibitor therapy should be offered eradication therapy.