The aim of this study was to evaluate the effects of High-dose Dual therapy combined with probiotics on the gut microbiota for Helicobacter pylori rescue treatment.

The combination of vonoprazan (VPZ) and amoxicillin (VA therapy) has been shown to achieve notable eradication rates for Helicobacter pylori (H. pylori). Patients who receive this treatment are prone to adverse reactions, such as diarrhea, abdominal distention. We plan to combine probiotic with the above treatment. However, it is not clear what changes in gut microbiota and metabolism may result from this therapy.

Inclusion Criteria:

• Age from 18 to 65 years;
• H.pylori infection diagnosed by 13C-urea breath test;
• A period of more than two months since the last eradication therapy for H. pylori;
• Patients who had previously failed 2 or more eradication regimens.

Exclusion Criteria:

• Allergy to any of the medications;
• Zollinger-Ellison syndrome, GC, Upper gastrointestinal bleeding, or Active peptic ulcer;
• Coexistence of significant concomitant illnesses, including heart disease, renal failure, hepatic disease, previous abdominal surgery, lactation, or pregnancy;
• Patients who had used probiotics, vonoprazan, and antibiotics in the past 12 weeks;
• Unwillingness to participate in this study.

We may balance the potential benefits and risks for each request and then provide the data that could be shared.