We've finally won the battle that proves that H pylorii is the primary culprit in the mucosal damage. But since the cure is antibiotics used in combination, and the prevention is unfeasible for almost all city water deparments (it reinfects you through the water you drink), very few, if any, clinical guidelines actually tell a doctor to check for and cure it. Further, training is so lacking that people can be given advice that invalidates a test while testing for any recurrence.
https://www.medscape.com/viewarticle/465198
Discontinuation of PPI Prior to Urea Breath Test ; Chey ; 12/09/2003
[article]PPIs have also been found to adversely affect the sensitivity of the UBT and stool antigen test. Studies have reported that between 33% and 50% of patients taking conventional doses of a PPI develop a false-negative breath-test result and that this effect resolves within a period of 7-14 days. The mechanisms responsible for the effects of PPIs on the UBT remain incompletely defined. [/article]
Most doctors offices, including mine, give the opposite advice to the above warnings. The nurse who explained the test to me told me it was Carbon Dioxide they were looking for!