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Helicobacter pylori and proten pump inhibitors interact. Proton pump inhibitors induce an increase of H. pylori corpus gastritis, which can accelerate the progression to atrophic gastritis. H. pylori eradication should therefore be considered in young patients with gastro-esophageal reflux (GERD) receiving proton pump inhibitor maintenance therapy. On the other hand, corpus gastritis augments the acid-suppresive effects of proton pump inhibitors. H. pylori-positive GERD patients may therefore respond somewhat quicker to proton pump inhibitors. This difference disappears in the maintenance phase. After therapy withrawal, clinically significant rebound hypersecretion can occur in H. pylori nagative patients, but not in H. pylori-positive patients. A tapering of therapy instead of abrupt withdrawal is sometimes advisable.