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Patients positive for <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u2009pylori<\/jats:italic><\/jats:styled-content> via a urea breath test (UBT) were randomly assigned to receive bacterial eradication with triple therapy for 2\u2009weeks either before or after proton\u2010pump inhibitor (PPI) treatment for 4\u2009weeks. Follow\u2010up was implemented with serial GerdQ evaluation and a subsequent UBT. The primary outcome was the incidence rates of symptom rebound between patients with and without <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u2009pylori<\/jats:italic><\/jats:styled-content> infection. The secondary outcomes included the severity of symptom rebound, incidence rates of symptom rebound, and successful eradication rates between the early and late eradication groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 248 patients were enrolled, of whom 107 (43.1%) tested positive for <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u2009pylori<\/jats:italic><\/jats:styled-content> infection. All patients with and without concurrent <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u2009pylori<\/jats:italic><\/jats:styled-content> infection had significant symptom improvement over the entire treatment. Patients with <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u2009pylori<\/jats:italic><\/jats:styled-content> infection had significantly lower rates of symptom rebound (19.8% vs. 34.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.034) and rebound severity (1.8\u2009\u00b1\u20090.7 vs. 2.8\u2009\u00b1\u20091.6, <jats:italic>p<\/jats:italic>\u2009=\u20090.031) 4\u2009weeks after eradication and PPI treatment than those without. The incidence rates of symptom rebound and successful eradication rates were not significantly different between the early and late eradication groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>GERD patients with concurrent <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u2009pylori<\/jats:italic><\/jats:styled-content> infection were less susceptible to symptom rebound after <jats:styled-content style=\"fixed-case\"><jats:italic>H.\u2009pylori<\/jats:italic><\/jats:styled-content> eradication compared to those without.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrial.gov\">ClinicalTrial.gov<\/jats:ext-link> 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