Efficacy and Safety of Black Seed Oil With Vonoprazan Based Triple Therapy in Treatment of Helicobacter Pylori

The aim of this study is to: • Evaluation of efficacy and safety of adding black seed oil with vonoprazan triple therapy ( vonoprazan ,clarithromycin and amoxicillin ) in eradication of Helicobacter pylori infection and this will be done through evaluation of: A. Efficacy by: 1. determination of successful eradication,which will be considered to be achieved on the basis of a negative stool antigen test four weeks after the end of treatment using Stool Ag test 2. The effect of N. Sativa on: I. Oxidative stress by measuring MDA II. Inflammation by measuring IL1B as inflammatory markers B. Safety will be done through: Monitoring of expected treatment related adverse effects (black seed oil and vonoprazan triple therapy ) will be done through the whole study period. C. Symptoms evaluation using the Gastrointestinal symptom rating scale D. Assessment of patient's quality of life using SF36 questionnaire

Inclusion Criteria: * Male or female patients * Age 18 to 75 years old * Patients with confirmed H. pylori infection by stool Ag test who had not received prior eradication therapy Exclusion Criteria: * History of hypersensitivity / allergy to any of the study drugs i.e., Esomeprazole, vonoprazan, penicillin, or clarithromycin * History of previous H. pylori eradication therapy * History of using PPIs, antibiotics that affect H. pylori within 4 weeks * History of gastric malignancy or surgery * Serious cardiovascular, pulmonary, renal, hepatic disorders or active malignancy * Pregnancy or breast feeding * History of drug abuse or active alcohol abuse