Helicobacter pylori in South-Eastern Asia

South-Eastern Asia is a subregion of Asia, consisted of the countries that are geographically South of China, East of India, West of New Guinea and North of Australia. South-Eastern Asian countries such as Korea, Japan, Singapore, Malaysia, Thailand, Vietnam, Indonesia, and the Philippines are known as endemic area of Helicobacter pylori infection. Food, lifestyle, and prevalence of H. pylori infection, physiological functions, and genetic factors are widely different in these countries. Although the prevalence of H. pylori infection has been declining in the Asian countries, H. pylori infection is still a health treat in South-Eastern Asia, and thus consensus on eradication has been actively implemented. H. pylori eradication is indicated for H. pylori-positive patients with the gastritis-associated diseases such as peptic ulcer disease, gastric cancer, or primary gastric B-cell lymphoma (MALToma). In areas with a high prevalence of gastric cancer, eliminating H. pylori infection through improvements had an impact in reducing the burden of gastric cancer. The currently recommended first-line therapy for H. pylori infection is proton pump inhibitor (PPI), amoxicillin and clarithromycin for 7 days. Classic quadruple therapy is consistent with bismuth, PPI, metronidazole, and tetracycline. Increasing rate of resistance to clarithromycin and metronidazole has led to reduced efficacy of PPI-based triple therapy. Further salvage therapy includes levofloxacin-based triple therapy; and rifabutin-based triple therapy. In this chapter, peculiarities on the aspect of epidemiology, diagnosis, treatment on H. pylori infection in South-Eastern Asian countries, excluding those countries which are mentioned in other chapters, will be discussed.

Keywords: Asian enigma, Asia-Pacific guideline, epidemiology, functional dyspepsia, gastric cancer, human migration, Korean guideline, phytoceuticals, probiotics epidemiology.