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.
