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South and Southeast Asia is a region where many ethnic groups are intermingled, and <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> strains have been shifting from Western\u2010type to East Asian\u2010type strains. We aimed to investigate the different endoscopic and histopathologic features in five South and Southeast Asian countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We examined differences in endoscopic and histopathological gastritis and <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> infection status in 2426 patients from South and Southeast Asian populations in Vietnam, Thailand, Myanmar, Bangladesh, and Nepal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among Asian patients with abdominal symptoms, such as epigastric pain, nausea, abdominal discomfort, constipation, and heartburn, the prevalence of gastric disease, <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> infection status (current, past, and non\u2010infection), and severity of histopathological gastritis significantly differed between countries. Less than 10% of patients had atrophy and intestinal metaplasia, irrespective of country and <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> infection status; their severity when present was also mild. Although patients with gastric cancer had higher rates of atrophy and intestinal metaplasia compared with those with other diseases, half of them had no pathological atrophy or intestinal metaplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Gastric condition and susceptibility to gastric disease differed among South and Southeast Asian populations. <jats:styled-content style=\"fixed-case\"><jats:italic>H. pylori<\/jats:italic><\/jats:styled-content> infection rates remain high in Asian countries, but the frequency and severity of atrophy and gastric mucosal atrophy were low.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jgh3.70242","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T06:50:38Z","timestamp":1758610238000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics of Gastric Endoscopic and Histopathological Findings in the South and Southeast Asian Populations"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9194-7392","authenticated-orcid":false,"given":"Mitsushige","family":"Sugimoto","sequence":"first","affiliation":[{"name":"Division of Genome\u2010Wide Infectious Microbiology, Research Center for GLOBAL and LOCAL Infectious Disease Oita University  Yufu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7376-8895","authenticated-orcid":false,"given":"Takeshi","family":"Matsuhisa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology St. Marianna University School of Medicine  Kawasaki Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hafeza","family":"Aftab","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Dhaka Medical College  Dhaka 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