title: Histology of gastritis and Helicobacter pylori infection in Thailand: a nationwide study of 3776 cases.
abstract: BACKGROUND
  Dyspepsia is a very common problem in Thailand. Etiology of gastritis, incidence of Helicobacter pylori and mode of transmission of Helicobacter pylori infection in the country was proposed.
  
  
  METHODS
  A nation-wide study of gastric biopsy in 3776 dyspeptic patients from six different geographic regions for incidence of gastritis, type of gastritis, incidence of H. pylori infection, gastric atrophic change and intestinal metaplasia in three age-groups of each region was done.
  
  
  RESULTS
  58.7% of dyspeptic patients had histological gastritis. Pangastritis was the most common type (77.3%) with mostly mild active inflammation (60.6%) and was found most commonly in the age group 31-60 years. Incidence of gastritis was slightly lower in the coastal and peninsular community compared with the mountain, jungle, semiarid plateau and fertile plain communities. Geographic factor, socioeconomic status and dietary habit were proposed to be important factors in inducing gastritis. H. pylori infection was found in 48.2% of dyspeptic patients with high incidence in the age-group 31-60 years (63.7%) and 98.2% of H. pylori infection was found to be associated with gastritis. Semi-arid plateau, mountain, jungle and fertile plain communities had high incidences of H. pylori infection varying from 54.0 to 67.1% while the coastal and peninsular communities had low incidences of 32%. Oral to oral spread is proposed to be the mode of bacterial transmission. Incidences of gastric atrophic change and intestinal metaplasia were low in this country and were found in 11.6% and 8.2% of subjects, respectively, with no significantly different distribution in geographic regions. Type I or intestinal type was found to be the most common type of intestinal metaplasia.
authors.affiliation: Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Kanit
authors.initials: K
authors.lastname: Atisook
authors.forename: Udom
authors.initials: U
authors.lastname: Kachinthorn
authors.forename: Pairoj
authors.initials: P
authors.lastname: Luengrojanakul
authors.forename: Tawesak
authors.initials: T
authors.lastname: Tanwandee
authors.forename: Puripakorn
authors.initials: P
authors.lastname: Pakdirat
authors.forename: Anucha
authors.initials: A
authors.lastname: Puapairoj
mesh_terms: D000328:Adult; D017677:Age Distribution; D002908:Chronic Disease; D005260:Female; D005757:Gastritis, Atrophic / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology*; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology*; D016480:Helicobacter pylori; D006801:Humans; D015994:Incidence; D008297:Male; D008679:Metaplasia; D008875:Middle Aged; D015995:Prevalence; D017678:Sex Distribution; D013785:Thailand / Q000453:epidemiology