Why Are Vietnamese Prone to Gastritis? Diagnostic Criteria and Lifestyle Challenges

According to the Vietnam Society of Digestive Diseases, 70% of the Vietnamese population faces the risk of developing stomach diseases and Helicobacter Pylori (HP) infection, a primary cause of stomach cancer. Alarmingly, stomach cancer is increasingly affecting younger individuals, with those under 40 accounting for 20-25% of all cases. Associate Professor Dr. Nguyen Lan Hieu, Director of Hanoi Medical University Hospital, attributes this trend to several factors, including the subjective nature of diagnosis. During endoscopy, doctors visually assess the stomach lining via camera. "Slight redness, swelling, minimal mucus, or a few small bumps on the stomach lining can be classified as inflammation," he explained. This qualitative diagnosis is problematic as the stomach lining is sensitive and can easily redden due to spicy foods, late nights, stress, alcohol, painkillers, or prolonged fasting before the procedure. Globally, mild redness without ulceration is often recorded as "normal gastric mucosa" or "no significant lesions." However, in Vietnam, doctors tend to diagnose "inflammation" as a safety measure, to encourage lifestyle changes, and for health insurance purposes. Some unofficial medical facilities exploit this diagnosis to prescribe additional supplements and anti-reflux medications for profit. Unscientific dietary habits among Vietnamese also contribute to the rise of these diseases. Many consume insufficient vegetables, excessive protein and salt, repeatedly fried foods, and even stale or expired products, alongside the overuse of unsafe seasonings. Furthermore, smoking, heavy alcohol consumption, and stimulant abuse continue to increase the risk. The prevalence of HP infection in Vietnam is also very high. This bacterium resides beneath the protective mucus layer of the stomach, causing mild chronic inflammation for years without clear symptoms. Therefore, mild chronic inflammation observed during endoscopy may simply reflect a common epidemiological characteristic rather than a serious pathology. Professor Hieu emphasizes that a gastritis diagnosis should only be made with sufficient evidence from endoscopy or histopathology (microscopic tissue analysis). Reliable signs include ulcers, bleeding erosions, or atrophic mucosa where submucosal blood vessels are clearly visible. Doctors must also look for intestinal metaplasia or dysplasia, precancerous lesions, and evidence of significant inflammatory cell infiltration like lymphocytes and neutrophils, along with glandular atrophy and intestinal metaplasia from biopsy results. Dr. Ha Hai Nam, Deputy Head of the Department of Abdominal Surgery 1 at K Hospital, warns that the increasing incidence of gastritis in younger people will lead to a rise in digestive cancers. He recommends a healthy lifestyle, regular exercise, and a balanced diet for prevention. At least 30 minutes of daily exercise can boost immunity, while limiting alcohol and avoiding smoking are effective risk reduction strategies. He also advises against fatty foods, excessive seasonings, moldy products, and encourages increased intake of fruits, vegetables, and essential vitamins. Dr. Nam cautions against foods harmful to the stomach, such as fried items, high-fat foods, and processed meats like sausages and pickled vegetables. Numerous studies indicate that consuming red meat or processed meat multiple times a week significantly increases the risk of digestive cancers. For instance, eating just 100g of red meat daily raises cancer risk by 17%. Adding 50g of processed meat daily, like sausages or bacon, further increases this risk by 18%. This is attributed to preservatives like nitrates and nitrites in processed meats, which can convert into carcinogenic compounds in the body. For individuals with a family history of cancer, Dr. Nam recommends early screening, especially after age 30. Endoscopy allows direct visualization of lesions, accurate assessment of malignancy and local invasion, and biopsy for definitive histopathological diagnosis.