Thammasat University
Published on 28 November 2025
Thammasat University, international experts, and ASMG are developing new ASEAN guidelines for H. pylori treatment, supporting the region's advancement towards becoming a Medical Hub.
The Center of Excellence for Gastrointestinal Diseases at Thammasat University (TU), in collaboration with the ASEAN Stomach and Microbiota Study Group (ASMG) and a panel of international experts in gastrointestinal diseases, has developed the “Bangkok Consensus 2025 on the Management of Helicobacter pylori Infection.” This document has been ratified as a standard guideline for the treatment of Helicobacter pylori (H. pylori) infection at the ASEAN level, aiming to enhance the quality of treatment for this pathogen, which is a significant cause of chronic gastritis, gastric ulcers, and gastric cancer, thereby improving efficiency while ensuring appropriate budget utilization in both Thailand and ASEAN.
Prof. Dr. Ratha-korn Vilaichone, M.D., Head of the Center of Excellence in Academic Gastroenterology at Thammasat University and Secretary-General of ASMG, stated that H. pylori is a bacterium that is contracted through food and can be easily transmitted through shared items. Poor diet, like eating grilled foods or having few fruits and vegetables, contributes to the bacteria developing into more severe diseases. However, successful treatment significantly lowers the risk of developing these diseases, including stomach cancer. The risk of reinfection is also low due to improved immunity. Testing for the bacteria is simple and available through methods such as urine, blood, or breath tests.
In Thailand, over 20 million individuals are infected with H. pylori. The ASEAN region, with a population of 700-800 million, estimates 200-300 million infections, while globally, 2-3 billion people are infected. Critically, 7-15% of those infected may develop severe, potentially fatal diseases. Effective H. pylori eradication is essential to prevent severe illnesses like gastric cancer and ulcers. Collaborative ASEAN efforts are needed to establish unified guidelines for diagnosis, treatment, and monitoring, offering a key academic partnership opportunity for Thailand.
Prof. Dr. Ratha-korn announced this approved framework is ASEAN's second, updating the 2018 guidelines. Key changes include incorporating country-specific antibiotic resistance data, regional treatment formula adjustments (boosting efficacy from 60-70% to over 90%), emphasizing new molecular diagnostics, and focusing on preventing recurrence and long-term surveillance for gastric cancer. Thailand will promote these guidelines nationally, using them to reference adjustments for H. pylori reimbursement criteria across the Universal Health Coverage system, ensuring effective citizen access. Other ASEAN and Asian countries can adapt these guidelines based on their national context and drug resistance data.
Furthermore, in the recent past and currently, Thailand has been recognized as a destination for many countries around the world seeking medical treatment, due to its high-quality healthcare that is on par with international standards, yet at a lower cost than in many other countries. Therefore, if Thailand continues to advance in medical technology or innovation, along with possessing strong knowledge and a solid academic foundation, it will help attract more foreign nationals to seek services in Thailand, thereby generating revenue for the country and positioning Thailand as an international medical hub.
Prof. Dr. Varocha Mahachai, M.D., Chair of ASMG, announced that this Thammasat-supported, Thai-led treatment guideline is a new and effective dimension for ASEAN healthcare. They aim for international publication in a journal like the Journal of Gastroenterology and Hepatology to establish it as a fourth primary global guideline, alongside the existing three (Maastricht, American, and Asia-Pacific).
Professor Kentaro Sugano of Jichi Medical University, Japan, noted that despite the release of "Helicobacter pylori management in ASEAN: The Bangkok consensus I" in 2018, the first regional H. pylori treatment guideline, significant advances have occurred. H. pylori remains a major health challenge. This revised guideline is essential for ASEAN countries to treat infections appropriately and contribute to global knowledge. He emphasized that ASEAN-specific guidelines are necessary because Western approaches are insufficient due to regional differences in prevalence and medical resources.
