Introduction: Roasted and spicy food (mainly hot pepper)consumption is very common in Southeastern Anatolia. Smokedand spicy diets and Helicobacter pylori (H. pylori) infection areknown risk factors for gastric cancer. The aim of this studywas to investigate the effects of eating habits on the gastricmucosa, to investigate the rate of H. pylori positivity, and toexamine the association of these factors with histopathologicalfeatures in this region.Methods: Histopathological findings in endoscopic biopsies of943 consecutive patients were retrospectively evaluated.Results: More than half of the patients were female (54%;n=505), and the median age was 47±17.27 (range: 18-96).The most common non-gastritis histopathologic diagnosiswas gastric carcinoma (2.5%; n=24), followed by polypoidlesions (1.6%; n=16). The vast majority of patients (92%) hadchronic gastritis, and neutrophilic activity was present in 61%(n=537). The frequencies of atrophy, intestinal metaplasia, andregenerative mucosal changes were significantly correlatedwith the severity of neutrophilic activity (p<0.05). Patientswith atrophy and intestinal metaplasia were significantlyolder than those without atrophy and intestinal metaplasia(p<0.001; mean age: 47 and 46 vs 56 and 55, respectively).More than 50% were infected with H. pylori (57%; n=542), andH. pylori positivity was associated with the presence of chronicand chronic active gastritis, as well as lymphoid hyperplasia(p<0.001). In contrast, erosion, atrophy, and neuroendocrinecell hyperplasia were less common in patients with H. pylorigastritis (p<0.05).Conclusion: H. pylori infection and spicy food consumptionare key risk factors for gastritis in Southeastern Anatolia.Prospective epidemiological studies are needed to betterdemonstrate the causal interaction between dietary factorsand gastritis.