GASTROENTEROLOGY ARTICLE OF THE WEEK
October 9, 2003
Fennerty BM. Gastric intestinal metaplasia on routine endoscopic biopsy. Gastroenterology 2003;125:586-90
1. A patient with intestinal metaplasia of the stomach
a. should undergo repeat endoscopic examinations with biopsy every 3-6
months
b. should be placed on life-long acid suppressive therapy
c. should have H. pylori eradicated, if present
d. should undergo endoscopic surveillance if dysplasia is present, with possible
surgery if macroscopic progression.
True or False
2. Intestinal metaplasia of the stomach, being associated with chronic gastritis, is a frequent cause of dyspeptic symptoms.
3. Eradication of H. pylori infection usually results in improvement or disappearance of intestinal metaplasia of the stomach.
4. H. pylori eradication decreases risk of gastric cancer.
5. Type III or colonic form of gastric intestinal metaplasia is the specific subtype of IM associated with an increased risk for cancer.
6. When performing endoscopy for non-ulcer dyspepsia, biopsy of the normal appearing gastric mucosa should be obtained for histologic examination.
7. Intestinal metaplasia of the stomach
a. is less common than intestinal metaplasia of the esophagus (Barrett’s)
b. it is a premalignant lesion associated with a high risk of gastric cancer
c. it is usually caused by H. pylori infection
d. if associated with dysplasia, the risk for gastric carcinoma is 100x higher than
if dysplasia is not present