The American Gastroenterological Association (AGA) has reported recommendations for the management of a patient with gastric intestinal metaplasia (GIM).
Patient selection: gastric intestinal metaplasia
Patients with GIM at higher risk for gastric cancer:
(1) incomplete GIM
(2) extensive GIM
(3) family history of gastric cancer
(4) racial or ethnic group at higher risk of gastric cancer
(5) resident or immigrant from a region with a high incidence of gastric cancer
(6) ongoing chronic Helicobacter pylori infection
Recommendations:
(1) The patient should be screened for Helicobacter pylori.
(2) If a patient is positive for Helicobacter pylori, then the patient should be treated until it is eradicated.
(3) Routine surveillance is not recommended although the quality of evidence is very low.
(4) Surveillance is an option for a high-risk patient who understands the limitations of endoscopic surveillance (potential risk of endoscopy, unproven reduction in cancer).
(5) Routine repeat short-interval endoscopy with biopsies for the purpose of risk stratification is not recommended (based on very low quality of evidence).
