ASGE Postgraduate Course at ACG 2022: Expanding the Scope of Fundamental and Advanced Endoscopy | October 2022-Practice Updates: Management and Surveillance of Gastric Metaplasia

Practice Updates: Management and Surveillance of Gastric Metaplasia

Video Transcription

Video Summary

In this video, Robert J. Huang from Stanford University discusses the management and surveillance of gastric intestinal metaplasia (GIM). GIM is a precursor lesion along Correa's cascade and is associated with an increased risk of gastric cancer. Huang highlights that the prevalence of GIM in the US population is estimated to be around 5%. Risk factors for GIM include H. pylori infection, autoimmune gastritis, race, ethnicity, family history of gastric cancer, age, and tobacco smoking. To diagnose and stratify GIM, high-quality endoscopic exams, photodocumentation, narrowband imaging, and latest generation endoscopes should be utilized. Tissue-level factors, such as the topographic extent and histologic severity of the metaplasia, can help in risk stratification. Huang emphasizes the importance of eradicating H. pylori as the key management strategy. He also discusses surveillance guidelines, which recommend regular endoscopic exams every three to five years in patients at higher risk for gastric cancer. Ultimately, shared decision-making with patients is essential in determining the appropriate management and surveillance strategies for GIM.

Asset Subtitle

Robert Huang, MD

Keywords

gastric intestinal metaplasia

GIM

gastric cancer

H. pylori infection

endoscopic exams

surveillance guidelines