Gastric intestinal metaplasia and gastric cancer prevention: Watchful waiting

Shrouq Khazaaleh; Mohammad Alomari; Mamoon Ur Rashid; Daniel Castaneda; Fernando J. Castro

doi:10.3949/ccjm.91a.23015

ABSTRACT

Gastric intestinal metaplasia (GIM), a common histologic finding, is associated with increased risk of gastric cancer, and GIM associated with Helicobacter pylori infection is classified as an environmental metaplastic atrophic gastritis. Patients may be asymptomatic or present with various dyspeptic symptoms. Autoimmune metaplastic atrophic gastritis is a less common but important cause of chronic gastritis. The Correa cascade describes the evolution of precancerous mucosal changes that lead to development of GIM, with differentiation of 2 histologic types of GIM (complete and incomplete) and the consequences of each type. The risk of progression to malignancy is higher with incomplete GIM. It is also higher for those who immigrate from regions with a high incidence of H pylori infection to areas where the incidence is low. Guidelines regarding endoscopic management of GIM vary by geographic region.

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Shrouq Khazaaleh, MD

Department of Internal Medicine, Cleveland Clinic Fairview Hospital, Cleveland, OH

Mohammad Alomari, MD⇑

Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, FL

Address:
Mohammad Alomari, MD, Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331; dr_mohd1987{at}hotmail.com

Mamoon Ur Rashid, MD

Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, FL

Daniel Castaneda, MD

Department of Gastroenterology and Hepatology, Cone Health Annie Penn Hospital, Reidsville, NC

5386-fernando-castroFernando J. Castro, MD

Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, FL
Clinical Assistant Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH