Management of Gastric Intestinal Metaplasia
AGA Recommendations for Management of Gastric Intestinal Metaplasia
Comments: Patients with GIM at higher risk for gastric cancer who put a high value on potential but uncertain reduction in gastric cancer mortality, and who put a low value on potential risks of surveillance endoscopies, may reasonably elect for surveillance.a ( Very Low , Conditional (weak) )
- Incomplete vs. complete GIM
- Extensive vs. limited GIM
- Family history of gastric cancer
- Racial/ethnic minorities
- Immigrants from high incidence regions
Comments: Based on shared decision making, patients with GIM and high risk stigmata, concerns about completeness of baseline endoscopy, and/or who are at overall increased risk for gastric cancer (racial/ethnic minorities, immigrants from regions with high gastric cancer incidence, or individuals with family history of first-degree relative with gastric cancer) may reasonably elect for repeat endoscopy within 1 year for risk stratification. ( Very Low , Conditional (weak) )
Recommendation Grading
Overview
Title
Management of Gastric Intestinal Metaplasia
Authoring Organization
American Gastroenterological Association
Publication Month/Year
December 9, 2019
Last Updated Month/Year
October 3, 2024
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
Inform management of patients with GIM incidentally detected on gastric biopsies in routine clinical practice.
Target Patient Population
Patients with Gastric Intestinal Metaplasia
PICO Questions
Among patients with GIM, does testing and treating for H pylori vs no testing and treatment affect patient important outcomes?
Among patients with GIM who are identified as low risk, does subsequent surveillance upper endoscopy vs no follow-up affect patient important outcomes?
Among patients with GIM who are identified as high risk, does subsequent surveillance upper endoscopy vs no follow-up affect patient important outcomes?
Among patients with GIM without dysplasia, does short-term follow-up (<1 year) with biopsies to determine the extent of GIM vs no short-term follow-up affect patient-important outcomes?
Inclusion Criteria
Male, Female, Adult, Older adult
Health Care Settings
Ambulatory, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Management
Keywords
Gastric Intestinal Metaplasia, GIM
Source Citation
Gupta S, Li D, El Serag HB, Davitkov P, Altayar O, Sultan S, Falck-Ytter Y, Mustafa RA, AGA Clinical Practice Guidelines on Management of Gastric Intestinal Metaplasia, Gastroenterology (2020), doi: https://doi.org/10.1053/j.gastro.2019.12.003.