Chronic GERD and Intestinal Metaplasia: What Next?

A 42-year-old man with chronic GERD symptoms undergoes an upper endoscopy, which demonstrates salmon-colored tongues that extend 2 cm above the squamocolumnar junction. Biopsies reveal intestinal metaplasia without any dysplasia. Which of the following would you recommend?

a.    Ablative therapy for the Barrett tissue
b.    Continue proton pump inhibitors; no further endoscopy required
c.    Surveillance EGD every 3 years
d.    Refer for a Nissen fundoplication

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