Chronic GERD and Intestinal Metaplasia: What Next?
Upper endoscopy demonstrates salmon-colored tongues that extend 2 cm above the squamocolumnar junction in a 42-year-old man with chronic GERD. Biopsies reveal intestinal metaplasia with no dysplasia. What now?
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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