Metaplasia When to do endoscopy gastritis atrophic gastritis metaplasia dysplasia cancer

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Metaplasia. When to do endoscopy? gastritis, atrophic gastritis, metaplasia, dysplasia, cancer. • How to Manage a Patient With Gastric Intestinal Metaplasia: • An International Perspective. • hypothesis on the histopathological cascade leading to gastric adenocarcinoma claiming that gastric cancer usually resulted from chronic gastritis, subsequently leading to gland loss or atrophy, intestinal metaplasia, dysplasia, and eventually invasive cancer. • The most common risk factor for gastritis is colonization with Helicobacter pylori. Most infections occur during childhood and remain for • life. They are almost invariably associated with chronic gastritis. • Most patients with atrophic gastritis also develop gastric intestinal metaplasia (GIM). This condition can be found in about 20% of patients • undergoing endoscopic biopsy. • Extensive, severe GIM affecting both antrum and corpus is an identifier of patients at the highest risk for development of dysplasia and invasive cancer. • Which Patients Merit Surveillance? • Invasive cancer annually occurred in 0.2%–0.4% of patients harbouring GIM • Extensive, severe GIM is at the highest risk for development of dysplasia and invasive cancer. • Both antrum and corpus is at the highest risk for development of dysplasia and invasive cancer. • European/British Society of Gastroenterology: Surveillance with a 3-year interval to patients harboring GIM. Surveillance of patients at risk with intervals up to three years allowed for an early diagnosis of gastric cancer and thus improved prognosis!!! • USA: NO routine endoscopic surveillance of individuals with GIM • (because of insurance coverage) . • LOW coverage among African American, Hispanic, and American Indian citizens • HIGH level of invasive cancer among African American, Hispanic, and American Indian citizens • If USA adopts “3 year screening” then we will have discrepancy between low rate of GIM and high rate of mortality from invasive cancer • SUMMARY • Treat H pylori , it's the main cause of ch. gastritis • Extensive, severe GIM- every 3 years • Both antrum and corpus- every 3 years • Small GIM + family history (FH)-every 3 years • Extensive, severe GIM+ antrum and corpus+ FH- 1 or 2 years!!!! • ------------------------------------------------------------------------------ • https://www.gastrojournal.org/action/... • ----------------------------------------------------------------------------- • All my videos are for informational and educational purposes only. • For health coaching and speaking engagements contact me: http://drwaks.com/contact-me/ • 8 Common Causes of GERD: • Curing GERD and Acid Reflux: 8 Common... . • Identify your cause and then it is not that difficult to choose the correct treatment. • GERD course: http://acid-reflux-and-gerd.com/ • Stay healthy • Dr. Veronica

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