Health

What are the endoscopic surveillance recommendations for postgastrectomy surgery patients?  All postgastrectomy patients with a history of peptic ulcer disease should have an index endoscopy to assess for H. pylori , chronic gastritis, and intestinal metaplasia. Routine endoscopic surveillance is not recommended for these patients but may be considered after an interval of 15 to 20 years. …

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Are patients with pernicious anemia at an increased risk for gastric cancer? Is endoscopic screening or surveillance required?  Yes. Individuals with pernicious anemia have an estimated two- to threefold increased risk of developing gastric cancer. The risk for developing gastric cancer in patients with pernicious anemia is highest within the first year of diagnosis, so …

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Is partial gastrectomy a risk factor for the development of gastric cancer?  Yes. Patients with a history of benign gastric or duodenal ulcers requiring treatment with gastric surgery may be at an increased risk for neoplasia in the gastric remnant. Endoscopic surveillance studies have detected gastric cancer in 4% to 6% of these patients, but …

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What is gastric intestinal metaplasia (GIM)?  GIM has been identified as a premalignant condition that may be the result of an adaptive response to a variety of environmental insults, such as Helicobacter pylori infection, smoking, or high salt intake. Gastric intestinal metaplasia is histologically identical to esophageal intestinal metaplasia. How common is Gastric intestinal metaplasia? What is …

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Is endoscopic surveillance required after the removal of a gastric polyp?  Surveillance endoscopy is not necessary after the adequate sampling or the excision of a nondysplastic polyp. Gastric polyps with HGD or early gastric cancer necessitate individualized surveillance programs. Surveillance endoscopy should begin 1 year after removal of all adenomatous gastric polyps to assess for …

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How are gastric polyps managed when encountered radiographically or endoscopically?  Endoscopic evaluation is warranted for polyps of any size that are detected radiographically. During endoscopy, gastric polyps should be removed whenever possible because the gross appearance of polyps in most cases (typical small fundic-appearing glands excluded) cannot be used to differentiate the histologic subtypes. A …

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Malignant potential of gastric polyps Gastric polyps are often found incidentally during endoscopy and are histologically classified as hyperplastic, fundic gland, or adenomatous polyps. Hyperplastic polyps are the most commonly encountered type of gastric polyp (70% to 90%) and may have malignant potential. Recent clinical studies have demonstrated dysplasia in up to 19% of hyperplastic polyps …

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