PPIs for intestinal metaplasia of the gastroesophageal junction

Paul Moayyedi

Would you prescribe proton pump inhibitors (PPIs) for patients with intestinal metaplasia of the gastroesophageal junction when the biopsy was taken from a Z line with <1 cm of variability?

Paul Moayyedi, MB ChB, PhD: Only for symptoms. If they have bad reflux symptoms, they can still have a normal gastroesophageal junction with reflux, so I would still prescribe a PPI.

If, on the other hand, they feel fine and you were doing the endoscopy for whatever reason, then I would not prescribe a PPI. As I said [see: Diagnostic criteria for Barrett esophagus], I feel it is a normal variant. I would just leave them alone.

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