Endoscopic stratification of gastric intestinal metaplasia: where are we, where do we want to go and how do we get there?

Abstract

We appreciate the positive remarks from Quach and colleagues in response to our manuscript.1 2 The authors propose that endoscopic staging should replace non-targeted mapping biopsies in individuals at increased risk of harbouring gastric intestinal metaplasia (GIM), citing that endoscopic staging using the endoscopic grading of GIM (EGGIM) score (1) is a more resource-sensitive approach; (2) avoids the small added risk of biopsies; (3) can be performed effectively among adequately trained endoscopists; and (4) correlates with histological severity as measured via the operative link on gastric intestinal metaplasia assessment (OLGIM), at least based on a multicentre European study among trained endoscopists and external validation in a single-centre study from South Korea.3 4 Overall, we are conceptually aligned with the authors on these points. However, the theme of our article was a …