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We thank Dr Ghisa1 and colleagues for their kind interest in our recently published BSG guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma.2
The introduction of advanced endoscopic imaging technologies has led to a re-appreciation of the fact that the progression of mucosal atrophy in the chronically inflamed stomach over time occurs in a patch-wise fashion.3 4 In particular, gastric intestinal metaplasia arises as well delineated islands within the gastric mucosa.5 These islands can be visualised using high-definition endoscopy and there is now good evidence that endoscopy-lead risk stratification correlates well with histology and operative link on gastric intestinal metaplasia (OLGIM) stages.6–8 These studies have provided important impetus for us to advance endoscopy-lead risk stratification in our …
Contributors MB and MJ contributed equally to the letter.
Competing interests None declared.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; internally peer reviewed.