How do you approach surveillance and repeat biopsies in a patient with a diagnosis of intestinal metaplasia (aka Barrett's esophagus) on pathology who appears to have a regular Z-line or <1 cm of salmon mucosa?

I agree with the other responses to this question. One other aspect that can be tricky in patients where you did not do the index endoscopy is that many patients present with the expectation that they will need further surveillance, or have already been told that they will need surveillance at some ...

My first step would be to review the pathology with an expert pathologist.

If the salmon colored mucosa is < 1 cm in length, it is endoscopically not consistent with Barrett's esophagus. Junctional intestinal metaplasia does not have an increased risk of adenocarcinoma. I would review the biopsies with an expert pathologist to confirm there is no evidence of dysplasia. If ...