Attieh P, Al Hazzouri A, Al Qassab M, Mansour E, Rizk N, Karam K, Fiani E, Farhat SG. Gastric intestinal metaplasia: Management and surveillance strategies. World J Gastrointest Pathophysiol 2026; 17(1): 118156 [DOI: 10.4291/wjgp.v17.i1.118156]
Corresponding Author of This Article
Said G Farhat, MD, Associate Professor, Department of Internal Medicine, Division of Gastroenterology, Saint Georges Hospital University Medical Center, Rmeil Street, Ashrafieh, Beirut 3187, Beyrouth, Lebanon. saidfarhat@hotmail.com
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Gastroenterology & Hepatology
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Minireviews
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Mar 22, 2026 (publication date) through Mar 20, 2026
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Publication Name
World Journal of Gastrointestinal Pathophysiology
ISSN
2150-5330
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Attieh P, Al Hazzouri A, Al Qassab M, Mansour E, Rizk N, Karam K, Fiani E, Farhat SG. Gastric intestinal metaplasia: Management and surveillance strategies. World J Gastrointest Pathophysiol 2026; 17(1): 118156 [DOI: 10.4291/wjgp.v17.i1.118156]
World J Gastrointest Pathophysiol. Mar 22, 2026; 17(1): 118156 Published online Mar 22, 2026. doi: 10.4291/wjgp.v17.i1.118156
Gastric intestinal metaplasia: Management and surveillance strategies
Philippe Attieh, Antonio Al Hazzouri, Mohamad Al Qassab, Elissar Mansour, Nour Rizk, Karam Karam, Elias Fiani, Said G Farhat
Philippe Attieh, Department of General Surgery, University of Balamand, Beirut 1100, Beyrouth, Lebanon
Antonio Al Hazzouri, Mohamad Al Qassab, Elissar Mansour, Nour Rizk, Department of Internal Medicine, University of Balamand, Beirut 1003, Beyrouth, Lebanon
Karam Karam, Department of Gastroenterology, University of Balamand, Beirut 1003, Beyrouth, Lebanon
Elias Fiani, Department of Gastroenterology and Hepatology, University of Balamand, Beirut 100, Beyrouth, Lebanon
Said G Farhat, Department of Internal Medicine, Division of Gastroenterology, Saint Georges Hospital University Medical Center, Beirut 3187, Beyrouth, Lebanon
Co-first authors: Philippe Attieh and Antonio Al Hazzouri.
Author contributions: Attieh P, Al Hazzouri A, Al Qassab M, Mansour E, Rizk N, Karam K, Fiani E, and Farhat SG contributed to conceptualization, data curation and wiring original draft; Attieh P and Al Hazzouri A contributed equally to this manuscript as co-first authors. All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Said G Farhat, MD, Associate Professor, Department of Internal Medicine, Division of Gastroenterology, Saint Georges Hospital University Medical Center, Rmeil Street, Ashrafieh, Beirut 3187, Beyrouth, Lebanon. saidfarhat@hotmail.com
Received: December 25, 2025 Revised: January 17, 2026 Accepted: February 26, 2026 Published online: March 22, 2026 Processing time: 85 Days and 13.4 Hours
Core Tip
Core Tip: Challenges in the standardized management and surveillance of gastric intestinal metaplasia persist. Variations between the American Gastroenterological Association and MAPS III guidelines highlight the need for a unified, risk-based global approach tailored to regional cancer incidence and healthcare resources. Early detection through high-definition endoscopy, the eradication of Helicobacter pylori, and precise risk stratification using systems like operative link on gastritis assessment and operative link on gastric intestinal metaplasia have emerged as crucial strategies. Artificial intelligence offers promise in enhancing diagnostic accuracy and predicting malignant transformation, although real-world application requires broader validation. The future of gastric intestinal metaplasia management lies in the integration of multimodal risk assessment, combining endoscopic, histological, molecular, and artificial intelligence driven data, to personalize surveillance and optimize outcomes.
