American Journal of Gastroenterology ISSN 0002-9270 C © 2007 by Am. Coll. of Gastroenterology doi: 10.1111/j.1572-0241.2007.01230.x Published by Blackwell Publishing ORIGINAL CONTRIBUTIONS Detection of Intestinal Metaplasia in Barrett’s Esophagus: An Obse

OBJECTIVES: Intestinal metaplasia (IM) and dysplasia in Barrett’s esophagus are recognized surrogates for esophageal adenocarcinoma risk. While few would argue with the “hunt for dysplasia, ” there is a divide regarding the usefulness of the histological confirmation of intestinal metaplasia in endoscopically apparent long segment Barrett’s esophagus. We aimed to assess the frequency of intestinal metaplasia in 125 consecutive patients with columnar-lined esophagus and to determine the optimal biopsy protocol to detect intestinal metaplasia. METHODS: Two-hundred ninety-six endoscopies were performed over a 4-yr period in Barrett’s esophagus segments of mean length 4 cm (range 1–11 cm) at a single center and the resulting biopsies were analyzed retrospectively. Biopsies were all processed with routine hematoxylin and eosin (H&E