This presentation raises more questions rather than providing answers. It emanates from the sum of over 40 years of clinical
experience at ?shop floor level?. It is the result of caring for a continually better informed more demanding clientele, with
lofty expectations of nothing less than total cure! On the other hand we are almost drowned in a sea of incessant profuse scientific
research. However this wealth of knowledge seems to be largely targeting internal academic institutional ?Publish or Perish?
needs rather than pragmatic day to day community needs.
I have chosen benign diffuse gastric mucosal disease with emphasis on metaplastic change to drive home this message. The paper
starts with the generic issue of classification or the lack of it in a very brief address. I then move to focus on clinical management
issues based on the brief clinical profiles of nine patients sharing the problem of gastric intestinal metaplasia. Discussion is
developed around the lack of specific direction as to: What to tell the patient? What therapeutic ?cure? options? How to follow up
and to which end points and for which potential prognostic risks and what to do about them?
The paper ends with an open ended conclusion seeking answers rather than providing any?..!
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