We read with interest the article by Dinis-Ribeiro et al concerning a follow up model for patients with atrophic gastritis and intestinal metaplasia (IM).1 The model proposed is based on “a minimum of two endoscopic biopsies”, although 40% of patients had at least three biopsies, and more than 15% of patients had more than four biopsies performed. Within that setting, the authors investigated the significance of type I, II, and III IM, and concluded that those with type I IM should have a less intensive follow up protocol, whereas in those with type III IM, “a hunt for high grade neoplasia should be performed”. In previous …