Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Frequently Asked Questions
Intestinalmetaplasiais when the epithelial cells that line the stomach andesophagusare changed into cells resembling those in the intestines (goblet cells). These changes are not normal and increase the risk of cancer.
Although the reason that intestinal metaplasia develops is unknown, there is a strong theory that it may be linked to the bacteriaHelicobacter pylori(H. pylori).
This article discusses symptoms of intestinal metaplasia, who is at increased risk of it, the diagnostic process, and how it is treated.
jarun011 / Getty Images
Symptoms of Intestinal Metaplasia
Most people do not experience noticeable effects of intestinal metaplasia. In fact, the condition is not typically associated with any symptoms.
When they occur, symptoms can include stomach distress, such as acid reflux, ulcers, gastritis, or gastroesophageal reflux disease (GERD).
However, even for people who have intestinal metaplasia, these symptoms can occur for other reasons.
Complications
Intestinal metaplasia may be precancerous. When left untreated, the abnormal cells in the stomach or esophagus can undergo a change referred to asdysplasia. Dysplasia is the presence of abnormal cells in a tissue, which constitutes a stage that may be present before the cells become cancerous.
It is not known why some people develop intestinal metaplasia. AnH. pyloriinfection is commonly thought of as the primary underlying culprit.
Atrophic gastritis, which is inflammation and tissue loss of the stomach lining, can occur before intestinal metaplasia develops. Each of these two conditions can involveH. pylori, and they can each lead to gastric (stomach) cancer. But they can also occur completely separately.
What Is H. Pylori?
H. pyloribacteria are known to attack the lining of the stomach. According to a study published in the journalGastroenterology, over 50% of people worldwide may have anH. pyloriinfection.This infection usually occurs during childhood and is a very common cause ofpeptic (stomach) ulcer disease.
Another study performed in China involved over 1,600 healthy participants (at an average age of 42) withH. pyloriinfections. Nearly a third of the participants (29.3%) were found to have intestinal metaplasia.
Risk Factors
Intestinal metaplasia is very common across the globe; one in every four people who have had an upper endoscopy (a flexible tube inserted into the nose, then down into the upper digestive system for diagnostic purposes), is found to have intestinal metaplasia.
Aside from the presence of anH. pyloriinfection, specific factors that increase the risk of intestinal metaplasia include:
Reducing risk factors may lower the possibility of getting intestinal metaplasia, as well as reduce the risk of progression from dysplasia to the cancer stage.
The progression of intestinal metaplasia to cancer may be more likely to occur if someone has the following risk factors:
Smoking may increase the risk of developing many health-related conditions, including increasing the risk of intestinal metaplasia in the esophagus—known asBarrett’s esophagus. Smoking increases the rate of stomach cancer in the upper portion of the stomach, near the esophagus; the rate of stomach cancer is also double in smokers.
In order to make a diagnosis, a biopsy may be taken during the endoscopy. This involves removing a small sample of tissue for laboratory examination.
Endoscopy and Biopsy
If you are having an endoscopy, your healthcare provider will discuss preparation and recovery with you. Preparation may involve stopping blood thinners that you regularly take, and possibly dietary adjustments for several hours before the test.
During an endoscopy, a long, thin tube with a camera and a viewing platform is inserted into the mouth, through the esophagus, and into the stomach.
A biopsy is often taken during an endoscopy. The tissue sampled during a biopsy is examined with a microscope, and it may also be tested forH. Pylori. The biopsied cells may show characteristics of goblet cells, inflammation, dysplasia, or cancer.
What Is Endoscopy?
Once you are diagnosed with intestinal metaplasia, your provider will recommend treatment, which can include dietary modifications and medication. You will need regular follow up to determine whether the condition is well controlled or whether it’s progressing.
Monitoring your condition may include imaging tests, endoscopy, biopsy, or a stool test forH. Pylori.
According to a study in theWorld Journal of Gastrointestinal Oncology, stomach cancer is the second most common cause of cancer-related death in the world. In addition, the study noted that intestinal metaplasia increases the risk of stomach cancer six-fold.
Therefore, it’s important to treat intestinal metaplasia in order to prevent a progression to stomach cancer.
Dietary Changes
There is not enough clinical research to date to definitively prove that lifestyle changes are effective in treating intestinal metaplasia. However, your healthcare provider may recommend a change of diet to lower the acid level in the stomach.
Diet is thought to help prevent the progression of intestinal metaplasia to stomach cancer, because chronic acid reflux and conditions such as GERD (involving an excessive amount of stomach acid) may increase the risk of abnormal cells in the stomach becoming cancerous.
Dietary changes thought to treat intestinal metaplasia—while possibly helping to lower the growth ofH. pylori—may include;
Medications
The authors of a 2019 study reported: “Finding ways to get rid ofH. pyloribacteria may help reduce the risk of intestinal metaplasia.”
If a person with intestinal metaplasia tests positive forH. pylori, antibiotics are the treatment of choice to clear up the infection. Antibiotic therapy is usually given for approximately 14 days and may include drugs such as:
Treatment for intestinal metaplasia may also include medications that lower the acid in the stomach and esophagus to reduce inflammation in tissues that endure the effects of the high acidity levels from excess stomach acid on a long-term basis. Over-the-counter drugs that reduce stomach acid include:
In May 2022, the Food and Drug Administration (FDA) approved two treatments for H. pylori infection in adults:
Vonoprazan is a potassium-competitive acid blocker (P-CAB), and amoxicillin and clarithromycin are antibiotics used to kill the bacterium.
A Word From Verywell
It’s important to note thatH. pyloriare a very common type of bacteria that grows in the digestive tract. But when there’s an overgrowth of this bacteria, it can cause an imbalance in the intestinal flora (the types and amounts of bacteria In the digestive system). Eating a healthy diet rich in whole foods and low in saturated fats and unhealthy sugar may lower the risk of intestinal metaplasia.
Frequently Asked QuestionsIntestinal metaplasia, a condition in which the cells lining the stomach are abnormal, can be a sign that you are at risk for developing cancer; however, it does not necessarily mean that you have cancer.You may have intestinal metaplasia without ever developing stomach cancer.Learn MoreRisks of Stomach CancerIn general, a healthy lifestyle and a well-balanced diet seem to help with intestinal metaplasia.This may include avoiding high-fat and fried or greasy foods. Guidelines that help keepH. pyloriin check may benefit people with intestinal metaplasia.No. There doesn’t seem to be a connection between alcohol consumption and intestinal metaplasia.But alcohol consumption can increase the risk of gastric cancer and many other types of cancer.Learn MoreTypes of Cancer Related to AlcoholIncomplete and complete intestinal metaplasia are two types that describe the cells in the stomach. With complete intestinal metaplasia, cells in your stomach look like those in the small intestine. Incomplete intestinal metaplasia has cells that look like the cells from your colon.Some studies report that intestinal metaplasia can turn into cancer between four and a half and five years later.Keep in mind, though, that most cases won’t turn into cancer.According to researchers, the annual incidence of stomach cancer is 0.25% for patients with intestinal metaplasia. The rate of cancer after 10 years of follow-up is 1.8%.No, these are not the same. Gastritis is inflammation of the stomach lining and intestinal metaplasia is a change in the cells that line the stomach. These conditions have overlapping causes and complications, and they can occur together. Gastritis often causes symptoms of stomach upset or discomfort.Learn MoreWhat are the symptoms of gastritis?
Intestinal metaplasia, a condition in which the cells lining the stomach are abnormal, can be a sign that you are at risk for developing cancer; however, it does not necessarily mean that you have cancer.You may have intestinal metaplasia without ever developing stomach cancer.Learn MoreRisks of Stomach Cancer
Intestinal metaplasia, a condition in which the cells lining the stomach are abnormal, can be a sign that you are at risk for developing cancer; however, it does not necessarily mean that you have cancer.You may have intestinal metaplasia without ever developing stomach cancer.
Learn MoreRisks of Stomach Cancer
In general, a healthy lifestyle and a well-balanced diet seem to help with intestinal metaplasia.This may include avoiding high-fat and fried or greasy foods. Guidelines that help keepH. pyloriin check may benefit people with intestinal metaplasia.
No. There doesn’t seem to be a connection between alcohol consumption and intestinal metaplasia.But alcohol consumption can increase the risk of gastric cancer and many other types of cancer.Learn MoreTypes of Cancer Related to Alcohol
No. There doesn’t seem to be a connection between alcohol consumption and intestinal metaplasia.But alcohol consumption can increase the risk of gastric cancer and many other types of cancer.
Learn MoreTypes of Cancer Related to Alcohol
Incomplete and complete intestinal metaplasia are two types that describe the cells in the stomach. With complete intestinal metaplasia, cells in your stomach look like those in the small intestine. Incomplete intestinal metaplasia has cells that look like the cells from your colon.
Some studies report that intestinal metaplasia can turn into cancer between four and a half and five years later.Keep in mind, though, that most cases won’t turn into cancer.
According to researchers, the annual incidence of stomach cancer is 0.25% for patients with intestinal metaplasia. The rate of cancer after 10 years of follow-up is 1.8%.
No, these are not the same. Gastritis is inflammation of the stomach lining and intestinal metaplasia is a change in the cells that line the stomach. These conditions have overlapping causes and complications, and they can occur together. Gastritis often causes symptoms of stomach upset or discomfort.Learn MoreWhat are the symptoms of gastritis?
No, these are not the same. Gastritis is inflammation of the stomach lining and intestinal metaplasia is a change in the cells that line the stomach. These conditions have overlapping causes and complications, and they can occur together. Gastritis often causes symptoms of stomach upset or discomfort.
Learn MoreWhat are the symptoms of gastritis?
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Park YH, Kim N.Review of atrophic gastritis and intestinal metaplasia as a premalignant lesion of gastric cancer.J Cancer Prev. 2015 Mar;20(1):25-40. doi:10.15430/JCP.2015.20.1.25
Smith S, Fowora M, Pellicano R.Infections withHelicobacter pyloriand challenges encountered in Africa.World J Gastroenterol. 2019;25(25):3183-3195. doi:10.3748/wjg.v25.i25.3183
American Cancer Society.Stomach cancer risk factors.
National Cancer Institute.Stomach (gastric) cancer prevention (PDQ®)–health professional version.
Marcus EA, Sachs G, Scott DR.Eradication ofHelicobacter pyloriinfection.Curr Gastroenterol Rep. 2016;18(7):33. doi:10.1007/s11894-016-0509-x
Buckland G, Travier N, Huerta JM, et al.Healthy lifestyle index and risk of gastric adenocarcinoma in the EPIC cohort study.Int J Cancer. 2015;137(3):598-606. doi:10.1002/ijc.29411
Holmes HM, Jove AG, Tan MC, El-Serag HB, Thrift AP.Alcohol consumption and the risk of gastric intestinal metaplasia in a U.S. Veterans population.PLoS ONE. 2021;16(11):e0260019.
Aumpan N, Vilaichone R, Nunanan P, et al.Predictors for development of complete and incomplete intestinal metaplasia (IM) associated with H. pylori infection: A large-scale study from low prevalence area of gastric cancer (IM-HP trial).PLoS One. 2020;15(10):e0239434. doi:10.1371/journal.pone.0239434
Lam S, Lau G.Novel treatment for gastric intestinal metaplasia, a precursor to cancer.JGH Open. 2020;4(4):569-573. doi:10.1002/jgh3.12318
Aumpan N, Vilaichone R, Pornthisarn B, et al.Predictors for regression and progression of intestinal metaplasia (IM): A large population-based study from low prevalence area of gastric cancer (IM-predictor trial).PLoS One. 2021;16(8):e0255601. doi:10.1371/journal.pone.0255601
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
