Intestinal metaplasia of the gastric antrum is transformation of the gastric mucosa into intestinal mucosa due to chronic gastritis. Intestinal metaplasia is due to several factors that causes chronic gastritis: genetic, infection with Helicobacter pilory, lack of Vitamin C, smoking, stomach juice hypoacidity and bile reflux.
Intestinal metaplasia is considered as a precancerous lesion and may turn into stomac cancer.
Intestinal metaplasia is considered as reversible if the factors that provoked it are removed. Eradication of Helicobacter pilory combined with Vitamin C can reverse the intestinal metaplasion of the gastric mucose.
Did you made Helicobacter pilory serology?

Hi Dr. Nikola,

Thank you for your response. I have been tested for H Pylori and am negative. Just in case it was a false negative, my doctor put me on the three med. treatment for it. What dose of vitamin C should I take?
Also my doctor told me that the pathologist said that the IM is surrounding a scar so is probably related to an old ulcer which has healed. Do you know if IM of the stomach is a common finding and what is the statistical increase of developing stomach cancer if one has IM.

Thanks,

Sheltie

Intestinal metaplasija (IM) is not a common founding. It can be found in less than 5% of people infected with Helicobacter pilory. But Patients with a history of prolonged gastritis and intestinal metaplasia have a 6-fold increase in their risk of developing gastric cancer. The risk is especially high if the intestinal metaplasia is type-3. Some studies says that 5% of people with intestinal metaplasia type-3 will develop stomach cancer in the first 6 months after diagnosing IM.

Dear Dr. Nikola,

Please use more discretion in your replies to enquiries from persons whose history is unknown to you. In this case, "Keltie/Sheltie", who happens to be my sister, is extremely anxious concerning this subject. She suffers from OCD and has spent the last year researching intestinal metaplasia. She is convinced that a biopsy indicating the presence of some metaplasia in her gastric antrum was, in her words, "a death sentence". Your quoting of uncorroborated statistics out of context has sent her spiraling into yet another round of panic. She is now convinced that she is doomed to die a horrible death due to gastric carcinoma.

Among the terms that are vague or out of context I would cite:
- "history of prolonged" - how long?
- "6-fold increase" - relative to what incidence in the general population?
- "some studies" - how many, how reliable?
- "5% of people" - what is the relative incidence of type-3?

As you are aware, medical science does not yet have a definitive model of gastric carcinoma, nor even reliable statistics on co-occurrence of related conditions. Such uncertainty only exacerbates obsessive thinking.

Respectfully,

David Maulsby

Dear David,
Sorry to hear that my honest attention to help resulted in a panic attack. I had no idea that your sister suffer from OCD and panic disorder.
I know that some statistical data I gave to your sister look scary but she insisted to receive them. I know that all those statistical data shows only some possibility and not certainty because the precise cause and pathogenesis of the stomach cancer (like any other cancer) is still not understood well. There is one strange thing in your sister's case: she has intestinal metaplasia but does not have Helicobacter pilory infection. This could be good circumstance in her case.
1. In the medical science The term "prolonged" refers to "chronic". Chronic is opposite of acute. In every disorder the border between acute and chronic is different. In case of stomach disorder everything that lasts more than a month is considered as chronic (prolonged).
2. Incidence of stomach cancer in general population is different in different countries, regions and nations. In USA the incidence is 7 new diagnosed per year on every 100.000 people.
3. You can find many studies on the Internet. I needed lot of time to find the requested data and I am not sure about studies' reliability.
4. I couldn't find any data about the incidence on intestinal metaplasia type-3 among the general population but it represents about 30% of all types of intestinal metaplasia. It is highly associated with chronic atrophic gastritis and Helicobacter pilory infection.