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focal intestinal metaplasia of the stomach (Page 1)

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Hi,

I was recently diagnosed with focal intestinal metaplasia of the gastric antrum. It is next to some scar tissue so I have been told that it is probably the result of a healed ulcer. My question is: Do I need to be concerned about this and what is the probability of it becoming dysplastic and possibly turning into cancer. I am also wondering if it is reversible.

If anyone has some info I would appreciate the help.

Thanks,
Keltie
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First Helper cmkalm
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replied May 2nd, 2008
Doctor
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?
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Users who thank Dr. Nikola for this post: davidmaulsby 

replied May 2nd, 2008
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
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replied May 19th, 2008
Doctor
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.
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replied June 13th, 2008
focal intestinal metaplasia of the stomach
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
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replied June 24th, 2008
Doctor
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.
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replied May 7th, 2010
focal intestinal mataplasia
Attn, dr Nikola or any GAstro doctor,
Hi, my name is Lokman,I live in Indonesia, I am so thankful to know a bit more about focal intestinal metaplasia, I was diagnosed with focal intestinal metapalsia ( FIM ) found in my mucosal fragments , but my Helicobater pylori is absent ( negative ) but I was suffered from H- pylori about 4 r 5 years ago and it was cured and healed with some antibiotic.
my qestions are :
1)what is my posiibilities in getting stomach cancer if FIM is found ?
2)if Yes, how long will it take to reform become stomach cancer ?
3) is there any type of fruit or vegetable can reduce the speed of FIM to become cancer ? I have read from a few article in newspaper that seaweed , water chesnut and a type of fruit called soursop can slow down process of cancer, do you agree with that ?
please advise, thank you,

By the way, where are you located ? and may I know what is your doctor qualification is ?are a specialist in GAstro ?
thank you very much for your attention
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replied December 24th, 2010
extensive intestinal metaplasia
I have been diagnosed for extensive intestinal metaplasia. I am scared. Doctor, is there anyway to see if this is reversible? Help me please!!!! I was diagnosed during my endoscopy in November of 2010. I am 33 years old.
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replied December 27th, 2010
Focal Intestinal Metaplasia
I have been diagnosed with intestinal metaplasia in my gastric antrum in 11/2010. I was shocked. My GI Doctor recommended a two year endoscopy follow up and a high fiber diet! Two years?! Are you kidding?! He said there is no cure just to monitor it...I have been praying, researching and came across a newer procedure called radiofrequency ablation on the New England Journal of Medicine. You can Google it. I am going to see a doctor at M.D. Anderson Cancer Center and see if she will do the procedure for me? Prayers of healing for all who have been diagnosed with intestinal metaplasia - it is a scary diagnosis. I am believing God and modern medicine for healing! God bless each of you.
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replied October 21st, 2012
Hi cmkalm,

I hope you are doing fine.
I read all your posts which are very informative.

"I am going to see a doctor at M.D. Anderson Cancer Center and see if she will do the procedure for me?"

Did they do the procedure for you?

Thanks,
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replied October 21st, 2012
Hi cmkalm,

I hope you are doing fine.
I read all your posts which are very informative.

"I am going to see a doctor at M.D. Anderson Cancer Center and see if she will do the procedure for me?"

Did they do the procedure for you?

Thanks,
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replied December 27th, 2010
Thank you cmkalm. I believe in God also and it is very encouraging to hear that you are helping me out. I will definitely google it. I felt hopeless and sad. Thank you so much and please keep me up to date as to what you are going to do, I will do the same as I come across any procedures. By the way, where is Anderson Cancer Center?
Also for endoscopy, my GI doctor said he will do it every 6 months. I think it's better to do it every 6 months then 2 years.
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replied December 28th, 2010
Intestinal Metaplasia
Intestinal Metaplasia is supposedly the same as Barretts Esophagus from what my general practitioner told me. Intestinal Metaplasia can occur in the esophagus and other parts of the stomach. Some studies say it can be reversed. Google "Cure Intestinal Metaplasia" and it should come up.
My suggestions - make dietary changes - like more of a plant based diet, 5 small meals a day. NO smoked or barbeque meats - no lunch meats with nitrites. They say large doses of Vitamin C (ascorbic acid) are good - say 1000-5000 milligrams (check with your doctor). MD Anderson Cancer Center is in Houston, Texas. I have also heard that the Mayo Clinic does it too. What did your doctor recommend for your diet? What meds and vitamins are you taking? God bless you as you seek healing! My prayers are with you!
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replied August 14th, 2011
Hey you guys,

There's an MD anderson conference coming up on Cancer in September 16-17 in Texas. Although we don't have cancer at this time, i think it's important to be aware about it. It's a survivorship conference and I am going.

Here's the link.
http://www.mdanderson.org/patient-and-canc er-information/guide-to-md-anderson/patien t-and-family-support/anderson-network/supp ort-programs/patient-conference.html

It's only $50.00. If you want to share a room with me it's only $50.00 at the Omni hotel. Let me know if you are interested. Thanks!
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replied August 27th, 2011
MDA Conference
I live in Houston so I don't need to stay at the Omni. I would be happy to meet up with you though! Please send me your contact information!
God bless,
Christine
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replied December 8th, 2011
Suggestions
Hello,

My dad was just diagnosed with IM. It is very scary for him and so I decided to look more into it, as doctors said there is no cure. Could you please suggest any way in which it could be at least stopped or delayed if not reversed?
I understand ascorbic acid is one of them. What about some plants, herbs or other suggestions that you might have. Any info would be much appreciated. Thank you and take care you all!
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replied December 14th, 2011
Intestinal metaplasia diagnosis and diet changes
I have been told that IM in the stomach is quite different than the esophagus per my GI doctor at MD Anderson. I suggest a diet with Apple Cider Vinegar, lots of vitamin C, turmeric, ginger...I have gone to a mostly organic, plant based diet, occasional chicken or turkey - NO processed meat, no nitrates, no nitrites, no grilled (cut it off and eat the middle), no smoked foods, no sausage, etc. I have to go but will post more later. God bless!
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replied February 4th, 2012
I just turned 28 in November of 2012 and was diagnosed with IM by one of the top GI's in NYC. His first recommendation to me was cease caffeine (both coffee and tea), alcohol, and all smoking forever. They only exacerbate the problem. Otherwise small meals, regular exercise, plenty of rest, and limited acids is what he suggested. Along, of course, with annual endoscopies. So, I have to take it in stride. I have no other choice. Stay positive, enjoy every day, and pray. Good luck to all of you.

FC
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replied February 4th, 2012
I just turned 28 in November of 2012 and was diagnosed with IM by one of the top GI's in NYC. His first recommendation to me was cease caffeine (both coffee and tea), alcohol, and all smoking forever. They only exacerbate the problem. Otherwise small meals, regular exercise, plenty of rest, and limited acids is what he suggested. Along, of course, with annual endoscopies. So, I have to take it in stride. I have no other choice. Stay positive, enjoy every day, and pray. Good luck to all of you.

FC
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replied February 5th, 2012
Intestinal Metaplasia in Stomach
Cafare52:
where is your IM in your stomach? I agree on NO caffeine, alcohol and smoking for sure!

Interesting take on the annual endoscopy! My GI at MD Anderson said she would not recommend endoscopic surveillance. She feels that the procedure carries more risk than benefit. I don't completely agree with that determination but I've been waiting for some other results before pushing for the endoscopy.

About 3 months ago, I did a gastric emptying test and found out that my stomach was taking 126 minutes to empty half the contents of my stomach! Normally, that would only take 45 minutes! My GI said she believes this is linked to my hypothyroidism. I have been waiting for this appt since December 1! Tomorrow I finally get to see an endocrinologist. I am hoping to be put on Armour Thyroid or NatureThroid and see if I get some digestive relief. I will have to give it some time to see if it works. I have been reading a book called Stop the Thyroid Madness. Everyone should get their thyroid checked and if you have thyroid problems, read the book and join the Yahoo group. It is helpful to find others dealing with what you're dealing with.

So little is known and shared about IM in the stomach. I am praying it's eradicated in all of us!
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replied May 19th, 2012
@ cmkalm
Recently my wife's biopsy report indicated FIM, & the GI doctor suggested annually endoscopy test as well as gastric emptying test. We have no idea how helpful the gastric emptying test would be. Taking it for granted that her stomach takes long to empty the content, is there any need for the doctor to order this test associated with nuclear medicine--isotope? Is the doctor unlikely to diagnose FIM without the help of gastric emptying test?
We were wondering how your doctor dealt with your situation after the test had reported your prolonged emptying procedure. Thanks in advance for your suggestion.
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replied May 19th, 2012
Delayed Gastric Emptying and Intestinal Metaplasia
I am looking to do an endoscopy with my original GI doctor in November - it will have been two years since the last. The gastric emptying test confirmed what I had been telling my MD Anderson GI -- that I felt like food just sat in my gut. I could eat breakfast - like a bowl of oatmeal and I would not be hungry until dinner time! Of course eating radioactive oatmeal can't be the best thing for you! I was not really wanting to do it but the doctor needed a way to confirm if it was really an issue? When the results came back it made me feel better that I was not imagining things. I really could go long periods with no eating! FIM is diagnosed by endoscopy/biopsy - not gastric emptying to my knowledge. I asked my MDA GI if the delayed emptying could cause my Intestinal Metaplasia? She said it could be a factor. My MDA GI felt pretty strongly that some of my digestive issues may be because of my thyroid issues. That is why I have been trying to get my hypothryoidism address with Armour Thyroid or Naturethroid. I have been diagnosed with Hashimoto's in January 2012. That Endocrinologist refused to put me on Armour or Nature. She would only prescribe Synthroid or Levoxyl which I do not want to take...
I wish there was more knowledge on Intestinal Metaplasia in the stomach...the studies out there have been on military personnel or alcoholics - neither which fit closely to my situation.
It would be interesting to know if your wife has a delayed emptying problem because to me maybe it is likely that the delayed emptying can be causing the IM? My MDA GI said about half of the contents of your stomach should be gone within 45 minutes of eating...since mine takes 126 that is almost triple the amount of time...
I hope this helpful. Please keep posting on here so we can all work on this together. Prayers for healing from God for all of us!
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replied May 20th, 2012
@ cmkalm
Thank you ever so much for your prompt & kind reply.
Assuming the presence of my wife's delayed function in her stomach, who has suffered from GERD for a while, without the test, the doctor would be unlikely to do anything helpful?
2 years ago, she got the endoscopy test, & nothing positive was reported, but the GI doc suggested another test in '12. Thus she got the follow-up in March.
Frankly, my wife has received several radiating tests, such as X-ray,Cat Scan, MRI & so on. After hearing that the gastric emptying test should be based on nuclear medicine--isotope, we are hesitant to accept the appointment. From a friend of ours, we got something terrible that made us feel more confused: the patient should be quarantined & her/his clothing should be washed & rinsed for several times so as not to let other people contact the radiating stuff. Furthermore, my wife's family physician said she has the right to decide whether accepting the test or not. Besides, the family doctor revealed that the test is somewhat for research purpose. After reading your comment, I'm enlightened a lot--being able to obtain direct info from a patient who has already experienced the test. Now my key point is: what a helpful /successful result the test would offer you & your doctor as well? Any medication was offered directly relevant with the finding--delayed emptying process? In fact, my wife has the same symptom of hypothyroidism as you do. Is this only related to delayed process but having nothing to do with FIM?
Could you please tell me anything you have experienced & you are facing now? Thanks again for your kindness.
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replied May 20th, 2012
Hi, cmkalm:
Sorry to bother you again.
I told my better half all the info you had offered. She wanted me to show you her profound appreciation.
She has a question here.
According to the constant situation, one's stomach function should go in good harmony with the bowl movement. If the stomach is not emptying fast, maybe the bowl movement would be irregular either, constipation, diarrhea or something else. However, she said everything is okay with her said situation. What do you think of it? Certainly we can't take it for granted that A is okay, B must be okay too. Thanks for any info from you.
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