Gastric intestinal metaplasia

Gastric intestinal metaplasia is a change in the inner lining of the stomach. That lining is called the mucosa, a layer of cells that covers the inside of the stomach. In intestinal metaplasia, the stomach's own cells are replaced by cells that normally line the intestines. Picture a kitchen floor where, little by little, the tiles are swapped out for tiles from another room of the house. The floor is still covered, but with pieces that don't belong there.

This change is one stop along a long, slow path the stomach lining can travel. It starts with chronic gastritis, an inflammation of the stomach that lasts a long time. Next comes atrophy, when the lining thins out in several spots. Then comes intestinal metaplasia, and after that dysplasia: cells with an abnormal shape and arrangement that are not cancer yet. The last stop is invasive carcinoma, a cancer that has started to invade the tissue. What seems to push things along this path over the years is too much salt and, above all, infection with Helicobacter pylori, a bacterium that infects the stomach.

Intestinal metaplasia is considered a precursor condition, meaning one that can come before gastric cancer. But being on the path doesn't mean you have to reach the end of it. Having a risk factor like this one doesn't necessarily mean that cancer will develop.