Intestinal Metaplasia (IM)
When cells in the stomach transform into intestinal cells this is called metaplasia and can be a precursor to cancer. Intestinal metaplasia tends to occur due to chronic inflammation and is associated with Helicobacter Pylori infection, autoimmune gastritis, smoking and certain ethnic backgrounds. IM is associated with an increased risk for gastric cancer, although the absolute risk remains low. Patients with clinically significant IM need monitoring with gastroscopy every 1-3 years.
Intestinal metaplasia progresses to cancer in a step-wise fashion usually over a number of years. This generally occurs as follows:
Intestinal metaplasia --(years)--> IM with low grade dysplasia --(months)--> IM with high grade dysplasia --(weeks to months)--> Cancer
By monitoring we aim to prevent the development of cancer and intervene if dysplasia is ever detected.
- Extensive IM vs limited
- Family hx gastric cancer
- Racial risk for gastric ca (eg. Korean, Japanese)
- Monitoring IM using high-definition gastroscopes and narrow band imaging
- Advice on risk reduction
- Referral for resection when required