Answer:

Intestinal metaplasia in the stomach is a condition where some cells lining the inside of the stomach are replaced by cells that resemble those of the intestine. This condition develops on the background of prolonged inflammation of the gastric lining, with helicobacter pylori (H. pylori) infection being the primary cause. Autoimmune gastritis, where the immune system attacks the stomach's own cells, can also lead to intestinal metaplasia.

Intestinal metaplasia is not cancer, but it can increase the risk of stomach cancer, though the incidence is low. The risk of progression depends on various factors such as the extent of the lesion, microscopic cell characteristics, and a family history of genetic factors. This condition does not cause distinct symptoms and may be discovered incidentally during a gastroscopy.

A doctor may take biopsy samples from different areas of the stomach to assess the degree and extent of intestinal metaplasia, thereby determining the risk and selecting an appropriate follow-up schedule. Biopsy results also indicate the presence of dysplasia, meaning cells have undergone more abnormal changes than those seen in intestinal metaplasia.

Doctor Oanh examines a patient's abdomen. Illustration: Tam Anh General Hospital.

When intestinal metaplasia is detected, patients will be tested for H. pylori and treated to eradicate the bacteria if an infection is present. However, eliminating H. pylori does not guarantee that intestinal metaplasia will disappear. Therefore, patients should simultaneously treat H. pylori and monitor their gastric lining as directed by their doctor.

Patients diagnosed with intestinal metaplasia lesions require regular assessment via biopsy and endoscopy every one to three years, depending on the severity. Cases with mild lesions typically do not require routine follow-up endoscopy, but doctors should still consider it if there is a family history of stomach cancer.

If a biopsy reveals cells with more abnormal changes than intestinal metaplasia (dysplasia), the patient requires separate evaluation and management, without waiting for the regular follow-up schedule.

To prevent intestinal metaplasia from progressing to cancer, you should treat H. pylori and confirm bacterial eradication as advised. You should not smoke, reduce salt intake, limit cured foods, processed meats, and alcohol. Prioritize fresh vegetables, fruits, poultry, and lean meats. These changes aim to reduce risk factors; they do not guarantee the disappearance of intestinal metapasia but limit rapid lesion progression.

Once a lesion is present, patients must adhere to their doctor's regular follow-up schedule to enable early detection of abnormalities and timely treatment.

Master, Doctor Nguyen Hoang Oanh

Department of Gastroenterology - Hepatology

Tam Anh General Clinic District 7