Intestinal Metaplasia of the Stomach

Abstract

Intestinal metaplasia (IM) of the stomach is associated with a very small increased risk of developing gastric cancer. Endoscopic surveillance has been proposed and advocated for populations at risk. Risk factors for IM include Helicobacter pylori infection, high salt intake, smoking, alcohol consumption, and chronic bile reflux. IM tends to appear initially at the antrum–corpus junction, especially at the gastric angularis. As atrophy and metaplastic changes advance, they extend to the antrum and corpus. Gastric IM is categorized histopathologically into incomplete and complete types. Patients with incomplete IM should undergo endoscopic gastric mapping to define the extent of IM and rule out dysplasia or adenocarcinoma. In this video presentation, endoscopic and pathological findings in gastric IM and gastric mapping techniques has been described. This article is part of an expert video encyclopedia.