Intestinal Metaplasia of the Stomach: Understanding Your Pathology Report

섹션 편집자: David Driman MBChB FRCPC
2026 년 11 월 13 일

이 기사 인쇄

Intestinal metaplasia of the stomach is a change in which the normal cells lining the stomach are replaced by cells that look like the lining of the intestine. It is not cancer, but it is a common finding, usually caused by many years of inflammation, and it is described in many stomach biopsy reports. Intestinal metaplasia slightly increases the risk of stomach cancer over time, so some people with this finding are offered regular follow-up endoscopies.

Intestinal metaplasia is usually reported together with another condition, most often 위축성 위염 or 헬리코박터 위염. This article explains what intestinal metaplasia means, what the details in your pathology report describe, and how doctors decide who needs follow-up.

이형성증이란 무엇인가요?

화생 means a different normal cell type has replaced one normal cell type. In intestinal metaplasia of the stomach, the stomach lining is replaced by cells that normally line the small intestine or colon. These include 배상 세포, which produce mucus and are easy for pathologists to recognize.

Metaplasia is the body’s way of protecting itself from long-term injury. The new cells are better able to survive the damage, but they do not do the normal work of the stomach lining. Intestinal metaplasia in the stomach differs from Barrett esophagus, which is intestinal metaplasia in the lower 식도.

How common is intestinal metaplasia of the stomach?

Intestinal metaplasia of the stomach is common, especially in older adults. In European studies, it was found in about 14% to 19% of people who had an upper endoscopy. It is more common in people who grew up in regions where Helicobacter pylori infection is common, including East Asia, Latin America, and Eastern Europe.

What causes intestinal metaplasia of the stomach?

Intestinal metaplasia of the stomach develops after many years of damage and 염증 in the stomach lining. The damage first causes atrophic gastritis, in which the normal glands of the stomach are lost, and intestinal metaplasia then develops in the damaged areas.

  • Helicobacter pylori infection. A long-lasting infection with the bacterium Helicobacter pylori is by far the most common cause.
  • 자가 면역 위염. In this condition, the immune system attacks the acid-producing cells in the upper part of the stomach.
  • 기타 요인. Smoking, a diet high in salt, and bile reflux into the stomach may also contribute.

What are the symptoms of intestinal metaplasia of the stomach?

Intestinal metaplasia of the stomach does not cause symptoms. It is usually found in biopsies taken during an endoscopy done for another reason, such as indigestion, anemia, or H. pylori의 infection. Any symptoms are caused by the underlying gastritis or by the problem that led to the endoscopy.

How is intestinal metaplasia identified?

A pathologist identifies intestinal metaplasia by 검토 생검 of the stomach lining under a microscope. The pathologist sees intestine-type cells, especially goblet cells, in place of the normal stomach cells. During endoscopy, your doctor may also see pale or patchy areas that suggest intestinal metaplasia, especially with special lighting.

To measure how much of the stomach is affected, the 2024 American Gastroenterological Association (AGA) clinical practice update recommends at least five biopsies. Biopsies from the lower stomach, called the antrum and incisura, are placed in one container, and biopsies from the upper stomach, called the body or corpus, in another. This lets the pathologist report where the intestinal metaplasia is found.

Subtype: complete or incomplete

Many pathologists divide intestinal metaplasia of the stomach into two subtypes, based on which part of the intestine the new cells look like. The 2025 American College of Gastroenterology (ACG) guideline recommends including the subtype in the report, but not every report does.

  • Complete intestinal metaplasia. The new cells resemble the lining of the small intestine, and this subtype carries a lower risk of cancer.
  • Incomplete intestinal metaplasia. The new cells look more like the lining of the colon. Incomplete intestinal metaplasia carries about three times the risk of stomach cancer compared with the complete subtype.
  • Mixed intestinal metaplasia. Both subtypes are present in the same biopsy, and doctors usually treat mixed intestinal metaplasia like the incomplete subtype.

범위

The extent of intestinal metaplasia describes how much of the stomach is affected. Your report may describe the extent for each biopsy location, and some reports also give a percentage of the lining involved.

  • 제한된. Intestinal metaplasia is found only in the lower stomach, in the antrum or incisura.
  • 광범위한. Intestinal metaplasia is also found in the upper stomach, in the body. Extensive intestinal metaplasia carries a higher risk of cancer than limited intestinal metaplasia.

OLGIM stage

Some pathologists combine the extent and severity of intestinal metaplasia into a score called the OLGIM stage. OLGIM stands for Operative Link on Gastric Intestinal Metaplasia assessment. The stage ranges from 0, meaning no intestinal metaplasia, to IV, meaning severe intestinal metaplasia throughout the stomach. Stages III and IV are linked to a higher risk of stomach cancer. The OLGIM stage is optional, and many reports do not include it.

보고서의 다른 결과

Your report will usually describe other findings in the same biopsies. These findings help your doctor understand the cause of the intestinal metaplasia and your overall risk.

  • 헬리코박터 파일로리. The report will say whether H. pylori의 bacteria were seen in the biopsies. Learn more about 테스트 H. pylori의.
  • 위축. The report may describe atrophic gastritis, the loss of normal stomach glands that comes before intestinal metaplasia.
  • 이형성증. The pathologist will check for 이형성증, a precancerous change that can develop in areas of intestinal metaplasia. Most reports will say “negative for dysplasia.”

Does intestinal metaplasia mean I will get stomach cancer?

Most people with intestinal metaplasia of the stomach will never develop stomach cancer. In a large study from the Netherlands, about 1 in 400 people with intestinal metaplasia developed stomach cancer each year. The risk is higher for people with incomplete or extensive intestinal metaplasia, and about four times higher for people with a parent, sibling, or child who had stomach cancer.

Intestinal metaplasia matters because it shows the stomach lining has been damaged for a long time. Finding it allows your doctors to treat the cause and, for people at higher risk, to find any precancerous changes or early cancers when they are easiest to treat.

What happens after intestinal metaplasia is found?

What happens after intestinal metaplasia of the stomach is found depends on its subtype, extent, and your other risk factors. The following approach is based on the 2025 ACG guideline and the 2024 AGA clinical practice update.

  • Treating H. pylori. If H. pylori의 is present, treat it with antibiotics, and confirm the infection is gone with a follow-up test. Treating the infection lowers the risk of stomach cancer, although established intestinal metaplasia usually does not go away.
  • 낮은 위험. People with complete intestinal metaplasia limited to the lower stomach and no other risk factors usually do not need regular follow-up endoscopies.
  • 위험성이 더 높음. A follow-up endoscopy about every 3 years is recommended for people with incomplete intestinal metaplasia, extensive intestinal metaplasia, or intestinal metaplasia with other risk factors. Other risk factors include a close relative with stomach cancer and having been born in a country where stomach cancer is common. People with several risk factors may be checked more often than every 3 years.
  • Healthy habits. Not smoking and eating less salty and processed food may help protect the stomach lining.

의사에게 물어볼 질문

  • Where in my stomach was intestinal metaplasia found?
  • Is it limited or extensive?
  • Is it the complete or incomplete subtype?
  • Was an OLGIM stage reported?
  • 무엇 H. pylori의 found, and has it been treated?
  • Was any dysplasia found?
  • 저는 위축성 위염이 있는 건가요? 있다면 원인은 무엇인가요?
  • Do I need follow-up endoscopies, and how often?
  • Should my family members be tested for H. pylori의?

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