Intestinal metaplasia is the development of intestine-like cells where they are not normally found, often caused by chronic inflammation. It can occur anywhere in the body, but is most common in the stomach and esophagus. Treatment involves eliminating the cause, and diagnosis is usually made through biopsy and microscopic examination. It can be reversible under certain circumstances.
Intestinal metaplasia generally involves the development of intestine-like cells in places where this type of cell is not normally found. The condition is usually attributed to chronic inflammation caused by bacteria, the person, or environmental factors. The differentiated cell type frequently develops in the stomach and esophagus regions, but can occur anywhere in the body. Treatment may involve eliminating the causative factors.
The condition generally occurs when a constant regenerative process transforms normal squamous cells into columnar mucosa cells. Cell membranes and nuclei are usually distorted and have vacuoles that contain acidic mucin. As the name suggests, the transformed cells resemble those found in the intestines. These abnormal cells coalesce and can spread throughout the affected area. While generally considered a benign change, the condition is often equated with pre-malignancy.
Focal intestinal metaplasia is one of two classifications of the condition and has two variants. This focal form usually occurs in response to chronic mucosal injury or irritation and is further classified as complete or incomplete. Full focal forms of the condition generally produce cells that resemble those commonly found in the small intestine. The cells undergo a maturation process that allows them to look and function like intestinal cells. They can secrete peptides and absorb nutrients.
The other variation of focal metaplasia is commonly referred to as incomplete intestinal metaplasia. In this form, the transformed cells are similar to the microscopic structures found in the large intestine. The affected organ usually contains goblet cells and rudimentary villi, often associated with the colon.
Intestinal metaplasia of the mucus glands usually develops secondary to ulcerative conditions. It is the second major classification of this condition. The erosion of the gastric glands may eventually give way to the development of the mucous glands.
Doctors can discover intestinal metaplasia during an endoscopic evaluation. The early stages of the condition often appear as white plaques or patches. The abnormal cells might also appear as discolored regions. Definitive diagnosis usually involves biopsy and microscopic examination. Under certain circumstances the condition may be reversible.
Pathological stress caused by Helicobacter pylori frequently induces tissue inflammation and ulceration, which can lead to intestinal metaplasia. Antibiotic treatment regimens can usually eliminate the bacteria and subsequent irritation. Physiological stressors that contribute to gastric irritation include vitamin C-deficient diets, alcohol consumption, and smoking. Chronic use of nonsteroidal anti-inflammatory drugs can also create the condition.
Some autoimmune diseases attack the parietal and principal cells of the stomach, creating chronic inflammation and injury. In many cases, reversal of controllable factors allows tissues to heal normally. Individuals who have extensive or severe cases may undergo ablation or surgical removal of damaged tissue.
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