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Old 11-27-2012, 05:48 PM   #1
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Mild chronic gastritis with focal Intestinal Metaplasia

I was wondering if anyone has any information regarding mild, chronic gastritis with intestinal metaplasia focal of the antrum?

I was recently scoped (upper endoscopy) and the findings found IM focal in the antrum area of the stomach. I was negative for h pylori, in fact, everything was negative with the exception of the IM focal. My doc said he will rescope in one year. He seemed to indicate that there would be more of a concern if the IM was located at the GE junction. There was only mild, chronic gastroesophagitis in this area (negative for IM).

I have researched this topic for the past week. What I can't seem to find is any information that looks at the percentage of IM patients that will develop stoamch cancer. I found some people who think the risk is 6 fold greater than the average person. Not sure if this is 6% (or 6 out of 100). Others think it is not much of a risk at all. It is a bit confusing. The lab report does not indicate Type I, II or III. It simply says stomach, biopsy, antrum, - intestinal metaplasia, focal.

I have no symptoms regarding stomach. I do have frequent throat clearing due to reflux, but nothing in the stomach. I take Protonix twice daily.

I would greatly appreciate anyone sharing any information you have about this. Thanks!

 
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Old 12-19-2012, 04:22 PM   #2
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Smile Re: Mild chronic gastritis with focal Intestinal Metaplasia

Hey there, I also have exactly the same kind of diagnosis.

"The biopsies of your stomach showed mild chronic gastritis and no active inflammation or H. pylori infection. The biopsies also showed focal intesintal metaplasia, which means the stomach cells have transformed to look like small intestine cells. The significance of intesintal metaplasia in the stomach is not entirely clear, although in some cases it may be considered a high-risk condition which can potentially turn into cancer. In your case, it is likely a benign finding. "

She said there is nothing to worry and I have been asked to follow up in 3 years for follow endoscopy. Until that i must take prilosec for 3 months. Take vitamin A and C cupplements and eats lots of fresh fruits and vegetagles. I do not drink or smoke and my trigger is hot spicy foods. So i have cut down on that.

Did you doctor also give you similar kind of instructions?


 
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Old 12-20-2012, 09:52 AM   #3
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Re: Mild chronic gastritis with focal Intestinal Metaplasia

Thanks for the reply. My doc gave me a script for protonix 40mg twice daily. I also have gerd and have tried to alter my lifestyle as well (raising head of bed 6 inches, no food or drink 3 hours before bed, antacid an hour after meals and eating small, more frequent meals). I have also tried to cut down on coffee which is difficult (I've gone from 6 cups per day down to 2 or 3). I have a 3 month follow-up in February with the doctor. He plans to scope me in a year. I spoke to his nurse on the phone a few weeks ago and she indicated that they are always more concerned when the diagnosis of IM is at the gastroesophogeal junction rather than the stomach. Thanks again.

 
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Old 12-21-2012, 02:46 PM   #4
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Re: Mild chronic gastritis with focal Intestinal Metaplasia

Thanks for your reply. Based on your suggestion I am wondering why my doctor wanted me to have prilosec 20mg once a day. I have been on it for a week and feel much better in terms of my acidity
But still feel very hungry before food and have slight pain after I eat.

I looked up crazily on the internet about intestinal metaplasia and some say it is not precancerous and some say it is, some say it will go away with medications + life style modifications and some say it will stay as it is and some say it might progress. Not sure what will happen. I feel as if a death sentence has been written for me. All I wish that my report was “Normal” so that there is no need not worry about this. I am just 35 years old and small children to care for.

The sad part is there are people out there heavily smoking and drinking and yet living normal lives and I get this condition for just eating spicy food. I keep asking again and again to myself “Why me???” but the optimistic part In me believes that it will go away and not do me any harm and I will be there to see my children grow.

I have completely changed myself by eating a diet very very low in spice and oil, sticking to one cup of coffee, eating lots of fruits and vegetables, supplements for Vitamin A C B D omega 3 etc , eating smaller portions etc. I am also going request my doctor to scope me in 1 year.

Please do let me know what your doctor says in follow up appointment and also how you scope results turn out to be. Also please do share with me about how you feel so that It will give me peace of mind that I am not alone with this “IM”

 
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Old 12-21-2012, 05:00 PM   #5
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Re: Mild chronic gastritis with focal Intestinal Metaplasia

newwithIM......I wouldn't worry at all about the future prognosis. From what I've read it doesn't seem to be much of an issue as long as it is in the stomach and not the esophogas. IM I and IM II are relatively benign. IM III is the type that needs to be monitored more frequently. In many cases, IM will clear up on its own. My doctor did not tell me if I had I, II or III. I will ask when I have my follow-up in February. The reason that my dosage may be stronger than yours is because of my gerd. I also have LPR where acid affects the larnyx area (constant throat clearing). He increased my dosage to see if the LPR subsides, which it has. I am not clearing my throat much at all since my dosage was increased. My doc may reduce my dosage when I see him in February. Hang in there and keep up with the lifestyle changes. I will keep you posted on any feedback I get from my doc.

 
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Old 02-04-2013, 06:16 PM   #6
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Re: Mild chronic gastritis with focal Intestinal Metaplasia

After doing a lot of research on the internet, it was good to find 2 people with almost exactly the same diagnosis. I have mild chronic gastritis and reflux, normal ECJ but with moderate inflammation, and then focal metaplasia in the antrum. When I initially performed google research, I freaked out a bit. But when I called my gastro doc ( who is supposedly a good one), he told me on the phone he wished I had talked to him first, because my metaplasia finding is clinically insignificant. These words calmed me down a bit. But I want to discuss it in more depth with him at his office next, because it is a concern. If you'd like, I'll pass a long his reasoning after I hear it.

 
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Old 02-04-2013, 10:16 PM   #7
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Re: Mild chronic gastritis with focal Intestinal Metaplasia

Good to know you also have similar diagnosis. Do keep us posted about what your doctor says so that we will feel much better. amherstgrad also has a follow up with his doctor very soon and his information also will be much helpful if he
can share with us.

 
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Old 02-04-2013, 11:29 PM   #8
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Re: Mild chronic gastritis with focal Intestinal Metaplasia

It is interesting that this thread was updated yesterday. I had my 3 month follow-up with my GI yesterday and I asked many questions. My GI reassured me that my focal IM was nothing to be concerned about. He told me that he has treated many paitients with IM and none have progressed to gastric cancer. He said that focal IM means that it is localized to a specific area and is not spread throughout the entire area. He did say that IM is somethig that many GI docs are not totally in ageement when it comes to follow-up endoscopies. Some prefer to recope every 2 or 3 years, some scope every year. My GI prefers to scope one year after the initial diagnosis of IM. If the results are the same from the previous year then he will resope in 3 year cycles. He told me that in some cases after the first rescope the IM will clear up completely and will not be an issue again. He doesn't expect anything to change my medical outlook...in fact he said I was in excellent health as I was leaving his office and that I should not worry.

One interesting fact that he shared with me was regarding my bed. I told him that I raised the head of my bed six inches. He told me that I should not do this unless I was bothered with severe nighttime reflux that regurgitated into my throat during sleep. He said getting a good nights sleep outweighs any possible benefits from raising the head of the bed. He looked at my wife and then looked at me and smiled and said "a happy wife makes a good life." Meaning that raising the bed isn't doing either one of us any good and is making us tired the next day. A good night's sleep is one of the most important things we can do for ourselves and for our spouses according to my doc. So I plan to bring the head of my bed back to normal tomorrow. He also said the best thing I can do for myself is to eat 4 moderate-sized meals instead of 3 big ones, and not eat or drink anything 3 hours prior to going to bed.

I told him how much I love my coffee and I have had a difficult time cutting that out of my diet. He said I shouldn't have to cut anything out...just modify my diet and cut back on coffee. I told him that I like to have a couple of beers with pizza once a week. He said alcohol, like coffee, is okay as long as it is in moderation. It made my day when he told me that I can still have my coffee. He said to monitor what I eat and if there is a particular food that causes me discomfort then I should cut back on it...everything in moderation, according to him.

I wish I had spoken to him about 2 months ago. This IM stuff has been in the back of mind since the middle of November. I took my wife with me so that I would have an extra set of ears listening to what my doc said. After the office visit she and I went to lunch and we had a great time.

I hope this info helps both of you newwithIM and augustSartori. Keep us posted on any follow-ups you have with your docs. Please feel free to ask any questions and I will do my best to answer. I hope this info helps you...it sure helped me.

 
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Old 02-05-2013, 09:39 AM   #9
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Re: Mild chronic gastritis with focal Intestinal Metaplasia

Wow that was great news for all of us here. It was very helpful and you made our day by sharing all the great news you doctor shared with you. That was absolutely nice of you. I am excited to hear about that coffee news too. I would love to have coffee once a day and i am happy to know i need not quit that habit. I have totally cut out on the spicy food and seeing a lot of difference. I now realized how my acid reflux has been a chronic issue for me and how much i was just living with it and now it feels very strange not to have acid reflux at all.

I have a follow up in 3 months and will update you all with what my GI informed me. augustSartori as i see you are in the Santacruz area there is this very very good doctor "Anders K Dhalstrom". He is a very old man but a wonderful doctor with years and years of experience who was seeing my son for acid reflux. Now he moved out of that practice and is now settled in santacruz. Not sure if he is still seeing only pediatric patients.

 
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Old 02-05-2013, 10:46 AM   #10
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Re: Mild chronic gastritis with focal Intestinal Metaplasia

I'm happy that my follow-up info helps you, too, newwithIM. It sounds like you are doing the right things and have your reflux under control. Identifying the trigger foods is important. Not all "bad" reflux foods are bad for everyone. Moderation is the key. I put in a call to my GI doc's nurse for a follow-up questions that I forgot to bring up yesterday. I want to find out if I should stop taking my daily baby aspirin for heart health (aspirin does iritate the stomach lining). I will share the info when I get an answer.

 
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Old 02-07-2013, 12:06 AM   #11
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Re: Mild chronic gastritis with focal Intestinal Metaplasia

When I had originally talked with my GI doc over the phone and told him I was worried after googling focal IM, he immediately said "Oh,..I wish you had spoken to me before you did", and explained that it was "clinically insignificant".
Well I spoke with my GI doc today and asked him why he thought that my focal IM in the antrum was "clinically insignificant" and this is what he said: He said it was insignificant for me because I was Caucasian and there was no evidence that it leads to cancer, especially since there was no dysplasia. He said if I was Asian, he would treat me differently in which case he'd probably scope me periodically - although he did clarify that it was not necessarily precancerous for Asians either. He didn't comment on other racial categories. He also said he did not think it was medically necessary to scope me, but if I wanted it, the three-year mark is a reasonable scope interval. He also suggested he could do it at the same time he does my regular 5-year colonoscopies.
I may have him do a scope at 3-years ( next month) but haven't decided yet.
So I don't know how much trust you want to place in his comments. He is highly respected ( a doctor's doctor that other doctors come to see). He is a little older ( 70 ish, but I think he keeps up with the latest and is a caring person). I have to admit that if I relied only on what I've read on the internet, I'd be more concerned.
I wish I could simply say "don't worry about it" to all of you, but at the end of the day, we all need to be involved with our medical care and decisions, so I think it's a matter of research and instinct, at least for me. I want to believe my doc and not bother with the scope. But then rationally I know there MIGHT BE some counter arguments, so I'll have to sleep on it all.

 
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Old 02-07-2013, 09:28 AM   #12
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Re: Mild chronic gastritis with focal Intestinal Metaplasia

The docs who have been around awhile have seen trends and can pretty much tell what is significant and what isn't. My doc assured me that I had nothing to worry about. If my next endoscopy in November turns out well, which he expects it will, then I will probably not have one done for quite awhile. The one factor that he said was in my favor was that I tested negative for h pylori. He would have been much more concerned with my IM had h pylori had been the contributing factor. So for me, I simply have to put my trust in the guy who knows his stuff. I was pleased that he was concerned with my whole body health and not just my gastro issues. He put me totally at ease and I walked out of his office with a good feeling and knowing that I'm in good hands.

 
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Old 08-16-2013, 04:23 PM   #13
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Re: Mild chronic gastritis with focal Intestinal Metaplasia

Hi I just got the same diagnosis "antral mucosa with focal intestinal metaplasia" also with reactive (chemical) gastritis in the stomach

I read somewhere that radiofrequency ablation is now being trialled for treating IM of the stomach--does anyone know about this as I'd like to be as proactive as possible in treating this.

also, does anyone have any statistics on how common this is?

I read somewhere that 1 in 4 people undergoing endoscopy will get this diagnosis, so how frequently can it possibly lead to cancer??

 
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Old 08-17-2013, 11:55 AM   #14
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Re: Mild chronic gastritis with focal Intestinal Metaplasia

Quote:
Originally Posted by amherstgrad View Post
I was wondering if anyone has any information regarding mild, chronic gastritis with intestinal metaplasia focal of the antrum?

I was recently scoped (upper endoscopy) and the findings found IM focal in the antrum area of the stomach. I was negative for h pylori, in fact, everything was negative with the exception of the IM focal. My doc said he will rescope in one year. He seemed to indicate that there would be more of a concern if the IM was located at the GE junction. There was only mild, chronic gastroesophagitis in this area (negative for IM).

I have researched this topic for the past week. What I can't seem to find is any information that looks at the percentage of IM patients that will develop stoamch cancer. I found some people who think the risk is 6 fold greater than the average person. Not sure if this is 6% (or 6 out of 100). Others think it is not much of a risk at all. It is a bit confusing. The lab report does not indicate Type I, II or III. It simply says stomach, biopsy, antrum, - intestinal metaplasia, focal.

I have no symptoms regarding stomach. I do have frequent throat clearing due to reflux, but nothing in the stomach. I take Protonix twice daily.

I would greatly appreciate anyone sharing any information you have about this. Thanks!

 
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Old 08-17-2013, 12:05 PM   #15
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Re: Mild chronic gastritis with focal Intestinal Metaplasia

I also had the same diagnosis when I was scoped to fix my ulcers. He put me on PPI's and of course told me what I no longer can eat. Two months later I went in for another scope to check on my ulcers and my stomach was completely normal so just make sure you keep taking your PPI's and eat a good diet and I'm sure you'll heal in no time!

 
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