Intestinal Metaplasia

Intestinal Metaplasia: Overview

What is intestinal metaplasia?

It’s a condition where your intestines become abnormally thickened or hard. This condition may cause pain when passing stool, constipation, diarrhea, abdominal cramps and other symptoms. Some people with this condition have no symptoms while others experience severe discomfort. There are many possible reasons why someone develops intestinal metaplasia such as genetic predisposition, diet and lifestyle choices or even injury to the intestine.

Symptoms of intestinal metaplasia include:

Constipation (passing stools very slowly)

Abdominal Cramping (painful cramps in the abdomen)

Diarrhea (unusual color of stool) – may look like blood or greenish water. Sometimes there will be bloody stool. If there is blood, it usually comes out in small pieces and does not appear to be painful.

Sometimes diarrhea lasts longer than usual.

Bloody Stool (bloody stool) – sometimes appears black and looks like coffee grounds. Blood may come out in large chunks and may be painful to pass.

Fever (a high temperature) – fever is often present but less common than other symptoms. It can range from normal body temperature up to 104 degrees Fahrenheit. Symptoms of fever include chills, muscle aches, headache, sore throat and a runny nose.

Abdominal Pain (the abdomen may be tender to the touch)

Intestinal Blockage (blockage in the intestines that prevents stool from passing)

Nausea or Vomiting (some people feel sick to their stomach)

Painful Urination (some people feel like they have to urinate more often than normal and it burns when they urinate)

Who gets Intestinal Metaplasia?

Anyone can develop this condition but some people are at higher risk. Children who have a close relative with the disease have a higher chance of developing it themselves. Some of the most common causes are genetics, poor diet, and lifestyle choices such as lack of exercise. Other causes include steroids, diet additives known as excitotoxins (MSG and others), and smoking cigarettes. Fortunately it is not considered to be a hereditary disease or one that is passed on from parent to child.

The Disease Process

Intestinal metaplasia is caused by an abnormal thickening of the small intestine. The disease usually begins in infancy and childhood and can continue into adulthood. In infants this thickening is most often caused by an injury or virus.

In children and adults, it may be caused by a poor diet, smoking cigarettes, or lack of physical activity.

If you have any concerns about your health or that of your child, please consult a physician.

How is it Diagnosed?

If you have symptoms of bloody stool, fever and bloody urine, or other blood in your bowel movements, see a medical professional immediately. The earlier the disease is detected the easier it is to treat.

Your health care provider may order a series of tests to rule out other diseases like colorectal cancer. A colonoscopy will be ordered to look for and biopsy any possible tumors. When the disease is in its earlier stages, it closely resembles other diseases so it is important to make an exact diagnosis.

The next step is to confirm the disease through a test that checks for intestinal lining cells. The cells on the inside of your small intestine are usually thin and flat and those on the outside are thicker and heart-shaped. If the cells are reversed, then you have a condition known as intestinal metaplasia.

How is it Treated?

Your health care provider may suggest several different treatments for this disease. The most common are changes to your diet and lifestyle. If you are overweight or obese, weight loss may be recommended since this condition is more common in people who carry extra weight. In addition, it is important to eat a healthy diet that is low in fat and high in fiber. Eating more plant foods like fruits and vegetables and whole grains instead of animal foods like meat and dairy products may help slow the progression of this disease.

Your physician may also suggest stopping tobacco smoking since smoking can increase your risk for developing colorectal cancer.

If the disease has progressed significantly, further surgery may be required to remove the damaged part of the small intestine.


If you have this disease, you are at higher risk for developing colorectal cancer. This is one reason it is very important to see your physician if you have any symptoms that don’t go away or get worse. Early detection and treatment are important in combating this disease.

Sources & references used in this article:

Pathology of gastric intestinal metaplasia: clinical implications by P Correa, MB Piazuelo, KT Wilson – The American journal of …, 2010 –

Cdx2 ectopic expression induces gastric intestinal metaplasia in transgenic mice by DG Silberg, J Sullivan, E Kang, GP Swain, J Moffett… – Gastroenterology, 2002 – Elsevier

Intestinal metaplasia of the gastric mucosa by BC Morson – British journal of cancer, 1955 –

Carcinoma arising from areas of intestinal metaplasia in the gastric mucosa by BC Morson – British journal of cancer, 1955 –

The columnar-lined esophagus, intestinal metaplasia, and Norman Barrett by SJ Spechler, RK Goyal – Gastroenterology, 1996 – Elsevier

Diagnosis of specialized intestinal metaplasia by optical coherence tomography by JM Poneros, S Brand, BE Bouma, GJ Tearney… – Gastroenterology, 2001 – Elsevier