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Intestinal Metaplasia

Medically reviewed by Last updated on Jun 6, 2023.

Intestinal metaplasia (IM) is a condition that changes the cells that line your stomach or esophagus. The cells are changed into or replaced by cells that line your intestines. When IM happens in the esophagus, it is called Barrett esophagus. IM is a precancer lesion. This means it is not cancer yet, but it may develop into cancer over time. IM can be a sign that you are at a very high risk for gastric (stomach) or esophageal cancer. The type of cancer depends on where you have IM.

Digestive Tract


Seek care immediately if:

  • You have bloody bowel movements, bloody vomit, or vomit that looks like coffee grounds.
  • You have sudden, sharp stomach pain that does not go away or spreads to your back.
  • You have trouble breathing after you vomit.
  • You have trouble swallowing, or pain with swallowing.

Call your doctor or gastroenterologist if:

  • Your symptoms do not improve with treatment.
  • You feel full after eating only a small amount of food.
  • You lose weight without trying.
  • You have questions or concerns about your condition or care.


You may need any of the following:

  • Antibiotics are used to kill the bacteria. You may need to take this medicine for 10 to 14 days. Your healthcare provider will prescribe at least 2 antibiotics at the same time.
  • Antiulcer medicines help decrease the amount of acid that is normally made by the stomach. These help relieve pain and heal or prevent ulcers.
  • Bismuth is a liquid or tablet that may be used to decrease heartburn, upset stomach, or diarrhea. It may also decrease swelling in your stomach and help kill the infection if other medicines do not work. It also protects ulcers from stomach acid so they can heal.
  • Medicines may be given to decrease stomach acid.
  • Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell your provider if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Manage IM:

The following can help you prevent or manage symptoms. You may also help lower your risk for stomach or esophageal cancer with healthy lifestyle choices. Examples include eating healthy foods, exercising, and not smoking. Talk to your healthcare provider if you have questions about any of the following:

  • Eat healthy foods. Healthy foods include fruit, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Limit or do not eat foods such as salami, corned beef, ham, and bacon. Do not have foods or drinks that may increase heartburn if you have GERD. Examples include fried or fatty foods, spicy foods, onions, tomato-based foods, juice, and soft drinks.
  • Do not eat large meals. When you eat a lot of food at one time, your stomach needs more acid to digest it. Eat 6 small meals each day instead of 3 large meals, and eat slowly. Do not eat meals 2 to 3 hours before bedtime.
  • Drink liquids as directed. Liquids help your digestive system work correctly. Ask how much liquid to drink each day and which liquids are best for you.
  • Exercise as directed. Exercise can help increase your energy level and appetite. Ask your healthcare provider how much exercise you need and which exercises are best for you.
    Walking for Exercise
  • Elevate the head of your bed if you have GERD. Place 6-inch blocks under the head of your bed frame. You may also use more than one pillow under your head and shoulders while you sleep.
  • Do not smoke. Nicotine can damage blood vessels and make it more difficult to manage IM. Smoking also increases your risk for new or returning cancer and delays healing after treatment. Do not use e-cigarettes or smokeless tobacco in place of cigarettes or to help you quit. They still contain nicotine. Ask your healthcare provider for information if you currently smoke and need help quitting.
  • Do not drink alcohol. Alcohol can cause more stomach damage. Alcohol also increases the risk for stomach cancer.

Follow up with your doctor or gastroenterologist as directed:

Write down your questions so you remember to ask them during your visits.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.