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Intestinal metaplasia is the transformation (metaplasia) of epithelium, usually of the stomach or the esophagus, to a type that bears some resemblance to the intestine as seen in Barrett's esophagus. Chronic infection caused by H. pylori infection in the stomach and GERD in the esophagus are seen as the primary instigators of metaplasia and subsequent adenocarcinoma formation. Initially, the transformed eptithelium bears resemblance to the small intestine; in the later stages, the epithelium resembles the colon. It is characterized by the appearance of goblet cells and expression of intestinal cell markers such as Cdx2.