Intestinal metaplasia in Barrett's esophagus (BE) is not related to intestinal metaplasia in the stomach

Background: BE is considered a premalignant condition and is associated to chronic GER disease. Intestinal metaplasia (IM) and dysplasia may accompany BE but whether there is an increased frequency of IM in the stomach in patients with BE has not yet been evaluated. The high background frequency of IM in stomachs in Colombia provided an excellent opportunity to evaluate this question. Aim: To investigate the prevalence of IM in the stomach in patients with and without BE. Methods: Patients with endoscopic criteria of BE were studied. Biopsies were taken from the esophagus every 2 cm, starting 2 cm proximal to Z line. 4 biopsies from the body and 4 from the antrum were taken also for histological evaluation. A control group with 29 NUD patients with chronic gastritis and IM but without GER and/or hiatal hernia was also investigated with 3 biopsies from the cardia, 4 from the body, and 4 from the antrum. Results: 33 out of 63 patients, with the endoscopic diagnosis of BE had specialized columnar epithelium in the esophagus. In the control group the prevalence of IM in the stomach was 48%, 69%, and 90% for the cardia, corpus, and antrum, respectively. The frequency of IM in the stomach was slightly higher in BE patients with specialized epithelium than those without (12% vs. 3% and 15% vs. 7% for corpus and antrum respectively) but the differences were not significant. Conclusions: IM in the cardia reflects the severity of the underlying chronic gastritis and is not related to BE nor is it related to the presence of gastric IM in general.