Barretts: stomach or intestinal metaplasia

  When a biopsy is taken for Barretts, what are the odds that it will reveal stomach vs intestinal metaplasia ? Also, if it is stomach metaplasia rather than intestinal does this mean that it is not Barretts and that one does not have to have regular followups ?
Dear Richard,
Over the years there has been much controversy over the term Barrett's esophagus. The term refers to a change in the lining of the lower esophagus.More recently the term columnar lined mucosa has been introduced.This change in the lining can have three types of columnar epithelia: gastric fundic type(stomach), junctional (cardia-the type lining the area between the esophagus and stomach) and specialized intestinal type (lining looks more like intestinal cells-goblet cells, mucus secreting cells and villiform surface. The specialized intestinal metaplasia (change in the lining) is the most common, and appears to be the most important of the three epithelial types. Dysplasia (glandular distortion) and cancer in Barrett's esophagus almost invariably are associated with specialized intestinal metaplasia. Surveillance endoscopies are currently recommended only for patients who have specialized intestinal metaplasia. I hope you find this information helpful.

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