Gastric atrophy and intestinal metaplasia
Content date: 14 November 2026
These biopsy findings are not a cancer diagnosis. Their type, extent and your risk factors guide treatment and follow-up.
Your next step
Ask whether you need H. pylori treatment, iron/B12 testing or surveillance. Record the agreed date.
Get urgent help: Vomiting blood, black tarry stool, fainting or sudden severe abdominal pain: seek urgent care.
What do the words mean?
- Atrophy means loss of some stomach glands. Intestinal metaplasia means cells resembling intestinal cells appear in the stomach lining. H. pylori infection or autoimmunity may contribute.
- These changes can raise future cancer risk, but do not mean cancer is present or inevitable.
What happens next?
- Review whether the change is limited or widespread and whether the report describes its subtype or dysplasia. Mention stomach cancer in a parent, sibling or child.
- H. pylori should be assessed, treated if present and checked for eradication. Iron and vitamin B12 tests may be needed, particularly with atrophy or suspected autoimmune gastritis.
Will I need regular endoscopy?
- Low-risk, limited changes may not require routine surveillance. Extensive changes or other risk factors may warrant surveillance, often at three-year intervals with individualized timing. There is no single schedule for everyone.
- Dysplasia requires specialist review and may need closer examination or removal of a specific area. Discuss the result rather than waiting for a routine surveillance appointment.
What can I do?
- Complete prescribed H. pylori treatment, stop smoking and retain both reports. Do not start aspirin or supplements solely to prevent stomach cancer without an appropriate medical reason and plan.
When to get help
Vomiting blood, black tarry stool, fainting or sudden severe abdominal pain: seek urgent care.
Unintentional weight loss, repeated vomiting, worsening swallowing difficulty or dysplasia without a follow-up plan.
Related guides
Understanding endoscopy and biopsy results