GASTRIC ULCER AND INTESTINAL METAPLASIA

Abstract

The surface of the gastric mucosa is lined with mucous foveolar epithelial cells, forming the mucous barrier against gastric juice digestion. When intestinal metaplasia (I. M.) appears in the gastric mucosa, foveolar epithelial cells disappear. This study was made to observe whether or not the site of I. M. in the gastric mucosa is subject to ulcer. Specimens were obtained from around ulcers by endoscopic biopsy and were examined for comparison. As a result, I. M. was found more significant in the distal portion of the ulcer than in the proximal portion; in the edge than in the anterior or posterior portion 2 cm distant from the edge; and in the scarring stage than in the active stage; in the recurrent ulcer than in the initial ulcer in patients of the same average age. On the other hand, resected specimens of gastric ulcers were examined by the Tes-tape method, which is used to observe appearance of sucrase, to recognize the sites of I. M. Then, the relationship between the ulcer and I. M, was studied As a result, it proved that I. M. in the gastric ulcer developed from the antrum as I. M. in the stomach without ulcer developed and that ulcer was found in the proximal edge of I. M.. From these observations it was indicated that I. M. was not subject to ulcer and that ulcer enhanced the development of I. M..