Relation of intestinal metaplasia to the acid-secreting area.

The distribution of intestinal metaplasia in relation to the acid-secreting are was investigated in 66 patients not suffering from gastroduodenal diseases. Studies were made via the endoscopic Congo Red test in combination with the methylene blue staining method. In this test, the acid-secreting area is identified as a "discolored" area in which Congo Red turns from red to blue-black, and areas of intestinal metaplasia were observed as areas staining blue with methylen blue. A close relationship was found between the acid-secreting area and the distribution of intestinal metaplasia; in general, intestinal metaplasia tended to be more extensive and more frequent when the acid-secreting area was small. It was also found that intestinal metaplasia increased with age. However, even in patients who were over 40 years of age, intestinal metaplasia was seen in 12.5% only, if the acid-secreting area was large. Hence, it appears likely that development of intestinal metaplasia is more closely related to the acid-secreting function than to aging.