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Nausea, indigestion, heartburn: Do these symptoms mean GERD or stomach cancer?

From a wrong diet to a flu to a pre-existing gastrointestinal condition, many factors can cause your belly to hurt. A stomach pain is usually benign and easily treatable with changes in diet and medications. But what if your stomach pain is persistent, feels unusual, and disrupts your daily activities? What if the related symptoms indicate GERD (gastroesophageal reflux disease) or something more serious like stomach cancer? How do you differentiate between the eerily similar symptoms shared by both the conditions?

To clear the air, Dr. Azhar Perwaiz, Associate Director, GI Surgery, GI Oncology and Bariatric Surgery , Institute of Digestive and Hepatobiliary Sciences, Medanta, Gurugram, explains, “Stomach cancer and GERD are both different. The first occurs when cancer cells proliferate uncontrollably in the stomach and grow rapidly in the stomach, also known as gastric cancer,while GERD occurs when stomach acid regularly flows back into the tube that connects your mouth and stomach.”

According to the doctor, there is no known cause of stomach cancer, but there are risk factors that can increase the risk:

• Tobacco use and excessive consumption can increase the risk of stomach cancer

• Obesity has been linked to an increased risk of stomach cancer. It can raise the risk because of altered insulin signaling, chronic low-grade inflammation associated with obesity, and altered sex hormone metabolism

• Regular consumption of salty foods has been linked to an increased risk of stomach cancer. This includes foods that have been dried, smoked, salted, or pickled, as well as foods with a high salt content. Fresh fruits and vegetables as part of a healthy diet may help reduce your risk.

On the other hand, sedentary lifestyle, alcohol, obesity, smoking, and an unhealthy diet all contribute to GERD, the doctor shares.

How to differentiate between the symptoms of GERD and stomach cancer?

Dr Samit Jain, MD; DM; DNB Gastroenterology, Berenson’s Scholar in Advanced Endoscopy (Harvard Medical School, USA), Consultant Gastroenterologist, Hepatologist, & Therapeutic Endoscopist, Jaslok Hospital & Research centre, Mumbai, Patient with GERD will have symptoms like reflux, retrosternal chest pain, nausea, recurrent vomiting, whereas clinical patient with stomach cancer are likely to have symptoms such as loss of appetite, significant weight loss (Approx 10% of total body weight), persistent upper abdominal pain, sometimes recurrent vomiting, in addition to the kind of symptoms experienced by GERD patients.

As per Dr Perwaiz, loss of appetite and weight loss are two of the most common symptoms, while burning beneath the chest, food returning to the mouth, a lump in the throat, and upper abdomen pain are more common with GERD.

Treatment options

Given that GERD is more benign, certain lifestyle changes like losing weight, avoiding fatty and spicy foods and medications can help ease GERD symptoms. In more serious cases. Dr Jain says treating GERD with surgery is an option. “A patient also may also opt for surgery if he or she does not want long-term dependence on medications and their possible side effects,” he adds.

In the case of stomach cancer, it is best managed under the care of a multidisciplinary team.

Treatment options depend upon the stage of the cancer, which includes:

Radical surgery

Chemotherapy

Radiotherapy
Immunotherapy

According to the doctor, if the symptoms are similar or if the patient develops alarming symptoms like significant weight loss, swelling in upper abdomen region, persistent vomiting even after taking medications, low haemoglobin (Anaemia), they may require gastroscopy and certain imaging modality like Ultrasonography or CT abdomen to confirm the diagnosis of stomach cancer.

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