WHEN we experience discomfort, pain or uneasiness in the stomach, most of us asssume that’s it’s either gastric, wind or stomach ache.
But there are a number of conditions that can affect the stomach and cause pain or discomfort. Furthermore, the stomach — which is part of the digestive tract between the oesophagus and the small intestine — is but one of several organs in the abdomen, says Datuk Dr S. Mahendra Raj, a gastroenterologist from Pantai Hospital Kuala Lumpur.
“It is common for a patient to claim that he has ‘gastric’ or ‘wind’ simply because he has stomach discomfort. The term ‘gastric’ is a misnomer. We have to understand that the conditions affecting the stomach per se can cause symptoms which can be very similar to that of other conditions affecting the rest of the digestive organs like the pancreas, gallbladder, small and large intestines or the liver.
“We have to realise that abdominal discomfort can be due to a multitude of conditions,” says Dr Mahendra who specialises in internal medicine and gastroenterology.
COMMON GASTROINTESTINAL PROBLEMS
When it comes to abdominal discomfort, the cause could be either one of a number of serious gastrointestinal diseases such as stomach ulcers, gallstones or cancer, which cane lead to serious complications and life-threatening situations. Or, equally, it could be one of several less dangerous conditions that can be managed without the need for any major interventions.
Examples of the less serious group of conditions are Gastroesophageal reflux disease (GERD) and gastrointestinal functional disorders, the latter being an umbrella term to describe common disorders which result in various types of abdominal discomfort or altered patterns of passing stool.
“Functional dyspepsia, irritable bowel syndrome (IBS), functional heartburn and periodic abdominal pain are among the medical terms used to describe conditions that are categorised as functional gastrointestinal disorders and are responsible for a wide range of symptoms like abdominal pain, bloating, nausea, uncontrolled belching or difficulty in passing motion.
“Besides certain types of food, these conditions can also be triggered by stress and emotional distress,” says Dr Mahendra.
“GERD and functional gastrointestinal disorders are not serious in the sense that they are not life-threatening but nonetheless have a major impact on quality of life, work productivity and medical costs. They are often long-term conditions that are managed with lifestyle modification and medication,” he adds.
Peptic ulcers, gall stone disease and cancers are among the common serious gastrointestinal disorders.
Peptic ulcers are often caused by certain types of painkillers or Helicobacter pylori, a type of bacteria present in more than half of the people in the world. People infected with this bacteria are at a higher risk of getting peptic ulcers and stomach cancer, says Dr Mehandra.
“However, it should be emphasised that only a minority of all people who are infected with Helicobacter pylori will get gastric cancer or ulcers, depending on a multitude of factors including genetic differences, diet, and factors relating to the bacteria itself,” he adds.
This makes it difficult to predict which particular infected individual will be unlucky enough to get gastric cancer or ulcers. Therefore, individuals who have no complaints but have been found to be harbouring the bacteria during a routine test should discuss the issues surrounding treatment of this infection with their doctors.
Stones in the gall bladder and causing pain are also becoming increasingly common and are probably related to genetic factors and Westernisation of our dietary practices in recent decades.
Colon cancer is an increasingly common cancer in Malaysia, being the commonest cancer among Malaysian men and second only to breast cancer among Malaysian women. However, on the plus side, it’s a cancer that's potentially detectable at an early stage by a procedure called colonoscopy.
“Unfortunately, the symptoms of gastric cancer and pancreatic cancer often become apparent only when the conditions are already at an advanced stage. The symptoms of both conditions can be abdominal pain or discomfort, weight loss, jaundice, bleeding, bloating, vomiting blood or passing blood in stool,” he says.
So, when should a person be cautious about the symptoms he is experiencing?
Dr Mahendra says that since abdominal problems can be due to many things — some benign and troubling but not serious, while others could be potentially life-thretening — symptoms may often overlap. Thus, it is important to go for a check-up.
“See the doctor immediately if you feel severe pain in your abdomen or you have serious abdominal discomfort for days. You should also be aware of serious or red flag symptoms such as bleeding when passing stool, unexplained weight loss, looking pale or anaemic or vomiting blood – and this is particularly important for people aged 45 and above.
“Describe what you are experiencing so it can ease the diagnose process and enable you to get the right treatment.”
RED FLAG SYMPTOMS AND SIGNS
SEE the doctor immediately if you have these symptoms:
- Severe or persistent pain in the abdomen
- Sudden or unexplained weight loss
- Vomiting blood
- Difficulty swallowing
- Bleeding or passing blood in your stool
- Black stool
- Looking pale
- Feel a lump in your abdomen
TIPS TO MANAGE COMMON GASTROINTESTINAL PROBLEMS
- Avoid spicy, oily or any food that can trigger symptoms (if you have GERD)
- Reduce coffee and alcohol intake (if you have GERD)
- Eat a healthy diet (sufficient intake of fruit, vegetables and fibre)
- Eat in moderate amounts
- Avoid eating too much at one go
- Avoid lying down right after a meal
- If you are overweight, try to lose the excess kilos
- Manage stress (if it is the trigger)