The common problems of stomach seen in patients are related to stomach ulcers and cancer.
Stomach (Gastric) Ulcers
They can present with upper abdominal pain, bleeding or sometimes repeated vomiting. The cause may be tobacco, smoking, alcohol, too spicy and fatty food and sometimes due to infection with bacteria called H pylori. An Endoscopy is required to diagnose this condition. Patient may need long course of antacid medication. Sometimes emergency endoscopy, admission and occasionally emergency surgery may be required if there is massive bleeding from the ulcer or the ulcer perforates (becomes a hole through and through the wall) leading to spread of infection in your tummy. Very rarely a long standing ulcer can block the outlet of stomach due to recurrent scarring. Such patients have recurrent vomiting and lose weight. After thorough evaluation to exclude cancer, such patients may need laparoscopic bypass surgery to open up their Gastro Intestinal passage.
Overall due to availability of newer and better antacid medications, the complications of stomach ulcer is less frequently seen compared to the past.
Stomach (Gastric) Cancers
Stomach cancers are generally detected very late. As stomach can accommodate a large size of tumour, major problems like blockage of the outlet of stomach or bleeding occurs late. Minor problems of the initial disease are very commonly ignored leading to a delay in detecting the stomach cancers at an early stage. This is the reason we many a times advice for an endoscopy and/or a CT scan even for minor problems, especially if the problem does not improve with primary treatment.
Gastric cancers need multi disciplinary treatment for good outcomes. First of all, a thorough evaluation of the stage of the disease under the guidance of expert Upper G I Surgeon in needed. For cancers that are in a curable stage, a multi modal treatment with initial chemotherapy followed by re-evaluation and then surgery, followed by chemotherapy is the ideal treatment. As such each patient is different and treatment plan may change during the course depending upon the patient’s response to treatment.
Surgery for Gastric cancer is commonly done by laparoscopic method in today’s time. This improves the outcome and helps in faster recovery after such major surgery.