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If you experience recurrent or persistent gastric pain, heartburn, loss of appetite, loss of weight or anaemia, it may be best to consult a doctor for a proper diagnosis. Read on to find out what some common causes are. People often dismiss discomfort in the stomach as ‘gastric pain’ but Consultant Gastroenterologist Dr Chua Tju Siang cautions that that could be too simplistic. “Upper abdominal pain is often called ‘gastric pain’, implying that the pain is caused by a condition of the stomach. Though this is often the case, there’re other very serious conditions that can cause this too,” he explained. So what causes it? Upper abdominal pain or discomfort is usually due to inflammation or abnormal growths. The exact cause can only be determined after investigative tests. Given the high incidence of upper gastrointestinal cancers in Asian populations, Dr Chua says it’s important to do so to rule out possible malignancy. Here are some common causes: Gastro-oesophageal reflux disease (GERD): In some people, the lower oesophageal sphincter relaxes inappropriately, resulting in backflow of acid into the oesophagus and causing inflammation of the lining. Persistent inflammation can increase the risk of developing cancer. Look out for heartburn, acid regurgitation and a feeling of food getting stuck. Less common symptoms include excessive burping, a persistent sore throat and a persistent cough. Oesophageal cancer: About 100 new cases of oesophageal cancer are diagnosed in Singapore each year, more commonly among the Chinese than Malays and Indians, and with a steep rise in incidence after the age of 40 years. Risk factors include smoking, alcohol consumption and GERD. “A small cancer may not cause any symptoms but as the tumour grows larger, the path to the stomach becomes obstructed, leading to pain and difficulty when swallowing solid food and even liquids,” says Dr Chua. Hence, also watch out for weight loss. Gastritis, Gastric ulcer, Duodenitis, Duodenal ulcer: Gastritis refers to inflammation of the stomach lining while duodenitis is inflammation of the duodenal lining. These are commonly caused by the Helicobacter pylori infection. A course of antibiotics and acid suppressants can usually wipe out this nasty bacteria. Taking non-steroidal anti-inflammatory drugs (NSAID) such as aspirin, ibuprofen, mefenamic acid could also result in these conditions. Prolonged gastritis or duodenitis may lead to ulcers. As gastric ulcers may also be due to malignancy, multiple tissue samples would have to be investigated and repeat endoscopy done to make sure your ulcer heals completely. Untreated peptic ulcers can bleed or even result in the perforation of the stomach or duodenum. Stomach cancer: Common in both males and females, risk factors include a family history of gastric cancer and Helicobacter pylori infection. As the stomach is a relatively large hollow organ, symptoms rarely develop until the cancer is quite extensive. Symptoms tend to be vague, such as upper abdominal discomfort, bloating, feeling full after eating only a small amount of food or weight loss. The patient may also suffer from anaemia due to a loss of blood over a period of time. Pancreatitis: Inflammation of the pancreas, a gland behind the stomach that produces digestive enzymes, can cause severe abdominal pain which often requires hospitalization. Acute pancreatitis that surfaces suddenly can even be life-threatening. The most common causes are alcohol consumption or gallstones. Repeated episodes of acute pancreatitis, known as chronic pancreatitis, can lead to permanent damage and develop into pancreatic cancer. Pancreatic cancer: More common among those aged 45 years and older, risk factors include smoking, chronic pancreatitis and a family history of pancreatic cancer. Watch out for common symptoms like abdominal pain, obstructive jaundice (often without pain) and substantial weight loss. The pain from pancreatic cancer is usually severe and continuous, although small tumours may sometimes go unnoticed as they may not cause any symptoms. Gallstones: The gallbladder is a small, pear-shaped sac below the liver in the right upper abdomen. Its job is to store bile, which is made in the liver, until the bile is needed to help digest fat. It’s then ejected through a tube called the bile duct into the small intestine. If the bile in the gallbladder is too concentrated, this can cause stones to form. Gallstones then cause inflammation of the gallbladder, resulting in upper abdominal pain on the right sight. The most common treatment for symptomatic gallstones is Laparoscopic (keyhole) surgery to remove the gallbladder. But if they get trapped in the bile duct, it’ll require a specialized endoscopic procedure to remove the stones.
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