I do not know of many people, actually any, who like to go to the doctor. It is easier to go if you have a specific issue like a cold, but it is harder when you are having symptoms like fatigue, headaches, weight gain/loss, and abdominal pain that can be caused by so many things (for example, stress, working too hard and sleep deprivation). How many people today are not stressed, tired, and/or overworked? And if that’s not enough of a deterrent, add in having to discuss your gas, constipation, diarrhea, or other features of your bowel movements, and going to the doctor becomes even less appealing. Then when you finally get to the doctor, it can be difficult for your doctor to diagnose a digestive disorder. One, because in the case of many digestive issues, there is still a lot we do not understand; and two, many digestive disorders have the same symptoms. It took about six years from my initial complaint to my doctor about gas and bloating until I was diagnosed with fructose malabsorption. Year after year during my annual checkup, I mentioned my bloating, gas, and additional symptoms that were developing to no avail. It was not until after one painful night in the emergency room that doctors started diagnostic tests. At the end of months of testing, my doctor said the good news was that I did not have cancer, but the bad news was that I have fructose malabsorption. My two thoughts to hearing this news were, “What is fructose malabsorption?” and, “Wait, I could have had cancer?!”. Maybe that was naïve of me, especially because I am a biologist, but that thought never even entered my mind.
The fact that cancer was a possibility and that I had to wait six years to get tested made me realize the importance of advocating for one’s health. We need to work with our doctors and not solely rely on our doctors for our medical care. If I did not end up in the emergency room, how much longer would it have taken for me to be diagnosed?
One of the things I was tested for was the bacteria Helicobacter pylori. According to the Center of Disease Control, two-thirds of the world population has H. pylori, which lives in the lining of the stomach and can tolerate the stomach’s acidic environment. It can lead to an infection in the stomach and has been shown to cause ulcers. It also happens to be a carcinogen and one of the main causes of stomach cancer (gastric cancer). Although stomach cancer is not as prevalent in the United States as it used to be, 26,000 patients are currently diagnosed with stomach cancer and around 10,000 people die from it per year. However, worldwide it is ranked the fourth most common type of cancer with about one million people being diagnosed and 700,000 people dying from it per year. This is partly because it can be difficult to detect and diagnose until it is in a late stage. Early on, stomach cancer does not have specific symptoms. Further on, people might not think of going to the doctor right away and doctors might not test for it because symptoms include indigestion, heartburn, bloating after meals, slight nausea, and loss of appetite. Later on, more severe symptoms can develop, such as, dark red or black, tarry stools called melena, vomiting, weight loss, abdominal pain, and difficulty swallowing.
H. pylori is only one of the risk factors for developing stomach cancer. Other factors can be chronic gastritis or inflammation of the stomach, gastric polyps, pernicious anemia, previous stomach surgery, family history, obesity, heavy drinking, and smoking. People who consume diets high in red meat, cured meats, salty foods, and processed foods and or diets low in fruits and vegetables are also at greater risk. Additionally, African-American, Asian-American, and Hispanic males over the age of 55 are more likely to develop stomach cancer. Geographically, stomach cancer is most common in Japan, China, Southern and Eastern Europe, and South and Central America.
The good news is that there are ways to limit your risks for stomach cancer. Defenses include staying physically active, reducing your consumption of alcohol cigarettes, and eating a well balanced diet that includes fruits and vegetables and limits processed and salty foods and cured and red meats. Another strong defense is to be aware of your body and symptoms. If you feel bloated, tired, and have acid reflux with any regularity, don’t simply pop an antacid and ignore it; rather, go to the doctor and advocate for yourself. There are easy breath tests to determine if one has H. pylori early on before stomach cancer has developed and antibiotics can eliminate the bacteria. If you have more severe symptoms, ask for an upper gastrointestinal endoscopy, a biopsy, X-rays, and/or CT scans, which can assay for cancer. The earlier doctors can diagnose cancer, the better the chances of fighting the cancer.
My goal is not to worry people into thinking that because they are bloated and have nausea that they may have stomach cancer. Most people who have H. pylori will not develop stomach cancer. However, my hope is that for those who have been ignoring their symptoms, they might instead call their doctor to set up an appointment and learn more about what their symptoms can be so they can be the happiest and healthiest they can be. I relied on my doctor’s advice for six years until I became frustrated enough to start asking for tests to be done. Those were six years of feeling sick and worried. I now know how to better take care of myself and although I still have bad days, a couple of bad days with mostly good days is much better place to be.
Photo taken by Quinn Dombrowski on Flickr