Is it Acid Reflux…or Stomach Cancer?

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Your belly hurts in a new way and you begin to research your symptoms. As you play connect-the-dots with what you’re reading, you start to wonder, “Am I experiencing acid reflux or is it something more serious, like stomach cancer?” The symptom lists of the two conditions read eerily similar, and maybe you know someone who knows someone recently diagnosed with stomach cancer and with the same symptoms as you. But before you go down that rabbit hole, let’s consider the key characteristics of each condition.


What is Acid Reflux?

After you eat, the muscle at the end of your esophagus known as the esophageal sphincter ordinarily closes to keep food where it's supposed to be: in your stomach. According to the National Institute of Health (NIH), gastroesophageal reflux, or GER, occurs when the sphincter becomes weak and allows your stomach contents to come back up. The result? That tell-tale burning sensation in the middle of the chest. When someone experiences heartburn on the regular, it can become a condition called gastroesophageal reflux disease (GERD).


Mucinous adenocarcinoma of the stomach
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What is Stomach Cancer?

Stomach or gastric cancer occurs when abnormal cells form and multiply in the lining of the stomach. The majority of gastric cancers are adenocarcinomas that begin in the innermost mucosal layer of the organ. According to Memorial Sloan Kettering Cancer Center in New York City, other types of cancers that occur in the stomach are gastrointestinal stromal tumors, which start in the stomach muscle, carcinoid tumors that begin with the stomach’s hormone producing cells, and lymphoma.


What are the Symptoms of GERD?

In addition to causing heartburn, “[GERD] also often presents with regurgitation, which is the sense of liquid material moving from the stomach up through the throat. These symptoms frequently occur after eating,” says Jeffrey Alexander, M.D., professor of medicine, and the head of the Esophageal Clinic at the Mayo Clinic in Rochester, MN. If the symptoms are up in your chest and they go away with acid-blocking drugs then that’s probably reflux.


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What are the Symptoms of Stomach Cancer?

“Gastric cancer presents differently,” Dr. Alexander says. “The usual presentation is with nausea, weight loss, and upper abdominal pain.” Symptoms of more advanced stomach cancer can include vomiting, stomach pain, weakness, frequent burping, jaundice, fluid buildup in the abdomen, and trouble swallowing. If you’ve got something down in the pit of the stomach that is present 24/7 or continual pain in the abdomen, these symptoms suggest gastric cancer.


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When Should You Get Tested for GERD or Stomach Cancer?

You should make an appointment with your doctor if you have any concerning symptoms of GERD or stomach cancer including: frequent vomiting; throat pain, loss of appetite, or stomach pain that lasts more than a week; or unintentional weight loss.

Also important to know: One symptom of GERD is chest pain, which, according to the Mayo Clinic, can also be a symptom of a heart attack. You should seek immediate medical attention if you have chest pain especially if you also have a shortness of breath and jaw or arm pain.


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How is GERD Diagnosed?

A physician can often make a GERD diagnosis based on patient symptoms, says Tsion Abdi, M.D., an assistant professor of medicine in the division of gastroenterology at Johns Hopkins School of Medicine in Baltimore. “To confirm a diagnosis or check for complications, doctors may recommend further evaluation with upper endoscopy, motility testing such as an ambulatory acid (pH) probe test or imaging with a barium swallow,” he adds. In a barium swallow test, you gulp a thick, chalky drink. As you swallow the barium, a radiologist takes pictures via x-rays or fluoroscopy to see how the barium moving through your mouth and throat.


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How is Stomach Cancer Diagnosed?

To assess overall health, your doctor may start with a physical exam, blood chemistry study, and/or a complete blood count (CBC). Similar to a doctor who is testing for GERD, Dr. Abdi says testing for gastric cancer can include, “upper endoscopy and imaging test such as CT scan with barium swallow.”


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How is GERD Treated?

GERD is managed with lifestyle modifications such as avoiding late-night noshing, eating big meals, or lying down immediately after meals, Dr. Alexander says. “You also treat it with medications to block acid," he adds. "Antacids are a short-term way to bind things up and H2- blockers work to prevent acid secretion for 8 to 12 hours. Proton-pump inhibitors are the strongest acid-blocking drugs. We can also do esophageal-reflux surgery where we wrap some muscle around the bottom of the esophagus and the top of the stomach to make a new valve.”


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How is Stomach Cancer Treated?

“Gastric cancer is a growth in the stomach that is treated with surgery,” Dr. Alexander says. “You can also do chemotherapy and radiation, but surgery is the primary therapy.” According to the American Cancer Society, exact treatment depends on the type and stage of the tumor.


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Are GERD and Stomach Cancer Hereditary?

Probably, say experts. According to Dr. Abdi, you're at greater risk of gastrointestinal cancer if a close relative has or had it. And while they couldn’t find a specific gene, researchers at the University of Amsterdam found a pattern of inheritance of GERD among multi-generational family members.