Gastric (stomach) cancer occurs when malignant cells form in the lining of the stomach. By far, it is known to be the second most common cause of cancer-related deaths not only in Asia but also worldwide. Though it can affect both male and female populace, it is seen more commonly in men and in people aged 50 years or older.

Type: Gastric cancers can present as one of the following types - 

Adenocarcinoma: Begins in the glandular cells lining the inside of the stomach. This forms a majority of the stomach cancers.
Lymphoma: Begins in immune system cells present in the walls of the stomach. Occurrence of lymphoma, in the stomach, is rare.
Carcinoid Tumor: Begins in hormone producing cells of the stomach.  Occurrence of carcinoid cancer, in the stomach, is rare.
Gastrointestinal Stromal Tumor (GIST): begins in nervous system cells of the stomach. Occurrence of GIST, in the stomach, is rare.
Gender: It affects both male and female populace.

Etiology: The factors that are associated with increased risk of gastric cancer include the following mostly  

 Helicobacter Pylori  bacterial infection in the stomach is a common cause of gastric cancer of both the intestinal (expanding) & diffuse (infiltrative) type. Furthermore, studies indicate that high salt intake is synergistic with H. Pylori infection in the manner that it is likely to increase the risk of gastric cancer that is induced by H. Pylori bacteria.
Smoking, consuming alcohol, red meat, salty/ smoked/ processed foods, low intake of fruits and vegetables, diets rich in nitroso compounds, eating foods contaminated with aflatoxin fungus etc all.
Atrophic gastritis characterized by chronic stomach inflammation is known to increase the risk multi-fold. Chronic gastric inflammation can lead to atrophy of the gastric mucosa, metaplasia, dysplasia and finally carcinoma.
History of pernicious anaemia, gastric ulcers, adenomatous gastric polyp etc all.
Family history of gastric cancer. Several familial syndromes that have been associated with a pre-disposition to gastric cancer include familial adenomatous polyposis, Lynch syndrome, Peutz-Jeghers syndrome and e-cadherin mutation (diffuse type)
Blood group A, Obesity etc all are known to be associated with diffuse or cardia gastric cancer.
Low socioeconomic status - persistent lifestyle issues/ irregularities including high stress coupled with an improper diet/ dietary pattern.
Epidemiological evidence is indicative of a risk or pre-disposition to gastric/ stomach cancer for people suffering from diabetes mellitus (DM).
Very high dose ionizing radiation exposure is an uncommon risk for gastric cancer.
Features: There are often no early stage symptoms. Early stage symptoms, if any, are non-specific and are likely to be ignored, thus delaying the diagnosis most often. Hence, gastric/ stomach cancer is often detected at an advanced stage where the disease is either locally advanced or metastatic. The various presentations (of signs & symptoms), by stage (early or advanced), of gastric cancer are as enumerated below:

Early Stage   can present with one or more of the following non-specific symptoms/ signs -

Dyspepsia (Indigestion),
Stomach/ Epigastric discomfort,
Bloated feeling after eating,
Mild Nausea/ Vomiting,
Blood in Vomit (Haematemesis),
Heartburn,
Weight loss (Cachexia)
Anaemia,
Occult blood in stool/ Melaena,
Advanced Stage   presents with one or more of the following symptoms/ signs -
GI Bleeding with black tarry stools (Melaena),
Persistent Nausea/ Vomiting,
Blood in Vomit (Haematemesis),
Early Satiety,
Anaemia,
Loss of Appetite (Anorexia),
Weight loss (Cachexia),
Persistent pain in the abdomen,
Fluid build-up in the peritoneal cavity (Ascites),
Edema of the lower extremities,
Liver Enlargement (Hepatomegaly)/ Jaundice,
Difficulty swallowing food (Dysphagia)
Screening: Is generally recommended for asymptomatic populations in high incidence areas or as surveillance for high risk individuals. The goal of screening, as usual, is to be able to detect & diagnose gastric cancer at an early stage which is potentially curable. It is mostly endoscopic/ radiologic.
Diagnosis: Following are the diagnostics employed in gastic cancer - 

Physical Examination: May be remarkable for palpable abdominal mass, weight loss (cachexia), abdominal distension, ascites, hepatomegaly, lower extremities edema and lymphadenopathy for gastric cancers in the advanced stage. For early gastric cancers, however, physical examination is largely uninformative.
Blood: Hb- may be low, ESR   raised, tumor markers CEA & CA-19-9 could be raised sometimes in adenocarcinoma but are not frequently elevated. Abnormal blood test results may be indicative of malignancy, but a follow-up gastroscopy/ biopsy is always the gold standard for accurate diagnosis.
Stool: Occult blood may be +ve
Barium Meal X-Ray: Could show a filling defect at the site of the carcinoma/ cancer growth.
Gastroscopy/ Biopsy: Clinches the diagnosis.
Endoscopic Ultrasound: Maximizes tumor staging as it helps determine the depth of invasion of the tumor.
CT Scan: Of chest, abdomen & pelvis helps detect metastatic disease, if any, and also helps stage the disease (TNM) appropriately.
Bone Scan: Helps detect osseous metastasis (bone mets), if any.
Treatment: Conventional treatment includes surgery, chemotherapy and radiotherapy as contextually appropriate. Surgery (i.e. gastrectomy either sub-total or total), with an adjuvant chemotherapy and/ or radiotherapy as contextually relevant, is the only treatment that is known to cure the disease in light of the prognostic indicators as briefly enumerated in the section below. Chemptherapy and/ or radiation alone cannot be curative. Mostly, it can improve symptoms, and may prolong survival. Simultaneously, an adjunctive or integrative naturopathic treatment with suitable complementary & alternative medicines (CAM) too can help improve clinical outcomes and facilitate recovery as feasible contextually.
Prognosis: For gastric cancer is variable. Preventive measures, earlier diagnosis and right early treatment is key for an effective therapeutic management & better prognosis. Like most other cancers, the chances of cure for an early stage gastric cancer are more. The cure/ recovery chances are influenced by the grade, stage of cancer, recurrence and the patient s general health & vitality etc all. Distal tumors are known to be cured more often than the proximal ones. Again, intestinal-type gastric cancers are known to have a better treatment outlook in comparison to the diffuse-type gastric cancers.

Prevention: Rightly said, prevention is always a better choice. Although genetic risks are difficult to modify, still an adherence to a relative Mediterranean diet, maintaining an ideal body weight and an active lifestyle with due emphasis on regular exercising, de-stressing and relaxation is highly recommended for reducing the risks of many cancers including gastric cancer. A healthy eating plate comprises essentially a low fat diet, fibre rich foods including whole grain cereals, green leafy vegetables cooked using healthy vegetable oils, fresh fruits of all colours as seasonally available and healthy proteins/ fats including fresh fish, poultry, beans, nuts etc all. The consumption of alcohol, if any, has to be strictly in moderation, and is best avoided in a high risk scenario. Smoking is to be avoided too. Again, red meat, butter, refined grains, sweets, sugary drinks including carbonated beverages and other high calorie foods etc all, if any, are to be taken sparingly. Not only it is important to eat healthy, but also it is equally important to eat properly. Insufficient chewing, eating until full, eating meals within a short time etc all are best avoided so as to ease off digestive burden on the stomach/ other organs in the GI tract. Last but not the least, consumption of clean and filtered water, natural probiotics like freshly prepared yogurt/ butter milk, maintenance of cleanliness & hygiene including oral hygiene etc. all can help guard against H. Pylori infections. Breastfeeding is known to be protective against H. Pylori infections too.

Gastric Cancer - In a Nutshell!

Constipation usually refers to the troublesome bowel movement. It is normally referred to a condition where you defecate less than normal. Most people usually experience this at some point, yet it is not considered very serious unless it becomes a persistent problem. Instead of immediately turning to some medicine or laxative, (which usually worsens the issue) attempt some basic home solutions to get rid of your inconvenience, and prevent it from returning. Some of the most effective home remedies to get relief from constipation are:


Oil: Start your day by taking 1 tablespoon of olive oil. It works best when you have an empty stomach, so have it before you eat anything else. In case that you forget, wait until later when you have not eaten for some time. You can blend it with a bit of lemon juice. 
Lemon juice: The citrus extract in lemon juice acts as a stimulant for your digestive system and can flush out toxins and undigested material that may have developed along the walls of the intestine. Avoid blending the juice with water, as this may dilute the effect of the former. 
Caffeine: Caffeine is a natural solution for the digestive system. One or two cups are fine, however, ensure you do not try too hard. Consuming a lot can have the reverse impact. Coffee is a diuretic and makes you urinate more frequently and as often as possible. Yet, it can have a negative impact too. In case that you drink it in excess, it can bring about blockage by dehydrating the body and drawing out water that would otherwise soften your stool for easy passage. 
Fiber: Natural foods have a tendency to contain a huge amount of fiber. To put it plainly, fiber is a material that cannot be processed and it acts like a sponge. It draws water from its environment, making it swell, which makes the stool soft and adds bulk and mass to it, which helps it pass normally. 
Aloe Vera: It is best to use aloe vera gel straight from the plant itself. The gel straight from the plant is more concentrated than processed aloe juice so do not use more than 2 tablespoons. In case that you do not have an aloe plant, then drinking aloe juice can accomplish similar results. 
Baking soda: Baking soda lies at the heart of home cures. It is so flexible, and it practically does its work 95% of the time, as per many medical studies. It works well for constipation (and abdominal pain as a rule) since it is a bicarbonate. It will urge air to leave you somehow and calm pain from the pressure. It additionally re-alkalizes the stomach, killing the acid to some degree and helping waste pass through your gut.

Ayurvedic Remedies to Help You Get Relief from Constipation

Bowel movement is extremely important for the body. An abnormal bowel movement can lead to a painful, hard and dry stool. If the constipation is accompanied by symptoms such as weight loss, abdominal pain and blood in stool, it should be immediately reported to the doctor. For patients who face chronic constipation, there are some great remedies which can be tried at home to fetch great results: 

Olive oil: Olive oil is a healthy fat that can relieve constipation. It not only stimulates the digestive system, but also ensures that the colon functions properly and constipation is prevented. 1 tablespoon of olive oil should be consumed daily in empty stomach.
Lemon: Fresh lemon is a great agent for the stomach. The citric acid found in fresh lemon acts as a great stimulant for the digestive system. Furthermore, it has the ability to flush out undigested materials and harmful toxins that have queued up along the colon walls. It should be consumed every alternate day with 1 cup of warm water.
Molasses: Blackstrap molasses acts as a great agent for relieving chronic constipation. The vitamin, magnesium and mineral content of the molasses make them a perfect solution for the digestive tract. Due to their high fat content, they should be consumed on alternate days. 1 tablespoon of molasses in water should do the trick for addressing constipation.
Coffee: Apart from the fresh aroma of the coffee, they are a great stimulant for clearing constipation. 1-2 cups of it throughout the day should keep you in a good state. Over-consumption of caffeine, on the other hand, can have an opposite effect on the body. It dehydrates the body and constipation are set into motion.
Fibre intake: Natural fruits, grains and veggies such as apricots, beans, nuts, broccoli, potatoes etc. contain a lot of fibre. The body cannot digest fibre but it acts as a sponge and squeeze water from the surrounding making the stool soft and easy to pass. As a matter of fact, even plenty of water consumption helps the body a great deal in relieving constipation.
Aloe Vera: Aloe Vera has multiple health benefits. One of this includes the soothing effect of the tummy. 2 tablespoons of Aloe Vera on a daily basis should be mixed with hot water and consumed before breakfast. Gel extracted from real Aloe Vera leaf serves a better purpose of relieving constipation that the ones that are available in the market.
Baking Soda: Baking soda contains bicarbonate, which squeezes air from the tummy and relieves an individual from the pressure and the pain. Other benefits of baking soda are its acid neutralising and stomach re-alkalizing effect on the stomach. Baking soda can be consumed with warm water on a daily basis.

Chronic Constipation - 7 Ways You Can manage It!

Excessive gas can be defined as bloating, belching, flatulence and burping. It does not matter what you call it, but what matters is how you treat it and get relieved from the embarrassing symptoms. 

Here are some ways in which you can avoid gastric problems:

*Avoid eating foods that can cause gas or acidity. Vegetables which are known to cause acidity are Brussels, Onions, Garlic and Broccoli; dairy products like cheese, milk, ice cream and whole grains can cause acidity. The reason is that these products have fiber, starch and sugar which cannot be digested easily, thus causing pain in the intestines. Fruits which contain sorbitol and aerated drinks should also be avoided. Eat everything but in moderation.

*Avoid drinking before meals as the stomach acids are lost and the food cannot be digested well. Water and liquids should be taken half an hour after a meal for a better digestion.

* Food should be eaten slowly. Eating and drinking quickly, allows a lot of air to go into the stomach with the food. This in turn can cause a stomach pain.

* Over the counter drugs can be taken for immediate help in digestion. These medicines contain enzymes which aid in digestion. The enzyme works to dissolve the sugar that is found in many fruit and vegetables.

* Some habits like chewing gum, drinking from a straw and smoking, etc. causes air to fill in the stomach, thereby, leading to gas.

* Artificial sweeteners such as sorbitol should be avoided as these are difficult to digest and can easily lead to a feeling of bloating. 

However, all the pains might not be due to gas and could be a sign of something serious. These could be:

* Lactose intolerance: This is the inability to digest milk and milk products. The sugar in the milk is known as lactose and cannot be digested easily. 

* Irritable bowel syndrome: People who suffer with pain in the lower abdomen constantly might be suffering from IBS.

* Colon cancer: If the pain lasts too long then getting a screening done is a good idea to rule out if one is suffering from colon cancer or not.

* Upper gastrointestinal disorders: If one gets belching occasionally, then it is alright, but a constant belching might be a sign of gastrointestinal disorder in the upper tract. These could be gastroesophageal reflux disease (GERD), gastroparesis, or peptic ulcers.

Gastric Problems - Effective Ways To Manage It!

The food you eat plays an important role in your gastrointestinal health. Some foods can be difficult to digest and lead to bloating and heartburn while others increase the healthy bacteria in your gut and make digestion easier. 

Here are ten things you should include in your diet for a healthy digestive system.

1. Bananas: Bananas help regulate bowel movements and help bind food waste together thus helping with irritable bowel syndrome and diarrhea. They also help restore the electrolyte and potassium balance in the stomach.

2. Oats: Oats are rich in fiber and low in calories. It is also a rich source of phosphorus, vitamin E and Zinc. Oats helps with the proper functioning of the digestive system and the extraction of waste.

3. Curd: Curd rice is the most well known home remedy for an upset stomach. Curd is a rich source of probiotics that helps restore the balance of healthy gut bacteria and eases digestion.

4. Coconut oil: Coconut oil is an excellent substitute for normal cooking oil or butter. Coconut oil has antimicrobial properties and fatty acids that ease the digestive system and boost immunity and energy levels.

5. Lentils: Lentils are rich in prebiotics and fiber. These prebiotics promote the growth of healthy gut bacteria and prevent harmful bacteria from causing stomach infections.

6. Ginger: Herbs and spices are very helpful with digestion. Amongst these, ginger is foremost. It can be used to treat a number of stomach infections such as bloating, nausea and diarrhea. Ginger also helps 
speed up the movement of food from the stomach to the intestines.

7. Vegetables: Vegetables are rich in fiber and probiotics. While beetroots help relieve constipation, sweet potatoes help treat ulcers and bowel problems. Other vegetables that aid digestion include cucumbers, tomatoes and carrots.

8. Brown rice: A certain amount of carbohydrates are essential for a well balanced diet. Brown rice has a high calorific value but is less fattening. Brown rice helps food move smoothly through the digestive system and hence promotes regularity.

9. Peppermint: Peppermint helps ease indigestion and symptoms of irritable bowel syndrome. Peppermint can be had on its own as a flavoring agent in salads and on fruits or taken as a supplement.

10. Water: Water is crucial to healthy digestion. It helps smooth the movement of food through the digestive system and out of the bowels. Inadequate water is one of the most common causes of constipation. Ideally, you should have a minimum of 8 to 10 glasses of water a day.

10 Foods That Support Your Digestive Health

Constipation is an uncomfortable problem which causes bloating and build of gas. The problem can be painful if the gas is building up for more than 3 days. The only way to reduce constipation is to make changes in the diet and including leafy vegetables and fluid in daily diet. Fruits and vegetables are the best way to relieve from constipation. The fibre content in fruits and vegetables help in timely stools and hence, reduce constipation.

What Drinks are Good to Relieve Constipation?

Here are some of the drinks that one can try:

Apple Juice -
An apple has the highest fibre contents. You can make fresh apple juice in the home by cutting apples into small pieces and grinding them into a paste. Pass the content in the sieve and extract juice from it. The apple is a good source of pectin, which is soluble fibre and helps in relieving from constipation. Make this drink in the morning and drink it while it is still fresh.

Prune Juice -
Prunes (also known as dried plums) have mild laxative effects. Dried plums are very rich in dietary fibres, and are very healthy for bowel movements. With the laxative properties, they are best suited to people who are unable to go for regular stools. Take some prunes and soak them in water for overnight. In the morning, when they are soft and mushy, grind them into a fine paste. Extract the juice and drink immediately.

Salty Lemon Water -
The easiest drink to calm constipation is the Lemon water with salt. Lemons are a very good source of Vitamin C and fibres which regulate the bowel system. Salt is good for a bowel movement and healthy for maintaining PH balance. You can add lemon juice in a glass of water with two pinches of table salt. You can also add black salt or pink Himalayan salt for energy.
What is a Safe Laxative to Use Daily?

Over the counter, laxatives are not recommended for a long time. There are some natural laxatives available for daily consumption like prunes and pomegranate. Apart from fruits, you can also take fibre supplements which provide essential fibres to the body and help you calm constipation.

How Much Prune Juice Should I Drink to Poop?

Prune juice is not advisable if you are facing dysentery. However, prune juice is recommended by the doctors to treat constipation in adults as well as children. Prune has laxative effects in the body. Hence, its consumption should be limited according to the needs of the patient.

Do Prunes Make You Poop Right Away?

There is no evidence that prunes induce poops right after drinking. They help to add bulk to the food in the digestive system, which allows you to digest food quickly. It contains soluble fibre, which is helpful as a mild laxative.

Takeaway 

There are many fruit juices which help in treating and reducing the problem of constipation. However, it is advisable to consult a Gastrologist before making a change in the diet.

Constipation - Know Best Juices For It!

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