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!

In recent years there has been a rise in gastrointestinal disease due to lifestyle changes. Conditions like irritable bowel syndrome, gastroesophageal reflux disease, nonalcoholic fatty liver, cancer of colon, liver and pancreas have been affecting the young and the elderly equally.

The advancement of medical science has given rise to a series of laparoscopic surgeries relating to gastrointestinal diseases. These surgeries are minimally invasive compared to open surgeries. Let s have a look at the various forms of gastrointestinal surgeries.

Conditions Cured through Gastrointestinal Surgeries:

Gastrointestinal surgery can be used to prevent and treat the following health disorders.

  Peptic ulcer disease
  Barrett s Esophagus
  Hiatal hernia
  Radiation bowel injury
  Gastrointestinal tumours
  Inflammatory bowel disease
  GERD
  Achalasia
  Malignant disease of the pancreas
  Malignant disease of the biliary tract
  Infectious disease of the colon and rectum

Types of Gastrointestinal Surgeries:

Some examples of gastrointestinal surgeries include  

  Colon Cancer Surgery   It may involve local excision which is done in the early stage of colon cancer. Here the doctor inserts a cutting tool into the colon to remove the cancerous growth. Colectomy is the next stage that is performed only when the cancer has spread to the nearby tissues.

  Oesophagal Cancer Surgery   It includes esophagectomy or removing the oesophagus partially leaving the patient with the ability to swallow.

  Gall Bladder Cancer Surgery - It involves four stages of treatment namely Cholecystectomy, Surgical Biliary Bypass, Endoscopic Stent Placement and Percutaneous Transhepatic Biliary Drainage. Each procedure is performed at different stages depending on the severity of the condition.

  Liver Disease Surgery   Liver disease surgery involves Partial Hepatectomy, Liver Transplant and Ablation used at different stages of cancer.

  Pancreatic Cancer Surgery   The four stages of pancreatic cancer surgery includes Whipple procedure, Total Pancreatectomy, Distal Pancreatectomy and Gastric Bypass.

Apart from these open surgeries, the laparoscopic procedures include  

  Laparoscopic Adrenalectomy
  Laparoscopic Appendectomy
  Laparoscopic Nephrectomy
  Laparoscopic Splenectomy

Benefits of a Gastrointestinal Surgery:

  Minimally invasive due to which scarring is less
  Shorter recovery period
  Reduced chances of infection
  Reduced chances of reoccurrence of the disease

Most of these benefits apply specifically to the gastrointestinal surgeries performed using the laparoscopic technique.

With the rampant increase in gastrointestinal diseases among the masses the wide ranges of gastrointestinal surgeries have made treatment and prevention easier and more accessible.

Gastrointestinal Surgery - Everything About It!

Consuming too much alcohol can cause people a lot of problems like nausea and headache. Additionally, it can also mess up with your bowel movements and affects your motions by giving you loose motions or constipation. Alcohol hinders digestion, causes dehydration and drying out, discourages glucose metabolism and compromises the working of the central and peripheral nervous systems. The combined effect of these components is the primary reason for chronic constipation, identified with alcohol misuse. 

Here are a few reasons why and how alcohol can mess up with your poop:

Dehydration: Alcohol tends to dehydrate the body almost as much as a session in a sauna does. That is the reason your mouth feels so dry the next morning. Once your body gets dehydrated, it works extra minutes to recover the liquids and electrolytes from any place it can find them, including from the substance of your stomach. Accordingly, stools become dry, hard and difficult to pass.
Powerlessness to move bowels: Alcohol smothers intestinal peristalsis and kills the urge to move your bowels. For the same reason, it kills your decision making ability. Inability to move your bowel when you want, expands, impacts and solidifies the already dried out stools until it gets too difficult to go out without straining and subjecting yourself to anorectal harm. These are the two issues that usually precede chronic constipation.
Loss of electrolytes: Alcohol causes loss of electrolytes that are vital to hold dampness in the poop. Eg. Sodium and potassium. Water maintenance in the body and stools requires sodium and potassium, the minerals known as electrolytes. These are not stored in the body for the same prolonged way as calcium or magnesium and they require constant replenishment. Since alcohol stimulates urination and regularly causes diarrhea and nausea, these minerals are rapidly lost.
Occupies digestion: Alcohol in excess causes extreme vomiting that encourages the majority of the above conditions. Liquor hinders stomach absorption and causes deferred stomach emptying. This condition is known as gastroparesis. After around 8 to 10 hours inside the stomach, undigested proteins begin to spoil. This can lead to loss of appetite and the inability to eat proper meals.
Diarrhea: Alcohol affects your glucose level to such a degree that it might bring about loss of bowel capacity control and result in loose bowels, with symptoms like vomiting and nausea. Just like sometimes the knees go powerless on you from an excessive amount of alcohol, so does your bowel movement. In turn, diarrhea and vomiting are caused due to excess intake of alcohol may bring about serious irritation of the whole GI tract and digestive system, and fester in the body for quite a while.

Can Drinking Alcohol Mess with Your Poop?

Your stomach is lined with a mucosal membrane known as the mucosa and due to a variety of factors, it may become inflamed. This inflammation may cause a lot of problems and complications which are grouped under gastritis.
Symptoms of gastritis

Upper abdominal pain,
Hiccups
Diarrhea,
Nausea
Heartburn
Constipation
Reduction of appetite
Blood in the stool amongst the others
Gastritis can be quite debilitating and limiting for the people affected by it.

The Ayurveda approach
Ayurveda is a holistic form of medicine which takes into account many factors rather than just the physical disposition and symptoms that strives to cure the patients of the illness in a well-rounded manner. To this effect, Ayurveda helps you treat this problem with multiple angles of attack such as herbal medications and special cleansing therapies among many others. Let s take a look at some of the methods usually employed in various combinations among the patients.

Changes in diet: Consuming any diet which has a lot of spicy and rich foods over prolonged periods may result in gastritis and other problems. If you already have gastritis, then certain other types of food also need to be excluded such as tea, coffee, sour foods, chilies and buffalo milk among others. These food groups are excluded as they may increase the acidity of the stomach which may cause an escalation of the problems. Some of the foods that may help with gastritis are grapes, pumpkins, bitter gourd, pomegranate, melons and cucumber, etc.
Natural remedies: Some natural remedies that can be very effective in dealing with the symptoms of gastritis are mentioned below
Ajwain and rock salt have been an age old remedy in treating multiple gastrointestinal disorders and can be effective in this case as well.
Lemon juice is also very effective in treating symptoms or gastritis and also reducing inflammation.
Take amla, ginger, and licorice either in a raw form or as a dried option or mixed with other things such as milk or honey. These help in regulating and reducing the acidity within the stomach.
Ayurvedic medications: There are many specialized Ayurvedic medications which can be used to treat gastritis such as:
Amalaki choorna
Avipattikara choorna
Sootashekhara rasa
Sukumara Ghrita
Dhatri Lauha
However, you should consult a specialist Ayurveda doctor as they can prescribe the correct medications for you after studying your specific symptoms.

Gastritis - How Ayurvedic Remedies are Helpful?

Lactose intolerance is a condition wherein you are not able to digest lactose, which is a sugar found in milk. Other foods that contain lactose include cheese and ice-cream. Inadequate production of the lactase enzyme in children causes lactose intolerance. This enzyme is produced in the intestine that helps in the digestion of lactose.


Lactose intolerance is often confused with milk intolerance. The symptoms are similar but they do not share the same cause. Milk allergy is an adverse reaction towards milk and it is a problem of the immune system, whereas lactose intolerance involves the digestive system.


Symptoms-
The symptoms of lactose intolerance are:
Bloating; on consumption of milk over a period of time
Diarrhea is also very common
Stomach pain
Nausea


Diagnosis-
It is self -diagnosable; just strike out foods containing lactose from your child s diet and see if the symptoms get better with time. If the symptoms happen to fade away gradually, then it certainly must ve been lactose intolerance.
However, it can be tricky as many non-dairy products also contain lactose.
If the child is lactose intolerant, then he/she might have to undergo a lactose breath test. This is used to test the levels of hydrogen in the child s breath after the child consumes a lactose solution. Usually, hydrogen levels are low in one s breath. However, if the lactose solution is not digested properly, then it will lead to a temporary increase in the levels of hydrogen in the breath, thus indicating lactose intolerance.


Treatment-
This disorder does not have a cure; so in case your child has lactose intolerance, you need to adjust his/her diet accordingly. Over-the-counter lactase is also available that helps in digesting lactose based foods. You can also go for the  lactose- free  milk variety for your child.


Lactose Intolerance in Kids

When you have pain in the stomach that is accompanied by nausea and vomiting, chances of you having chronic gastritis are high. This is an issue that specifically affects the stomach and is caused because the lining of the stomach gets inflamed and swollen and in some cases it may get damaged. The deterioration of the lining may be caused because of a bacterial infection and that would have to be treated with specialised medicines and treatment methods.During that time you may feel like there is something wrong with your digestive system and you may need to see a doctor for the constant pain that you have to go through as soon as you eat something.

Getting help
There may be times when you can no longer cope with the pain that may be occurring in your stomach. You may want to go to sleep or just sit still and do nothing; however, you cannot spend your entire life in that manner and you may have to consult an expert to get relief from the problem. One of the first steps in coping with chronic gastritis is to make sure that you make important lifestyle changes, such as eating healthy, choosing the right timings for eating, cutting down on alcohol and smoking and making sure that you choose a well-qualified and experienced doctor for getting the treatment.

Treatment
Apart from lifestyle changes, it is highly essential to follow a medication routine in order to beat the chronic gastritis completely. Doctors may suggest you take the medication according to the severity of the problem, but before that, you may be asked to go through a number of tests to confirm the problem. The tests may range from regular blood tests, stool tests, to endoscopy or even biopsy in some severe cases. After the testes are done, the doctors may be further sure about the the problem and that would be of great help in treating the issue with much more ease and expertise.

While it may be obvious to you that you suffer from chronic gastritis due to the constant pain in the stomach, it is also important to understand that the problem should not be taken lightly and that the right steps of the treatment should be taken in time before the problem gets worse.

Chronic Gastritis - How to Cope with it?

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