Stomach

The stomach stores and begins digesting food before passing it to the small intestine. Stomach conditions include ulcers and their complications, polyps and a range of benign and malignant tumours. Endoscopy with biopsy is central to diagnosis, and treatment of tumours is planned within a multidisciplinary team.

Peptic ulcer disease

What it is: An open sore in the lining of the stomach or duodenum, most often caused by Helicobacter pylori infection or anti-inflammatory painkillers.

Symptoms: Burning upper abdominal pain, indigestion, nausea, and sometimes bleeding with black stools or vomiting blood.

Treatment: Eradication of Helicobacter pylori, acid-suppressing medication and stopping causative drugs. Surgery is now needed mainly for complications.

Perforated or bleeding ulcer

What it is: A complication in which an ulcer erodes through the full wall of the stomach or duodenum, or into a blood vessel.

Symptoms: Perforation causes sudden severe abdominal pain and a rigid abdomen; bleeding causes black stools, vomiting blood, dizziness or collapse.

Treatment: Emergency care. Bleeding is usually controlled endoscopically or by interventional radiology; perforation generally requires laparoscopic or open surgical repair.

Gastric outlet obstruction

What it is: A blockage at the lower end of the stomach that prevents food from emptying, caused by scarring from ulcers or by tumours of the stomach, duodenum or pancreas.

Symptoms: Vomiting of undigested food, early fullness, bloating and weight loss.

Treatment: Treatment of the cause, with endoscopic dilatation or stenting, or surgical bypass or resection when needed.

Gastric polyps

What it is: Growths arising from the stomach lining. Most are benign, but some types, such as adenomas, can become malignant.

Symptoms: Usually none; they are commonly found during endoscopy for other reasons.

Treatment: Biopsy or endoscopic removal depending on type and size, with surveillance when appropriate. Surgery is rarely required.

Gastrointestinal stromal tumour (GIST)

What it is: A tumour of the digestive tract wall, most commonly in the stomach, arising from specialised pacemaker cells. Its behaviour ranges from low to high risk.

Symptoms: Often found incidentally. Larger tumours may cause bleeding, anaemia, pain or a mass.

Treatment: Surgical removal with clear margins, often laparoscopically, is the main treatment. Higher-risk or advanced tumours may also be treated with targeted therapy such as imatinib.

Gastric neuroendocrine tumours

What it is: Tumours that develop from the hormone-producing cells of the stomach. Many are small, slow-growing and associated with chronic gastritis.

Symptoms: Frequently none; occasionally bleeding, anaemia or hormone-related symptoms.

Treatment: Small tumours may be observed or removed endoscopically. Larger or more aggressive tumours may require surgical resection.

Gastric cancer

What it is: A malignant tumour of the stomach, most often an adenocarcinoma arising from the stomach lining. Risk factors include Helicobacter pylori infection, smoking, diet and family history.

Symptoms: Indigestion, loss of appetite, weight loss, early fullness, vomiting, anaemia or bleeding; early disease is often silent.

Treatment: Very early tumours may be removed endoscopically. Most localised cancers are treated with perioperative chemotherapy and gastrectomy with lymph node dissection, while advanced disease is treated with systemic therapy.

How assessment is organized

Assessment is based on symptoms, blood tests and upper endoscopy with biopsies. For tumours, staging with CT, and when needed endoscopic ultrasound, PET-CT or staging laparoscopy, helps plan treatment, which is agreed within a multidisciplinary team.

This information is general and does not replace individual medical assessment.