Complaints & connections · borters.ch
Often a long-standing infection lies behind it — treating it is genuine prevention.
Also known as: stomach cancer · gastric adenocarcinoma
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
The main risk factor is long-standing Helicobacter pylori infection, along with heavily salted or smoked food, smoking and family history. Symptoms stay non-specific for a long time — upper abdominal pressure, early fullness, loss of appetite, nausea, later weight loss, swallowing difficulty or anaemia. Easily dismissed as an upset stomach, it is often found late. Assessed by gastroscopy with biopsy; a proven Helicobacter infection can be treated.
The treatment plan is not made by one person alone but in a round of surgery, oncology, radiology, pathology and radiotherapy. You may ask what was discussed there and which alternatives came up.
Before a big decision it is planned for in many clinics, and the records belong to you. It costs one to two weeks — acceptable in almost every course, and one asks about that if it is urgent.
It is today part of the treatment and not its opposite: it lessens the exhaustion, keeps muscle and bone and improves how the treatment is tolerated. Begin with guidance, less on bad days, but not nothing at all.
Unintended weight loss worsens how any treatment is tolerated. Restrictive diets do more harm than good here — with loss of appetite, dietary advice helps early, not only once kilos are already gone.
By the clock rather than as needed works better and needs less overall. Fear of dependence is the wrong adviser in this situation — untreated pain costs sleep, appetite and strength.
Psycho-oncological support, social advice for insurance and work, and the question of who takes on what at home. This is no emergency measure but belongs at the start — and the relatives belong in it.
Chemotherapy before surgery shrinks the tumour and raises the chance of removing it completely — about three months before and three months after. Antibodies against HER2 come into question only with a matching finding, so in about one in five. After removal of the stomach the uptake route for vitamin B12 is permanently missing; it is injected for life, and that is not a supplement but a replacement.
The frequency has fallen clearly in Europe over decades, linked above all to refrigeration of food and the decline of Helicobacter. About nine out of ten cases are connected with Helicobacter. From chronic inflammation through the change of the lining to cancer, ten to twenty years usually pass. Eradication lowers the risk measurably, most strongly if it happens before the change.
A dull fullness or burning that over weeks does not respond to the usual remedies. Usually a gastritis or Helicobacter is behind it — the endoscopy tells them apart.
A few bites are enough, meat suddenly tastes wrong, the portions shrink — and the weight follows.
Tar-black, sticky stool and vomit like coffee grounds mean bleeding in the upper digestive tract. That belongs in hospital the same day — whatever the cause.
The feeling that food gets stuck, or vomiting food eaten hours before. Both are signs of a narrowing and belong examined promptly.
Newly appeared and lasting for weeks, together with weight loss, this belongs in a check-up — not because it usually turns out that way, but because it shows early.
The loss of muscle mass helps decide how well a treatment is tolerated. Enough protein spread across the day, together with movement, is the part one holds oneself.
Taken up right at the end of the small bowel and needing a helper from the stomach. If either place is affected a deficiency arises — often only after years, because the liver holds a store.
Low values are common with a longer illness, and correcting them counts for bone and muscle. For high-dose courses against the illness itself there are no studies; they can interfere with treatment.
Taken up in the upper small bowel and needing stomach acid. Acid blockers, an inflamed lining and silent blood losses often come together here.
Nausea, diarrhoea and fever dry one out quickly, and several treatments strain the kidney. Drinking enough is no side issue here.
After removal of the stomach the intrinsic factor is missing, without which B12 is not taken up in the last stretch of the small intestine. Tablets are then not enough — it is injected, usually every three months, and for life. The stores last two to four years, which is why the gap shows only late.
Stomach acid releases iron from food. If the stomach is gone or the acid permanently damped, uptake falls markedly. Ferritin belongs here in the regular laboratory work, and iron together with a little vitamin C is better tolerated than on an empty stomach.
Calcium too needs an acid setting to dissolve. Calcium citrate manages without acid and is therefore, after stomach surgery, the more workable form than calcium carbonate.
If fat passes undigested after small meals, that is not a sensitivity but a mixing problem: the food reaches the small intestine faster than the pancreas delivers. Enzymes with the meal even that out.
Clearly worthwhile and well studied when deficient; fewer data for the wider uses. Fat-soluble — check blood levels at high doses.
With autoimmune gastritis the acid is missing, and gastrin rises strongly and permanently. Over years a neuroendocrine tumour can arise from that — the reason for regular checks with this history.
After the stomach is removed the hunger hormone is missing, and with it part of the appetite. That is one of the reasons for the weight loss afterwards — and a reason to plan eating instead of waiting for hunger.
Very salty and cured food is linked with more cases in population studies — where 12 g of salt and more is eaten daily. The Swiss average is about 9 g, the recommendation below 5 g.
Without stomach acid and intrinsic factor both fall over months to years. Levels are checked regularly and replaced according to the finding.
The claim usually rests on the PET scan: weakly radioactive glucose is injected, and the tumour lights up. That shows tumour cells take up sugar faster than the tissue next to them — not that eaten sugar feeds them. You come to a PET scan fasting, and the tumour lights up anyway; the body keeps blood sugar within narrow limits by itself. It cannot be starved out this way. There is an established link nonetheless, but it runs through body fat: in 2016 the International Agency for Research on Cancer (IARC) reviewed the available studies and found sufficient evidence, for thirteen cancers, that absence of excess weight lowers the risk. That concerns prevention — it is not an answer to where an existing illness came from.
After partial removal of the stomach the intrinsic factor is missing, without which B12 is not absorbed. Replacement is then usually by injection, not tablet — not a choice but a necessity.