Why you shouldn’t ignore recurring ‘gastric pain’

That burning sensation after a meal; the bloated feeling that comes and goes; the stomach pain you brush off as “just gastric”.

For many Malaysians, it’s tempting to pop an over-the-counter antacid and carry on with the day. But doctors warn that recurring symptoms commonly blamed on gastritis could sometimes signal far more serious health conditions, including colorectal cancer, gallstones, pancreatitis, or even a heart attack.

The danger, they say, isn’t the discomfort itself – it’s assuming you already know what’s causing it.

Consultant general and colorectal surgeon Dr Nurhashim Haron said about 40-50% of colorectal cancer patients referred to him initially believed they were simply suffering from gastritis.

“Patients only come for further checks after symptoms persist. As a result, when they are finally diagnosed, more than 70% are already at stage three or four,” he told Bernama.

Colorectal cancer is now the second most-common cancer in Malaysia after breast cancer, with national registry data showing cases are rising among both men and women.

More worrying, Nurhashim said, is that patients are also becoming younger. “Previously, most patients were between 55 and 65. Now, we are seeing cases as early as their 40s, and even younger.”

One patient in his 40s spent months treating what he believed was “wind” and gastritis with medication from clinics and pharmacies.

An initial upper endoscopy showed only inflammation of the stomach lining. However, a later colonoscopy revealed a tumour in his transverse colon, while a CT scan confirmed the cancer had already reached an advanced stage.

He eventually underwent surgery to remove part of his colon and stomach before beginning chemotherapy.

Nurhashim said people should pay close attention to persistent changes in bowel habits, as these are often among the earliest warning signs of colorectal cancer.

Red flags include blood or mucus in the stool, prolonged diarrhoea or constipation, narrower stools, unexplained changes in bowel frequency, and a persistent feeling that the bowel has not emptied completely.

“Many patients assume these symptoms are caused by gastritis, stress or diet and wait until the condition worsens,” he said.

Embarrassment and fear of procedures such as colonoscopies also cause many people to delay seeking medical attention.

Notably, stomach discomfort isn’t always linked to the digestive organs. Consultant general and hepatobiliary surgeon Dr Thamarai Velan said gallstones and pancreatitis can also produce symptoms that resemble gastritis.

“Many patients come in complaining of heartburn, indigestion and abdominal discomfort, which they assume is gastritis,” he told Bernama. “However, in my experience, more than half of such cases are caused by other conditions.”

Unlike gastritis, gallstone pain is often sharper, usually occurs on the right side of the abdomen, and may spread to the back. Some patients also experience nausea, vomiting or yellowing of the eyes and skin if a blocked bile duct causes jaundice.

Thamarai said he is also seeing younger patients with gallstones, a trend he attributes to increasingly sedentary lifestyles, obesity, and diets high in fat but low in fibre.

Left untreated, gallstones can lead to gallbladder infections, pancreatitis or severe infections of the bile ducts that may require intensive care.

Both specialists stressed that recurring digestive symptoms should not be ignored simply because medication provides temporary relief.

“In many cases, symptoms return if the root cause is not identified and treated promptly,” Thamarai said.

Nurhashim added that early diagnosis can make all the difference. “When colorectal cancer is detected early, treatment is often simpler, more effective and offers a much better chance of recovery.

“Many patients could be saved if they had come earlier instead of waiting too long.”

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