Most stomach cancers are caused by bacteria called helicobacter pylori or H. pylori. Having H. pylori doesn’t mean you’ll get stomach cancer, but it does increase your risk.
We talked to Patrick Lynch, M.D., a gastroenterologist in Internal Medicine, about H. pylori and other stomach cancer risk factors, how to recognize symptoms and what you can do to reduce your chances of developing this disease.
What’s the link between H. pylori and stomach cancer?
H. pylori is a common bacterium. There are multiple strains, and different strains have different effects on the stomach. Most people never experience side effects or illness.
Most stomach ulcers are caused by H. pylori. Certain strains can also raise your risk for stomach cancer.
“The whole process of stomach cancer risk associated with H. pylori is one of inflammation,” says Lynch. “With H. pylori, you have an infection, which causes inflammation, then healing, then more inflammation. Over time, this cycle of constant cell regeneration can result in mistakes that lead to cancer.”
How do you know if you have H. pylori?
Symptoms of H. pylori infection include chronic dyspepsia – or indigestion – that may be accompanied by abdominal pain, bloating and the urge to burp. Lynch describes it as a “sour stomach.”
Dyspepsia should not be confused with heartburn, which feels like acid and food are coming back up from the stomach into the esophagus. This causes discomfort or pain in the chest.
“Someone with H. pylori is actually less likely to have acid reflux and heartburn, because H. pylori reduces the stomach’s ability to produce acid so it can survive,” says Lynch. “Someone with heartburn likely doesn’t have an H. pylori infection.”
It’s important to pay attention to your symptoms, where they are occurring and what they feel like, so your doctor can make a proper diagnosis. H. pylori infection can be treated with a combination of antibiotics and other drugs.
“Indigestion that is severe enough or has gone on long enough to prompt a doctor’s visit may lead to somebody being evaluated and can sometimes be the means for reducing risk of stomach cancer by identifying and treating H. pylori,” says Lynch.
Know the symptoms of stomach cancer
Stomach cancer is often found in later stages, because symptoms don’t appear until the disease is advanced.
“There are no early signs of stomach cancer,” says Lynch. “If a patient is really paying attention to their body and sees their doctor as soon as symptoms do appear, there is a better chance of successfully treating the disease,” says Lynch.
Symptoms of stomach cancer include:
Abdominal pain or discomfort
Loss of appetite
Heartburn, indigestion or ulcer-type symptoms
Nausea and vomiting
Bloating or swelling in the abdomen
Diarrhea or constipation
Feeling full after eating small amounts of food
Bloody or black stools
Having one or more of these symptoms does not mean you have cancer. However, if you notice any of them for more than two weeks, talk to your doctor. The earlier cancer is detected, the easier it is to treat.
Steps to reduce stomach cancer risk
The healthy lifestyle choices that reduce your overall cancer risk will also reduce your risk of stomach cancer and a host of other diseases. These include:
Don't smoke. People who smoke are more likely than nonsmokers to develop stomach cancer. “If you’re talking about a lifestyle intervention that makes a difference, stopping smoking is important,” says Lynch.
Maintain a healthy weight. Being overweight or obese raises the risk of at least 13 cancers, including cancer in the area where the esophagus connects with the stomach. This is likely due to the chronic inflammation caused by excess body fat.
Limit alcohol.Avoid alcohol for cancer prevention. If you choose to drink, limit yourself to no more than one drink per day if you are a woman, and two drinks per day if you are a man. The risk for stomach cancer begins to go up at three or more drinks per day.
Watch your diet. A diet heavy in foods preserved through pickling or salting or that contain nitrates can increase your risk for stomach cancer. Eating foods that have been stored or prepared in unsanitary conditions or have not been properly refrigerated raises the risk of H. pylori infection and stomach cancer.
Talk to your family about their cancer history. Some hereditary cancer syndromes can increase your risk for stomach cancer. If you are concerned, talk to your doctor. “People who have a family history of stomach cancer or the genes associated with them should undergo endoscopy, because they’re at higher risk,” says Lynch. “Even though these conditions are fairly rare, there are situations where you could really pinpoint risk to an individual.”