Cancers and abdominal symptoms
Different types of abdominal symptoms can accompany cancer or provide a hint for further investigation that could potentially
reveal the presence of a malignancy. These symptoms include abdominal pain, flatulence, bloating, fluid retention, nausea/vomiting, constipation, diarrhea, or abdominal rigidity. Unfortunately, early cancer rarely causes symptoms. However, other symptoms such as loss of appetite, weight loss, change in bowel habits, rectal bleeding are potential cancer red flags. Early diagnosis is essential for improved prognosis.
Esophageal cancer (Cancer of the food pipe)
Esophageal cancer is one of the worst malignant digestive neoplasms, and also has a poor prognosis. Patients with possible esophageal cancer may complain of dysphagia (difficulty in swallowing solid foods) recorded in 74% of patients, while 17 percent report odynophagia (pain on swallowing food and liquids) unexplained hemoptysis (blood in sputum), or hematemesis(blood in vomitus). Weight loss is also common (in 57 percent of patients) and is an independent indicator of a poor prognosis, especially if there is a loss of more than 10 percent of body mass. Longstanding gastroesophageal reflux (gas or acidity) disease may be seen in 21 percent of the population; however, the vast majority of these people will never have esophageal cancer. Hepatomegaly (enlarged liver) suggests advanced disease.
Upper abdominal pain in patients over the age of 55 years, when accompanied by resistant dyspepsia/reflux and weight loss, in the presence of nausea/vomiting and thrombocytosis (increased number of platelets) requires upper gastrointestinal endoscopy to rule out esophageal or stomach cancers. Stomach cancers have a very high mortality rate, and weight loss and epigastric pain are the most common symptoms in patients at diagnosis. Some patient pass black tarry stools due to bleeding from the tumors in stomach and some may present with abdominal distension/swelling or a neck node enlargement.
Gall bladder cancer
Gallbladder cancer will cause symptoms similar to biliary colic or gall stone pain. Right upper or mid abdominal pain is the most common symptom (54–83%), followed by jaundice (10–46%), nausea and vomiting (15–43%), loss of appetite (4–41%), and weight loss (10–39%). Only 3–8% of patients will complain of a swelling in the right upper abdomen. Symptomatic patients most commonly present with advanced disease, with 75% being non-operable, and a poor outcome.
Pancreatic cancer may also cause upper abdominal pain and severe unexplained weight loss, accompanied by diarrhea, constipation, or nausea and vomiting. Early-stage pancreatic cancer is usually clinically silent, and disease only becomes apparent after the tumour invades surrounding tissues or metastasizes to distant organs. Most people who present with symptoms attributable to pancreatic cancer have advanced disease. Typical presenting symptoms of pancreatic cancer include abdominal or mid-back pain, jaundice, and weight loss.
Abdominal symptoms include loss of appetite, upper abdominal pain, nausea/vomiting, and distension of the abdomen and very rarely jaundice.
Abdominal pain in the presence of altered bowel habits (constipation alternating with diarrhea) and/or rectal bleeding can indicate colorectal cancer. Colorectal cancer is the single most common cause of large intestinal obstruction, and up to 20% of patients with colonic cancer present with symptoms of acute obstruction. Cancer of the rectum or left colon is more likely to obstruct than cancer arising in the proximal colon. Acute colonic obstruction produces a dilated bowel that results in vomiting and pain abdomen.