Don't Assume Every Stomach Ache Is Just Gastritis: Endoscopy Can Help Identify the Real Cause

Many Malaysians have their own explanations when they experience stomach pain. Some blame spicy food, coffee, work-related stress, or irregular mealtimes.

Others immediately purchase antacids from pharmacies, hoping the problem will go away as usual.

However, according to medical experts, if symptoms such as heartburn, bloating, or pain in the upper abdomen occur frequently, they may not simply be signs of ordinary “gastritis”. Instead, they could indicate an underlying health condition that requires further investigation.

Dr Tee Sze Chee, Consultant General & Upper Gastrointestinal Surgeon, and Dr Muhammad Ilham Abdul Hafidz, Consultant Gastroenterologist, Hepatologist & Internal Medicine Physician, from Sunway Medical Centre Damansara (SMCD), explained that upper gastrointestinal (GI) endoscopy is among the most effective procedures for identifying the underlying causes of patients' symptoms.

Symptoms That Should Not Be Ignored

According to Dr Tee, many patients delay medical examinations because their symptoms come and go, leading them to believe that the problem is not serious.

In reality, symptoms such as persistent heartburn, acid reflux, bloating, nausea, upper abdominal pain, and difficulty swallowing can be caused by various conditions, including gastritis, peptic ulcers, Helicobacter pylori infection, or even more serious conditions such as gastric cancer.

He added that taking over-the-counter medications may only provide temporary symptom relief without identifying the underlying cause.

“Symptoms such as frequent heartburn, difficulty or pain when swallowing, persistent nausea, unexplained weight loss, loss of appetite, vomiting blood, or black stools are among the warning signs that should be evaluated by a doctor.

“Although over-the-counter medications may provide temporary relief, they can sometimes mask an underlying health condition that requires medical treatment,” he further explained.

What Is Endoscopy?

Upper GI endoscopy is a procedure that uses a thin, flexible tube equipped with a high-definition camera to directly examine the inside of the oesophagus, stomach, and duodenum.

Through this procedure, doctors can obtain a clearer view of the digestive tract rather than relying solely on the symptoms described by patients.

It also allows doctors to identify ulcers, inflammation, polyps, or tumours, and to collect tissue samples (biopsies) when necessary.

Many Patients Are Afraid, but the Procedure Is Actually Very Simple

According to Dr Muhammad Ilham, most patients are more frightened by their perception of the procedure than by the procedure itself.

Among the most common concerns are the fear of experiencing pain or waking up during the examination.

However, he explained that both concerns are generally unfounded.

Before the procedure, patients are required to fast for six to eight hours to ensure that their stomach is empty. They must also inform their doctor about any medications they are currently taking or any history of allergies.

During the procedure, patients are given intravenous sedation before the endoscope is inserted through the mouth.

“Patients will not feel or remember anything throughout the procedure.”

The entire process usually takes less than 10 minutes.

After the procedure, patients only need to rest briefly in the recovery area until the effects of sedation wear off before they are allowed to return home.

A Biopsy Does Not Mean You Have Cancer

Many patients also become anxious when their doctor informs them that a biopsy is necessary.

According to Dr Ilham, however, a biopsy is a standard procedure in many endoscopy cases.

It does not necessarily mean that the doctor suspects cancer. A biopsy may also be performed to detect Helicobacter pylori infection or assess tissue changes when ulcers, polyps, or tumours are identified during the examination.

According to the Malaysian National Cancer Registry, more than 60% of cancer cases in the country are only detected at stage three or four.

For gastric cancer, GLOBOCAN 2022 data recorded 1,528 new cases and 1,223 deaths within a single year in Malaysia. These statistics indicate that many patients seek treatment only when the disease has reached an advanced stage.

Dr Tee emphasised that experiencing relief after taking medication does not necessarily mean that the underlying problem has been resolved.

“Medication that provides relief does not mean the problem has been resolved.

“Many conditions that cause persistent upper GI symptoms are common and easily treatable. However, some symptoms may actually be early warning signs of more serious diseases, including gastric cancer. Symptoms alone are not enough to determine what is really happening.”

Early Detection Provides More Treatment Options

Dr Muhammad Ilham also emphasised that delays in obtaining a diagnosis can significantly affect treatment opportunities.

“In clinical practice, late detection does not merely make treatment more difficult. It also means that patients may face very different treatment outcomes.

Earlier detection provides more treatment options. When gastric cancer is detected too late, the chances of a cure are often very limited. This is the reality we are trying to change.”

He also reassured those who remain afraid of undergoing endoscopy.

“There is nothing to be afraid of. The procedure is very simple and straightforward. It is painless, quick, and very safe.”

Ultimately, endoscopy is not merely a procedure to look for diseases, but an important step towards obtaining accurate answers about the symptoms a patient is experiencing.

Rather than continuing to assume that every stomach ache is caused by “gastritis”, obtaining an early diagnosis can not only provide peace of mind but may also save lives through faster and more effective treatment.

*Originally published in Maskulin