Signs and Symptoms of Stomach Cancer

The signs and symptoms of stomach cancer, also known as gastric cancer, range from blood in the stool to abdominal pain. Often, however, stomach cancer does not have symptoms, particularly in the early stages. In addition, symptoms may be non-specific and easily mistaken for other conditions.

Symptoms of stomach cancer can vary based on the stage of the disease and the type of cancer you have, some of which may be more aggressive than others.

Symptoms alone cannot diagnose stomach cancer. Only an investigation by a healthcare provider, which may involve imaging studies and a biopsy, can definitively diagnose the disease.

This article explains the seven symptoms commonly experienced in people with stomach cancer.

Blood in the Stool

Bloody stool can be a symptom of stomach cancer. However, it can occur with other noncancerous conditions as well. The color of blood in the stool often provides vital clues about the origin of bleeding.

Bright Red Blood

Bright red blood in the stool, also known as hematochezia, is generally not a sign of stomach cancer. When the blood is bright red, it indicates that the bleeding is occurring nearer to the rectum rather than farther up in the gastrointestinal tract.

Bright red blood may indicate different conditions, including:

• Cancer in the colon or rectum (colorectal cancer)
• Hemorrhoids (swollen veins in the rectum)
• Anal fissures (a tear in the anus)
• Ulcerative colitis (a form of inflammatory bowel disease)

Black and Tarry

By contrast, black and tarry stools are signs that bleeding is occurring in the upper portion of the gastrointestinal tract. That is because the blood will progressively darken as it makes its way to the rectum.

Black and tarry stools, called melena, occur when hemoglobin (a protein in red blood cells) reacts to digestive enzymes and intestinal bacteria. The most common causes of melena are:

• Peptic ulcer disease (open wounds in the stomach)
• Liver disease
• Gastric cancer

Blood in the stool is not always visible. Your stool can contain trace amounts of blood that only a test, such as the fecal occult blood test (FOBT), can reveal.

Abdominal Pain

Abdominal pain is one of the most common signs of stomach cancer. Moreover, it is often the symptom that usually prompts people to seek medical attention.

Symptoms can range from persistent mild discomfort to severe pain. The pain and discomfort generally occur in the upper abdomen area.

With that said, because of how the body delivers nerve signals to the brain, where you feel pain doesn't necessarily reflect the source of the pain. For example, stomach pain can sometimes occur due to problems with the liver, esophagus, pancreas, and other organs.

Abdominal pain has many possible causes that are far more common than stomach cancer. These include:

• Stomach flu
• Gastritis (stomach lining inflammation)
• Pancreatitis (pancreas inflammation)
• Gastroesophageal reflux disease (GERD) (also called acid reflux and heartburn)

Other cancers that involve abdominal pain include pancreatic cancer, liver cancer, bile duct cancer, and gallbladder cancer.

Regardless of where it occurs, you should have persistent abdominal pain evaluated by a healthcare provider. Chronic symptoms should never be ignored and may require an endoscopic exam to uncover the cause.

Persistent Nausea or Vomiting

Nausea and vomiting are also common symptoms of stomach cancer. While many other conditions cause nausea or vomiting, the persistence of symptoms is generally a sign of a more serious medical condition.

If symptoms are ongoing or you vomit up blood—even if just a tiny amount—make an appointment to see your healthcare provider right away. Bloody vomit, also known as hematemesis, may be a sign of cancer or a noncancerous condition, including:

• Peptic ulcer
• Severe GERD
• Esophageal varices (varicose veins in the esophagus)

Bleeding from the stomach can also give vomit a coffee ground-like appearance. This kind of bleeding is more typical when stomach cancer is advanced. However, it can also result from conditions affecting the esophagus or other parts of the upper gastrointestinal tract.

A gastric hemorrhage is a medical emergency. If you are vomiting up a large amount of blood—more than a few teaspoons—go to the emergency room.

Changes in Bowel Habits

Changes in bowel habits, including diarrhea and constipation, are common occurrences that everyone experiences at one time or another. But persistent changes, including intermittent bouts of constipation and diarrhea, may be early signs of stomach cancer.

Cancer itself can alter digestion and lead to these problems. At the same time, as the malignancy (cancer) spreads, it can cause the intestinal passageway to narrow (strictures), resulting in constipation. Accumulating fluid behind the stricture can eventually cause watery diarrhea, accompanied by acute abdominal pain.

Loss of Appetite

It's not uncommon to lose your appetite for a day or two, but if you find that you don't feel like eating for more than a few days, see your healthcare provider. Although stomach cancer is one of many conditions that can cause a loss of appetite, the persistent loss of appetite should raise concerns.

In addition, people with stomach cancer may also experience early satiation, in which you feel full after eating only a few bites.

Cancer can change the body's metabolism and increase the production of inflammatory cytokines (proteins that act as messengers between cells). These changes can affect the chemical messengers, called neurotransmitters, that influence appetite. If the tumor grows, it can also reduce the functional size of the stomach, making you feel prematurely full.

The persistence of these symptoms can lead to unintentional extreme weight loss, a condition referred to as cachexia. This kind of weight loss is common in people with advanced cancer.

Call your healthcare provider if you have lost more than 5% of your normal body weight during six months or less and haven't been dieting or exercising. Unintentional weight loss is a key symptom of advanced cancer.

Bloating and Heartburn

Abdominal bloating can be a symptom of stomach cancer, primarily when it occurs after meals. Even so, bloating is frequently missed in people with stomach cancer because it is a symptom of other, more common causes, including:

• Indigestion
• Constipation
• Menstruation

Similarly, heartburn is more often related to conditions like acid reflux and GERD but can also signify stomach cancer. The bacteria H. pylori is not only linked to GERD and peptic ulcers but significantly increases the risk of stomach cancer.

On the flip side, chronic acid reflux can lead to a condition called Barrett's esophagitis which, in turn, increases the risk of esophageal cancer.

Persistent Fatigue

Fatigue that lasts more than a few days or weeks may suggest a medical concern. For example, with stomach cancer, fatigue is often related to anemia (low red blood cells) due to blood loss in the stool.

At the same time, being under the burden of chronic inflammation can trigger fatigue—a phenomenon common in people with cancer, autoimmune diseases, and neurodegenerative disorders like Huntington's and Parkinson's disease.

Cancer-related fatigue is different than fatigue associated with exhaustion, depression, or acute illness. It is the kind of fatigue that doesn't improve with a good night's rest or other common interventions.

Cancer-related fatigue often develops gradually, and it may help to think back six to 12 months to compare your energy levels. However, persistent fatigue is not "normal" even if cancer is not the cause.

Summary

Many symptoms could indicate stomach cancer. However, many of these symptoms are signs of other more common conditions. Symptoms that could mean stomach cancer include bloody stools (predominantly black and tarry stools), abdominal pain, bloating and heartburn, changes in bowel habits, loss of appetite, fatigue, and nausea and vomiting. Symptoms are especially suspect if they are persistent.

A Word From Verywell

Most of the time, the symptoms of stomach cancer turn out to be something more benign. However, if you feel like something is amiss, it's best to see a healthcare provider for a diagnosis.

The worst thing that can happen is losing the time and money to see a healthcare provider. But, not listening to your inner voice could have far worse consequences. An early diagnosis almost invariably leads to better treatment outcomes.