When it comes to gas, bloating, and "acidity," it is easy to think that these are simply a case of IBS or nervousness about eating. However, gastric cancer is one of the most frequent causes of cancer-related deaths in the world, including in India, where it is a common form of gastrointestinal cancer. In some cases of early gastric cancer, the symptoms are so similar to other digestive troubles that it could prove fatal to ignore the warning signs.In an interaction with Health and Me, Dr Rakesh Kumar Sharma, Senior Consultant Medical Oncologist at M | O | C Cancer Care & Research Centre, Gurugram, spoke about the symptoms of stomach cancer and how it can often be confused with IBS.Why is IBS confused with stomach cancer?IBS is a functional gastrointestinal condition, which means the patient’s gut may seem fine, but it is not functioning properly. Common complaints in IBS include abdominal pain, bloating, diarrhoea, and constipation. Patients may notice a pattern in which their symptoms come and go over several months and may even associate them with food triggers or emotional stress.However, IBS does not cause ulcers, bleeding, or intestinal damage, and patients have no greater likelihood of developing cancer when evaluated properly. This means that since many symptoms of IBS, inflammation, and cancers can overlap, there is a risk of diagnosing something serious as “just IBS."What are the symptoms of stomach cancer?Stomach cancer commonly begins in the inner lining of the stomach and usually presents with non-specific and subtle symptoms in its early stages. Common complaints include continuous indigestion and heartburn that fail to respond to common anti-acidity medication. Early satiety is another common complaint, whereby patients feel full too soon during meals, along with upper abdominal discomfort and heaviness. Other common symptoms include bloating, nausea, and gradual loss of appetite over weeks.It is important to differentiate early-stage gastric cancer from simple acidity and IBS, since the latter conditions usually show periodic improvement and respond to common medications. However, if the above symptoms persist for two to three weeks without relief despite basic management, further evaluation may be required, especially in middle-aged and older patients.Stomach cancer symptoms to never missThere are certain symptoms that should never be overlooked and are regarded as red flags requiring prompt investigation for possible stomach cancer:Sudden weight loss and poor appetiteConcurrent vomiting and regurgitationDysphagia or difficulty swallowingMelena or hematocheziaAnaemia (reduced haemoglobin level), tiredness, and weakness due to chronic blood lossOngoing or progressive upper abdominal pain or a lump in the upper part of the abdomenAny of these require immediate attention, regardless of an IBS diagnosis.Who is at an increased risk?Persistent infection by the bacterium Helicobacter pylori is the most well-established risk factor for the development of stomach cancer, primarily lower stomach cancers. H. pylori infections affect about half the global population and may lead to chronic inflammation, ulcers, and eventually precancerous changes in the stomach lining. High dietary consumption of salt, pickled or smoked foods, and processed meats increases the risk, especially when there is an existing H. pylori infection.Smoking and alcohol abuse independently contribute to an increased risk of gastric cancer, along with obesity and specific genetic or familial risk factors. There are higher rates of gastric cancer in some parts of India, with the majority of cases being detected at later stages of the disease. This emphasises the importance of early detection and evaluation in populations with a high burden of gastric cancer.When should you be alarmed?You do not have to worry about every episode of acid reflux, but you should never dismiss anything unusual that occurs in your body. You need to consult your doctor if your indigestion, epigastric pain, early satiety, and bloating persist for two to three weeks even after conventional treatment. You experience alarming symptoms such as weight loss, vomiting, dysphagia, black stools, and anaemia