Persistent acidity and weight loss could be early signs of GI cancer

Every day in India, patients walk into my clinic with symptoms they have been quietly enduring for months, sometimes years. A persistent burning in the chest. Difficulty swallowing food. An unexplained loss of weight. By the time many of them reach me, the cancer that has been growing inside them is no longer a small, manageable lesion.

It has become a formidable adversary. And I am left wondering, as I often do: what if they had come sooner?

Gastrointestinal cancers, those affecting the oesophagus, stomach, colon, liver, pancreas, and bile ducts, collectively represent one of the most significant cancer burdens in our country. Yet they remain poorly understood by the public, inadequately screened for in clinical practice, and tragically, almost always diagnosed at a stage when our options are limited. This must change.

The tragedy of gastrointestinal cancer in India is not a lack of medical knowledge. There is a gap between what we know and what we do. We know these cancers develop slowly.

We know they begin as small, often harmless-looking lesions on the inner lining of the digestive tract. We know that if we find them at this stage, we can remove them with minimal intervention and restore a patient to full health. And yet, the vast majority of our patients arrive with a disease that has already spread.

Several forces conspire to produce this outcome. Awareness of early symptoms is low. Access to quality diagnostic facilities is uneven. We do not yet have the kind of population-wide endoscopic screening programmes seen in Japan or South Korea, where gastric cancer survival rates are dramatically higher than our own.

And perhaps most painfully, there is a cultural tendency, one I encounter constantly, to dismiss persistent digestive discomfort as merely acidity, stress, or something that will pass on its own.

It will not always pass. Sometimes, it tells you something urgent.

The tool at the centre of early detection is endoscopy: a thin, flexible tube equipped with a high-definition camera, passed through the mouth or rectum, allowing a physician to observe the inner walls of the digestive tract directly.



Modern endoscopy is a world away from what it was even fifteen years ago.

With narrowband imaging, magnification technology, and image-enhancement techniques, we can now detect changes in the mucosa that would have been entirely invisible to an earlier generation of doctors.

But endoscopy is only as powerful as the moment it is performed. The technology exists. The expertise is growing. What is missing, in too many cases, is the patient sitting in front of me before the disease has progressed.

When we do catch a cancer early, we can often treat it right there, during the same endoscopic procedure. A technique called Endoscopic Submucosal Dissection allows us to remove even larger early-stage lesions in a single, precise excision: no surgical incision, no weeks of recovery. The patient goes home. The cancer is gone. This is what is possible when detection happens at the right time.

Not everyone needs a routine endoscopy. But certain individuals carry a meaningfully higher risk of developing these cancers, and for them, early evaluation is not advisable. It is essential. If you are a regular user of tobacco in any form, if you consume alcohol heavily, if you have been living with chronic acid reflux for years without investigation, or if close family members have had gastrointestinal cancers, please do not wait for symptoms to declare themselves loudly.

Warning signs that deserve attention if they persist beyond two to three weeks:

1. Persistent indigestion or acidity that does not resolve with medication

2. Difficulty or pain when swallowing

3. Unexplained loss of weight over weeks or months

4. Blood in the stool, or stools that appear black and tarry

5. Persistent abdominal pain or discomfort

6. Unexplained anaemia detected on a blood test

7. A significant and sustained change in bowel habits

Most people who experience any one of these will not have cancer. But some will. And for those individuals, the difference between seeking evaluation now and waiting another six months can be the difference between a straightforward endoscopic procedure and a major surgical operation, or worse.