How stomach cancer is diagnosed

The doctor at the hospital will ask you about your symptoms and general health before doing a physical examination. You’ll probably have a blood test taken to check your general health. You may also be asked to bring a sample of your bowel motion (stools) with you so that it can be tested for blood.

Your doctor may arrange for you to have an endoscopy or a barium meal to look at your stomach. Some people may have just one test while others may have both.

Endoscopy/ Endoscopic ultrasound

This is the most common test used to diagnose cancer of the stomach. The endoscope is a thin, flexible tube with a light and camera at the end. It is used to take photographs of the lining of the stomach and to take a small sample of cells (biopsy) to be examined under a microscope.

Sometimes the endoscopy tube has an ultrasound probe at the end, which allows an ultrasound scan|  to be done of the stomach and surrounding structures. This is known as an endoscopic ultrasound.

Before an endoscopy the stomach has to be empty, so you’ll be asked not to eat or drink anything for at least four hours beforehand. Most people have a sedative before an endoscopy to make them feel relaxed and drowsy. This is given as an injection into a vein in your hand. The doctor or nurse doing the endoscopy may also use a local anaesthetic spray to numb the back of your throat.

You lie on your side on a couch. The doctor or nurse will ask you to swallow the first part of the endoscope. They will then gently push it further down your gullet, and into your stomach. Once the endoscope is in place some air will be put down it. This makes it easier to see all areas of your stomach. When the test is over the endoscope is gently pulled out.

An endoscopy takes about 10 minutes. It can be uncomfortable but it’s not painful. After a few hours the effects of the sedative should have worn off. You’ll then be able to go home. You should not drive for 24 hours afterwards and it’s advisable to arrange for someone to drive you home or to travel home with you. Some people have a sore throat after their endoscopy. This is normal and should disappear after a few days.

Barium meal

This test will be done in the hospital x-ray department. It involves drinking a white, chalky liquid (barium) which helps the gullet and stomach to show up on an x-ray.

Before a barium meal the stomach needs to be empty so it's important not to eat or drink anything for at least four hours before the test. You will be given some barium to drink and asked to lie on a couch. The doctor will watch on the x-ray screen as the barium passes through your stomach. To get a clear picture, the room will be darkened during the test. The couch will be tipped in several different positions to allow the barium to flow through the stomach.

The test usually takes less than an hour and may be slightly uncomfortable. The doctor, and often a nurse, will be in the room with you and will be able to answer any questions you may have.

Most people feel fine after the test, but it may be a good idea for a relative or friend to travel home with you. Your stools are likely to be very pale for a few days until all the barium has passed out of your system. Sometimes the barium causes constipation so you may need to take a laxative for a couple of days. Drinking plenty of fluids will also help.