10 Stomach Symptoms You Should Never Ignore. They can signal cancer, COVID-19 or another serious disease 千萬不要忽視的 10 種胃部症狀。它們可以預示癌症、COVID-19 或其他嚴重疾病 By Michelle Crouch AARP

Everyone has stomach issues from time to time, and occasional digestive discomfort is not usually something to worry about. That said, doctors note that there are a few gastrointestinal symptoms you shouldn’t write off, because they could signal something serious.

“I’ve seen many cases where patients have waited way too long before seeking medical attention,” says Christine Lee, M.D., a gastroenterologist at the Cleveland Clinic.

1. Prolonged diarrhea 長期腹瀉

Diarrhea can be a symptom of a number of things — from a food allergy to a bacterial infection. It can also be a warning sign of COVID-19, appearing before more well-known symptoms such as cough or fever, says Brennan Spiegel, M.D., director of health services research for Cedars-Sinai Medical Center in Los Angeles. 腹瀉可能是多種情況的症狀 – 從食物過敏到細菌感染。洛杉磯 Cedars-Sinai 醫療中心衛生服務研究主任 Brennan Spiegel 醫學博士說，它也可能是 COVID-19 的警告信號，出現在咳嗽或發燒等更廣為人知的症狀之前。

Studies show that as many as half of COVID-19 patients have gastrointestinal (GI) symptoms, and about 15 to 20 percent have only GI symptoms. Diarrhea is the most frequently reported GI symptom, followed by nausea/vomiting and abdominal pain. 研究表明，多達一半的 COVID-19 患者有胃腸道 (GI) 症狀，約 15% 至 20% 的患者僅有 GI 症狀。腹瀉是最常報告的胃腸道症狀，其次是噁心/嘔吐和腹痛。

If you have diarrhea, nausea/vomiting or abdominal pain that lasts more than a day, “don’t wait for a cough or shortness of breath to get tested for COVID,” Spiegel says. If your test is positive, you could be eligible for highly effective antiviral treatments that can help keep mild symptoms from progressing to more serious ones. New research shows these treatments may also lower a person’s risk for developing long COVID. 如果您有持續超過一天的腹瀉、噁心/嘔吐或腹痛，“不要等到咳嗽或呼吸急促才進行 COVID 檢測，”Spiegel 說。如果您的測試結果呈陽性，您可能有資格接受高效的抗病毒治療，以幫助防止輕微症狀發展為更嚴重的症狀。新的研究表明，這些治療方法還可以降低一個人患長期 COVID 的風險。

If it’s not COVID-19, prolonged diarrhea could signal another type of infection or an underlying condition like ulcerative colitis or irritable bowel syndrome (IBS). 如果不是 COVID-19，長期腹瀉可能預示著另一種感染或潛在疾病，如潰瘍性結腸炎或腸易激綜合徵 (IBS)。

2. Blood in your stool

Whether bright red, maroon or black, seeing blood in the toilet can be frightening. Fortunately, it’s usually not a symptom of anything life-threatening, says Nicholas E. Anthony, M.D., a gastroenterologist at Atrium Health in Charlotte, North Carolina. The most common causes are hemorrhoids and anal fissures (tears in the lining of the anus). But blood in your stool can also be one of the first symptoms of colon cancer, especially if accompanied by a change in your bowel habits or the shape of your stool. Since colon cancer is more common among those over age 50, it’s especially important for older adults to see a doctor without delay. Other possible causes of bleeding are colon polyps, inflammatory bowel disease, colitis and diverticulosis.

3. Severe cramps after eating

Severe cramping is a warning sign of a bowel obstruction — a serious condition that requires immediate medical treatment. It’s also a classic symptom of irritable bowel syndrome (IBS), a chronic digestive disorder that has been on the rise since the start of the COVID-19 pandemic. Experts aren’t sure how COVID-19 is linked to IBS, Spiegel says. It could be that the virus changes the gut microbiome or the lining of the intestinal system, triggering IBS. Or the boost in cases could be caused by pandemic-related stress and anxiety. Other IBS symptoms include abdominal pain (often related to bowel movements), bloating, gas, diarrhea or constipation.

4. Difficulty swallowing

If you feel like your food is getting stuck in your throat or it hurts as it’s going down, that can be a sign of something serious. “The big thing we worry about is esophageal cancer,” Anthony says. Esophageal cancer is more common in adults over 55 and three or four times more likely to occur in men than women, according to the Centers for Disease Control and Prevention. 

Other things that can cause discomfort when you swallow include an infection, an ulcer, a sore or scar tissue (which can develop if you have chronic acid reflux). In addition, a growing number of people are being diagnosed with eosinophilic esophagitis (EOE), a chronic allergic inflammatory disease that is a major cause of swallowing issues. To pinpoint the cause of your problem, your gastroenterologist will probably insert a tube with a camera attached to it down your throat in a procedure called an endoscopy.

5. Unexplained weight loss (especially if accompanied by abdominal pain)

Weight loss when you haven’t changed your diet or exercise habits is a common symptom of many serious illnesses, including cancer, Lee says. “Most people gain weight as they get older because their metabolism slows down,” she says. “If you’re losing weight without much effort, that’s a red flag.” See a doctor if you’ve dropped 5 percent or more of your body weight within six to 12 months. Although such weight loss is a symptom of some types of cancer, a 2014 study published in the journal American Family Physician found that in patients over 65, it is often due to other causes, like peptic ulcers, celiac disease, inflammatory bowel disease or an overactive thyroid.

6. Chronic or prolonged constipation (especially if you’re having pain)

Almost everyone experiences occasional bouts of constipation, and studies show that it’s especially prevalent among older adults. Constipation is typically defined as three or fewer bowel movements per week. It may not seem like a big deal, but if your constipation isn’t treated, over time the stools in your colon can become so large and solid that your body can’t remove them — and that can be painful or even deadly, Anthony warns. “If it goes longer than seven days, I want to see you,” he says. Constipation can be caused by a wide variety of issues, including certain medicines, a diet low in fiber, and medical conditions such as irritable bowel syndrome, thyroid issues, diabetes or, in rare cases, colorectal cancer.

7. Sudden, intense abdominal pain

A sharp pain that doesn’t let up can indicate acute appendicitis (if it’s on your lower right side), diverticulitis or a serious infection. The context is important, Lee says, because muscle cramps and other issues can also manifest as sharp pain. “If you’re an athlete rock climbing and you get a sharp pain in your abdomen that only lasts a second, you probably just pulled a muscle,” she says. If it’s something serious, she explains, usually the pain keeps escalating and doesn’t let up.

8. Frequent, severe or worsening heartburn

Occasional heartburn — a burning, uncomfortable sensation in your chest — is common among older adults and can usually be treated with over-the-counter medications. But if your heartburn is frequent and worsening, or if it’s not responding to medication, you may have gastroesophageal reflux disease (GERD), a disorder in which the valve between your stomach and esophagus doesn’t close properly. Left untreated, GERD can lead to complications including erosion or narrowing of the esophagus, or a precancerous condition called Barrett’s esophagus. In rare cases, severe heartburn can also indicate a more serious condition such as esophageal cancer or a hiatal hernia.

9. Swollen abdomen

It’s not unusual to feel bloated after you eat a big meal. But there’s a difference between bloating and distension, an actual increase in measured abdominal size. “Do you literally see your belly puffing out? Is it bigger in circumference?” Spiegel asks. If the answer is yes — and the symptom persists after you’ve had plenty of time to digest a meal — it can be a sign that excess fluid or gas is forming in your small intestine as the result of an obstruction, inflammation, bacterial overgrowth or a gastrointestinal disease.

10. Feeling full after eating very little

If you feel stuffed even though you didn’t eat much, the most common cause is gastroparesis, a condition in which food stays in the stomach longer than it should. It can happen when a severe illness “stunts the electrical system of the stomach,” Anthony says, so gastroparesis can be a long-term side effect of COVID-19. Influenza, stomach surgery and diabetes can also trigger the condition. Although it can resolve on its own, your doctor can prescribe medications that will stimulate your stomach to contract and help speed digestion. If it’s not gastroparesis, other more serious causes of early satiety include an ulcer, an obstruction or a tumor.

If you don’t have one of the above symptoms, don’t let that keep you from seeing a gastroenterologist if you suspect that something’s wrong, Lee says. The earlier you detect a problem, the more options you have and the better your chances of success at managing it.

“The longer I do this, the more I realize that it doesn’t matter what the textbook says — patients know their bodies,” Lee says. “If something is not normal for you, then it is a red flag, even if it’s not on the list of top five. If something bothers you, you should get it checked out.”