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Cancer Keys: PPIs masking red flag symptoms for stomach cancer

Proton Pump Inhibitors (PPIs) are widely used to treat acid reflux and dyspepsia. NICE cautions that PPIs can mask or alter symptoms of stomach cancer, leading to later diagnoses.

Potential Pitfall

Patients on PPIs who have developed stomach cancer may increase their doses to manage further acid reflux and dyspepsia, further masking red flag symptoms. However, symptoms may become resistant or alter in character – perhaps manifesting as pain rather than burning, for instance.

Helpful hint

NICE NG12 guidelines advise to consider non‑urgent direct access upper gastrointestinal endoscopy to assess for stomach cancer in people aged 55 or over with treatment‑resistant dyspepsia.

Offer urgent direct access upper gastrointestinal endoscopy (to be performed within 2 weeks) to assess for stomach cancer in people with dysphagia, or aged 55 and over with weight loss and any of the following: upper abdominal pain, reflux, dyspepsia.

 

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