Research is still ongoing that link the consumption of certain types of foods high in salt, processed meats and smoked foods to stomach cancer. What can be said is that eating poorly preserved food represents a risk factor for the development of cancer cells over the years.
Antacids are drugs that are widely spread among the population and are gaining increasing space in the rankings of medical prescriptions. Among them, proton pump inhibitors (PPIs) are worth mentioning, represented in Brazil by omeprazole, pantoprazole, lansoprazole and esomeprazole. This class of medication is known to be the most effective in fighting gastric acidity, reducing it by more than 99%, which provides symptomatic relief in the overwhelming majority of users.
Its indications for use are various and, in general, for short intervals of time, except in a condition called Zollinger-Ellison syndrome, in which the acid-secreting cells are continually hyperstimulated. The main recommendations involve, among others, the treatment of: benign gastric and duodenal ulcers, gastroesophageal reflux disease, erosive esophagitis, Helicobacter pylori infections or general dyspeptic symptoms such as heartburn. In general, 4 to 8 weeks of therapy is sufficient to resolve most situations. However, there are cases that may require use for long periods of time, without specific deadlines to end.
Despite being safe drugs, some of their long-term side effects still remain somewhat uncertain. And the hypothesis that most raises concerns in this regard is that proton pump inhibitors may be involved in the development of precancerous lesions in the stomach.
Well, although some results support this concept, most of the available literary data does not support it. A meta-analysis (high-quality scientific work) recently published in December 2014 analyzed all major studies conducted in adults for this purpose. The researchers concluded that, in light of current knowledge, there is no scientific evidence to support the idea that long-term use of proton pump inhibitors is related to the development of precancerous lesions. However, despite the very rare cases reported, they consider that there is a potential built-in risk of thickening (hyperplasia) of certain stomach cells that can give rise to a neoplasm called carcinoid, a type of tumor with low malignant potential.
A gastric ulcer is a sore on the stomach lining, which is usually manifested either by pain in the upper abdomen or by bleeding. The main type is peptic ulcer, represented by a benign erosion of the stomach wall, or duodenum, from the corrosive action of gastric juice, rich in acid and enzymes, on the cells. The stomach has defense mechanisms against its own acidity. The cells are prepared to produce a layer of mucus, which prevents their direct contact with the acid produced. However, in some people, factors such as genetics, smoking, use of anti-inflammatory drugs and H. pylori infection, for example, contribute to breaking this barrier and predispose the individual to the development of peptic ulcer disease. This disease, which was once very problematic and difficult to control in the past, is now less of a concern and its treatment has been revolutionized with the advent of potent antacids, such as proton pump inhibitors.
The main differential diagnosis of benign peptic ulcers is stomach cancer, which can also appear in the form of ulcers, however composed of malignant cells. The precise definition between the two entities requires biopsies by endoscopy and laboratory analysis, since both the macroscopic appearance and the clinical symptoms manifested are very similar. In general, peptic lesions have a rounded or oval shape, well-defined edges, and tend to be flatter or slightly elevated. The fundus is normally filled with fibrin and areas of granulation tissue, which denote a healing appearance. On the other hand, malignant lesions stand out for being asymmetrical and irregular and for being deeper. In addition, they usually have raised edges, asymmetrical folds that widen and taper abruptly and reveal areas of cell necrosis at their bottom. Unlike peptic disease, malignant gastric tumors are complex diseases and deserve aggressive treatment, often with extensive surgical resections, chemotherapy and/or radiotherapy.