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Stomach cancer is no longer one of the most common cancers in the United States, accounting for just 1.5% of new cancer diagnoses per year, according to the American Cancer Society. Still, early recognition is crucial, and being able to identify the possible signs of stomach cancer—and distinguish them from run-of-the-mill digestive woes—could make all the difference.

The most common feature of the early stages of stomach cancer is that there are no symptoms at all, said Umut Sarpel, M.D., the chief of the division of surgical oncology at Beth Israel Deaconess Medical Center in Boston. “We all get stomachaches from time to time, and that can make people worry about stomach cancer,” Dr. Sarpel said. “But it’s not one of the most common cancers, and in most cases, stomachaches or pain are not going to be the result of cancer.”

Meet the expert: Umut Sarpel, M.D., the chief of the division of surgical oncology at Beth Israel Deaconess Medical Center in Boston.

But what are the signs then, when they do appear? Read on to discover the digestive problems that may be associated with stomach cancer and would merit a call to your doctor.

Top symptoms of stomach cancer

Blood in your vomit or stool

While both colitis and Crohn’s disease can cause bloody stool, it can also be a sign of cancer. Regardless, blood in either your poop or your vomit demands a visit to a GI doctor, Dr. Sarpel said. If the bleeding is related to cancer, the blood in your stool is likely to look maroon or tarry black. “It looks that way because it’s been acted on by your digestive enzymes,” she explained. If the blood is in your vomit, it’s more likely to look bright red, and it may have a coarse texture similar to used coffee grounds because it has been partially digested, Dr. Sarpel added.

Feeling full after just a few bites of food

You were definitely hungry when you sat down to eat. But after a few bites, your appetite vanishes and the food isn’t appealing. Dr. Sarpel called this “early satiety” and said it’s another symptom that could—emphasis on could—indicate stomach cancer. “Especially if feeling full really quickly is different than what you’re used to, that’s something you shouldn’t ignore,” she said.

Constant, gnawing stomach pain

Yes, in some cases stomach pain is a sign of stomach cancer. But in most cases, your run-of-the-mill pain or stomach cramps are going to be the result of some other gut or abdominal ailment, not cancer, Dr. Sarpel said. If it is a result of cancer, the pain will be a consistent gnawing in the middle of your stomach that never ceases, she added. “It’s not something you feel for one day, and then it goes away for two weeks and comes back again,” she said.

Losing weight without trying

Many health conditions—including type 1 diabetes, Addison’s disease, and Crohn’s disease—can lead to unexplained weight loss. Add stomach cancer to that list, Dr. Sarpel said. “If you’re losing weight and not dieting, that’s something to pay attention to,” she explained. In the case of stomach cancer, the weight loss may be gradual. While you may not notice a sudden drop, you might step on a scale and find you’ve lost 10 pounds during the last six months. It is totally natural for your weight to fluctuate, but if the weight loss is noticeable and you haven’t been doing anything that accounts for it, talk with your doctor.

Frequent, unexplained heartburn

Heartburn, indigestion, and other common symptoms of an unhappy gut can also be early warning signs of stomach cancer, according to the MD Anderson Cancer Center at the University of Texas. Again, Dr. Sarpel said these sorts of symptoms are much more likely to be something other than cancer. But it’s still a good idea to let your doctor know what’s going on, especially if they are constant and don’t seem to be caused by consumption of specific foods and drinks.

Regular bloating, diarrhea, or constipation

It makes sense that a cancer growing in your stomach could make you feel bloated or mess with your bowel movements. While each of these symptoms is never going to scream “stomach cancer!” to a doctor and is likely due to some other cause, experiencing them with some of the other issues on this list—especially if you have other stomach cancer risk factors, like being over 60, being overweight or obese, having a history of smoking, or having had stomach surgery in the past—could lead to cancer-related follow-up testing if your doctor can’t pinpoint another explanation.

—Additional reporting by the Editors of Prevention

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