Usually you begin by seeing your family doctor (GP), who will examine you and arrange any tests or x-rays that may be necessary. Your GP will refer you to hospital for these tests and for specialist advice and treatment.
The doctor at the hospital will take your full medical history before doing a physical examination. You will probably have a blood test taken to check your general health. You may also be asked to bring a stool sample with you so that it can be tested for blood.
To examine the stomach in more detail, your doctor may arrange for you to have an endoscopy or a barium meal. 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. Before an endoscopy the stomach has to be empty, so you will be asked not to eat or drink anything for at least four hours beforehand. Most people are given a sedative before an endoscopy. The sedative is usually given as an injection into a vein in your arm. This will make you feel sleepy so you don't feel too uncomfortable during the test. A local anaesthetic may also be sprayed onto the back of your throat and the doctor or nurse passes an endoscope (a thin, flexible tube) down the gullet into the stomach.
The endoscope has a light and camera at the end. Photographs are taken of the lining of the stomach and a small sample of cells (biopsy) is taken for examination 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.
An endoscopy can be uncomfortable but it is not painful. After a few hours the effects of the sedative should have worn off. You will then be able to go home. You should not drive for several hours afterwards and it is advisable to arrange for someone to either drive you home or travel home with you. Some people have a sore throat after their endoscopy. This is normal and should disappear after a few days.
This test will be done in the hospital x-ray department. You will be asked not to eat or drink anything for at least six hours before the test. You will then be given a white, chalky-tasting liquid to drink. This contains barium, which makes the gullet and stomach show up on an x-ray.
You'll be asked to lie on a couch, and 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. A barium meal 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. Sometimes the barium causes constipation so you may need to take a laxative for a couple of days. Your stools are likely to be very pale for a few days.