29/10/2026

THURSDAY | OCT 29, 2026

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COMMENT by Dr Tee Sze Chee and Dr Muhammad Ilham Abdul Hafidz

Don’t be your own doctor: Seek advice M ALAYSIANS are remarkably good at finding explanations for stomach discomfort. Too much chilli, too much coffee, too much stress – there is always a reason ready and often an antacid within reach. important point is persistent symptoms should not be left to guesswork.

The challenge with upper GI symptoms is that they rarely announce their own severity. Persistent heartburn, recurring abdominal pain and ongoing bloating can all stem from easily managed conditions or they can be the earliest signs of something that requires more urgent attention. On the surface, the symptoms look the same. The difference only becomes clear with proper investigation. This is where late detection becomes a real concern. According to the Malaysia National Cancer Registry, more than 60% of cancer cases in this country are detected at stage three or four. For upper GI cancers specifically, Globocan 2022 data shows that stomach cancer recorded 1,528 new cases in Malaysia in a single year alongside 1,223 deaths – a ratio that reflects how often the disease is caught too late to treat effectively and why earlier intervention matters. Medication that works is not the same as a problem that is solved. Many of the conditions behind persistent upper GI symptoms are common and very treatable but some can be early signs of something more serious, including gastric cancer. The symptoms alone cannot tell you which one you are dealing with. In practice, late detection does not just mean harder treatment. It often means we are discussing a different set of outcomes entirely. Earlier detection gives us options. When gastric cancer presents very late, it is not uncommon that little can be done towards cure. That is the reality we must try to change. For those who have been putting off an evaluation out of fear, rest assured that there is nothing to fear. The procedure is very simple and straightforward – painless, quick and very safe. Most patients are surprised by how manageable it turns out to be. Whether the symptoms are caused by something mild and treatable or require further attention, getting a proper diagnosis early can offer reassurance, guide the right treatment and prevent potential complications from being overlooked. An endoscopy is not about expecting the worst. It is about understanding what your body has been trying to signal. While “gastric” may be a familiar label, it should not be the reason patients put off getting proper answers. Dr Tee Sze Chee is a upper gastrointestinal consultant and general surgeon, and Dr Muhammad Ilham Abdul Hafidz is a consultant gastroenterologist, hepatologist and physician at Sunway Medical Centre Damansara. Comments: letters@thesundaily.com merit, market forces will drive wage growth upward without direct state intervention. Given Malaysia’s abundant natural wealth and favourable demographic scale, the nation possesses the latent capability to outpace its regional peers. Achieving this potential hinges entirely on an educational framework that aligns human capital with an era defined by automation and artificial intelligence. Consequently, reinstating the teaching of science and mathematics in English must be prioritised to cultivate a workforce equipped to lead on the global stage. In a similar vein, GLCs must also transcend their reliance on protected state contracts and learn to compete aggressively in international markets. Patrick Teh

For occasional discomfort, that may be enough but when symptoms keep returning, worsen over time or stop responding to the usual remedies, what many call “just gastric” may need a closer look. When one starts to feel persistent heartburn, bloating, nausea, epigastric pain, difficulty swallowing or recurring indigestion, it can point to a range of conditions – from gastritis and acid reflux to peptic ulcers or more serious concerns that warrant early attention. An upper gastrointestinal (GI) endoscopy is one of the procedures doctors may recommend to better understand what is happening inside the oesophagus, stomach and upper part of the small intestine. Yet for many patients, an endoscopy can feel intimidating before it even begins. Questions around fasting, sedation, discomfort, biopsies and recovery often create more anxiety than the procedure itself. Don’t take persistent symptoms lightly Upper GI symptoms are common and many Malaysians learn to live around them, dismissing them as part of daily life, especially when over-the-counter medication appears to offer temporary relief. Lifestyle factors also play a role in how symptoms develop and persist. Spicy food, acidic beverages, caffeinated drinks, irregular meal timings, late-night eating and heavy meals can all contribute to bloating, reflux or indigestion – patterns that are deeply embedded in how many Malaysians eat and work. Stress and poor sleep can compound the picture further. Antacids or dietary changes may help manage discomfort but they do not explain what is causing it. This matters because similar symptoms can point to very different conditions. Persistent heartburn may be linked to gastroesophageal reflux disease. Recurring upper abdominal pain may be associated with gastritis, peptic ulcers or helicobacter pylori infection. The challenge is that because symptoms tend to come and go, many patients delay seeking evaluation until the condition has begun to affect daily life. Certain symptoms should not be repeatedly self-treated. Frequent heartburn, difficulty or pain when swallowing, persistent nausea, unexplained weight loss, reduced appetite, vomiting blood or passing black stool are all

Knowing what happens can make an endoscopy feel less uncertain. But the more important point is persistent symptoms should not be left to guesswork. – REUTERSPIC

symptoms that should be properly assessed by a doctor. Sometimes these symptoms can mask underlying conditions that require medical attention. An upper GI endoscopy provides the diagnostic clarity that symptom management alone cannot. Using a thin, flexible tube fitted with a high definition camera, a gastroenterologist can directly examine the lining of the oesophagus, stomach and duodenum in real time. This can provide a much clearer understanding of the root cause of the symptoms. What is an endoscopy? Much of the anxiety around endoscopies usually comes from not knowing what to expect. The two most common concerns – regardless of a patient’s age or background – are fear of pain and the worry of waking up mid-procedure. In practice, both are largely unfounded. 0 Before Patients are typically required to fast for six to eight hours, so the stomach is empty for a clear examination of the upper digestive tract. Patients should also inform their doctor about any regular medications, allergies, existing medical conditions or previous make a direct comparison imperfect, the figures raise legitimate questions about Malaysia’s public-sector staffing levels, wage bill and scope for greater efficiency. If Thailand can commit to a 5% reduction, Malaysia can easily afford an 8% consolidation, particularly given how modern automation has rendered manual processing obsolete. Today, essential transactions like utility payments, quit rent and municipal assessments are seamlessly managed online. While the introduction of the goods and services tax (GST) in 2015 was a highly effective measure to arrest federal debt, its subsequent abolition in 2018 severely derailed fiscal consolidation. Amid recent calls by certain parties to reinstate a pure GST framework rather than a hybrid model, the current administration should seize the opportunity to implement GST

reactions to sedation. 0 During

Sedation is administered intravenously before the procedure begins. Once the patient is comfortable and asleep, the endoscopy proceeds. They will not feel or remember anything during the procedure. The doctor then guides a thin, flexible scope through the mouth to examine the oesophagus, stomach and duodenum – a process that typically takes less than 10 minutes. In some cases, a biopsy may be taken during the procedure. That biopsies are routinely used to test for H.pylori infection. They may also be taken if a visible abnormality – such as an ulcer, polyp or growth – is identified during the examination. 0 After Patients are moved to a recovery area and monitored while the sedation wears off. Mild bloating or throat discomfort can occur but these usually settle on their own. Some findings may be discussed shortly after the procedure. Biopsy results typically take a few days and are reviewed at a follow-up appointment, where the doctor will also outline the appropriate next steps based on what was found. Why earlier detection is crucial Knowing what happens can make an endoscopy feel less uncertain. But the more at a modest 5%, with clear exemptions for essential goods. The rakyat expect more than just anti corruption rhetoric; they require concrete structural measures to dismantle economic inefficiency. All public contracts and major infrastructure projects must be awarded transparently through competitive open-market bidding. Furthermore, a firm policy must be established to halt the unconditional bailing out of underperforming government-linked companies (GLCs). Populist handouts become obsolete when state resources are managed efficiently. Capital wasted on artificial lifelines for failing GLCs should instead be channelled into building a robust economic foundation that naturally yields high-value job opportunities. When domestic corporations thrive on

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LETTERS

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EVERY federal budget announcement consistently prioritises short-term populist handouts over the structural reforms needed to resolve decades-old economic vulnerabilities. Running continuous deficits has become an accepted norm, pushing our national debt past the trillion-ringgit threshold since 2018. A sobering contrast can be seen in Thailand, which recently announced plans to trim its 1.7 million-strong civil service by 5% to curb public spending for a population of 71 million. In comparison, Malaysia maintains a public sector of 1.3 million civil servants for a population half that size. While differences in workforce definitions and reporting periods