Problems with the gastrointestinal tract force a person to radically change their eating habits. And this is understandable, because experiencing acute pain, tingling, burning, heaviness, tightness in the stomach or constant heartburn, you can not only give up your favorite dishes, but also completely lose your appetite. However, a food boycott can harm the patient even more. Therefore, a clear understanding of how to eat if you have stomach problems will help relieve acute symptoms of the disease and once again feel the joy of life. Today we will look in detail at what diet you should follow if you have a stomach ulcer.
Diet for stomach ulcers is the most important direction of therapy
Nutrition certainly has a significant impact on our health. A properly formulated diet can speed up the healing of ulcers and prevent the development of complications. Therefore, everyone who is faced with a similar disease needs to know how to eat properly if they have a stomach ulcer. Of course, diet does not replace treatment, but without special nutrition, drug therapy will not be effective.
With an ulcer, the integrity of the mucous membrane is compromised, so digestion, accompanied by the secretion of hydrochloric acid, causes a lot of pain. What diet for stomach ulcers will help relieve symptoms and speed up healing? The main goal of nutrition is to promote the speedy closure of the ulcer. However, this process is long, and if, with the first signs of relief, the patient returns to foods that provoke the development of the disease, then the ulcer will not be long in coming. To prevent this from happening, therapeutic nutrition should become a way of life for several months, or even years.
How to eat if you have a stomach ulcer
What you don’t need to do is starve, because then the acid begins to corrode the walls of the stomach even more, which only aggravates the course of the disease. Therefore, it is imperative to adhere to the diet prescribed by the gastroenterologist, avoiding feelings of hunger and discomfort. What should you eat if you have a stomach ulcer?
- Food should not cause irritation of the mucous membrane and increase the acidity of gastric juice.
- You should consume only easily digestible food in liquid, pureed, crushed form, chewing it slowly.
- Hot and cold foods are prohibited, because such dishes interfere with enzyme formation and slow down the restoration of the mucous membrane. The optimal temperature is from 26 to 33 °C.
- You need to eat in small portions with breaks of no more than three hours. The regularity of meals is determined by the severity of the condition and ranges from five to eight times a day.
- Drinking regime - from 1. 5 to two liters per day.
This is interesting
The first medical diet for patients with stomach ulcers was developed by Mikhail Pevzner, the founder of clinical gastroenterology and dietetics.
It has been proven that diet directly affects the course of the disease. Therefore, strict adherence to the nutritionist’s recommendations is the key to recovery. The diet for people with stomach ulcers is called "table No. 1". Let's look at the basics of this diet.
Table No. 1 - diet for exacerbation of stomach ulcers
So, the most important question: what can you eat if you have a stomach ulcer? A medical diet accompanies pharmacological treatment of ulcers during subsiding exacerbation and remission and lasts from six months to a year. Therapeutic nutrition involves minimizing the mechanical, chemical and thermal load on the sore stomach. Food should activate regeneration and healing of damage, reduce inflammation, and improve gastric secretion and motility.
When following a therapeutic diet for stomach ulcers, permitted foods can be boiled, baked or steamed. Meat and fish must be completely cleaned of skin, bones, cartilage, veins, tendons and fat. When cooking meat, you need to drain the boiled water twice to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: lean meat of rabbit, turkey, chicken, veal, beef, lean sea fish, soft-boiled eggs or omelet. It is necessary to enrich the diet with fats in the form of unsalted butter, and add vegetable oils only to ready-made dishes, not using them for heat treatment.
Among carbohydrate foods, some vegetables are recommended (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked grains (oatmeal, semolina, rice, buckwheat), as well as various pasta, dried white bread, crackers, biscuits, unleavened biscuits.
Desserts included in the diet include purees, mousses, jellies from soft, sweet berries and fruits, baked fruits, natural marshmallows, marshmallows and marmalade, jam and marmalade. Honey is recommended as it soothes pain and inflammation and helps neutralize acid.
It is useful to drink milk, which envelops the walls of the stomach and protects the mucous membrane. Fermented milk products should be included in the diet with caution and ensure that they do not contain vegetable fats (for example, palm oil), which have a detrimental effect on digestion. Let's say low-fat cottage cheese in the form of casseroles, acidophilus, fresh (! ) kefir, natural yogurt and sour cream, unleavened cheese.
Recommended drink: decoctions of chamomile, rose hips, mint, weak tea, compotes, jelly, fruit drinks, diluted sweet juices, as well as water at room temperature. With the approval of a doctor, you can drink fresh cabbage juice, which has an antibacterial effect, normalizes the enzymatic processing of food, and promotes the healing of damaged stomach walls.
The role of salt in diet No. 1 deserves special mention. The maximum allowable amount of salt is 6 g per day. But the less of it enters the body of a person suffering from a stomach ulcer, the better. It should be borne in mind that we also get salt from finished products; for example, it is present in large quantities in cheeses, including processed ones.
It is important to understand that many foods are completely unacceptable for patients with ulcers for the reason that they cause irritation of the mucous membrane, take a long time to digest and provoke bleeding. All fatty, spicy, salty, sour, smoked, fried and canned foods, sausages, offal, spices, ketchups, sauces and marinades are excluded. You need to give up white cabbage, radishes, radishes, turnips, sour greens (sorrel, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard, and onions.
Also on the list of prohibited items are strong tea and coffee, citrus fruits, nuts, wholemeal bread, any baked goods, including homemade baked goods, chocolate, ice cream, alcoholic and carbonated drinks.
At different stages of the disease, different subtypes of table No. 1 are used. What diet to follow for a stomach ulcer depends on the patient’s well-being and the severity of the symptoms.
So, to alleviate a sharp exacerbation, a more strict diet is recommended— table No. 1a. This diet is prescribed during periods of intense disease, accompanied by acute pain. As a rule, at this time the patient is forced to remain in bed. The goal of the diet is a purely delicate attitude towards digestion and the maximum exclusion of any impact of food on the stomach.
What can you eat during an exacerbation of a stomach ulcer and what can you not? The diet for acute stomach ulcers involves split 6-7 meals a day in very small portions and reduced energy value (up to 2010 kcal). All foods that cause the secretion of gastric juice and irritate the mucous membrane are absolutely unacceptable. Salt consumption is significantly reduced. Food, boiled and steamed, is served in a liquid or pureed state. Cream soups, liquid and slimy porridges, and souffles are widely used.
In addition to the main list of prohibited foods from the dietNo. 1abread in any form, fermented milk products, all vegetables and fruits are completely excluded.
This diet is prescribed until the ulcer begins to heal. After this, the patient switches to gentlediet No. 1, the purpose of which—not only provide protection to the mucous membrane, but also accelerate its recovery. The essence of the diet as a whole is preserved, while the list of acceptable foods is expanded and the nature of preparation changes: from completely liquid, pureed food to the state of "small pieces".
The energy value increases to 2500 kcal per day, the frequency of food intake is reduced to six times a day. Dried white bread is allowed, as well as mashed potatoes or soufflés from potatoes, beets and carrots. Various mousses, jellies, jelly with milk, sweet fruits and juices, honey and sugar are introduced. Steamed dishes made from unleavened cottage cheese and egg whites, sour cream, mild cheese, and butter are allowed.
Stomach ulcer - symptoms and treatment
What is a stomach ulcer? We will discuss the causes, diagnosis and treatment methods in the article by Dr. Nizhegorodtsev A. S. , a surgeon with 17 years of experience.
Definition of disease. Causes of the disease
Stomach ulcer(Stomach ulcers) is a chronic, relapsing disease in which defects occur in the gastric mucosa. If left untreated or untimely, it can cause disability or death.
Causes of stomach ulcers
The most common cause of stomach and duodenal ulcers isHelicobacter pylori infection. It is detected in approximately 70% of patients with gastric ulcers and up to 90% of patients with duodenal ulcers. The prevalence of H. pylori, as the main cause of gastric and duodenal ulcers, has decreased in recent years in developed countries (for example, in Sweden it is 11%). Typically, this is due to improvements in the quality of medical care, which allows for timely diagnosis and treatment of infection, as well as improved sanitation conditions (for example, the quality of tap water). In our country, the prevalence of infection reaches about 70%, while most infected people do not even suspect it and do not complain about anything.
The second leading cause of peptic ulcer disease ispainkillers, in particular non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of the action of NSAIDs relieved people of various pains, on the other hand, due to prolonged uncontrolled use of these drugs, "medicinal" ulcers of the stomach and duodenum began to occur more often.
In third place among the causes of stomach and duodenal ulcers arediseases that increase gastrin production- a hormone that increases the production of hydrochloric acid and increases the aggressiveness of gastric juice. These include B12 deficiency anemia, gastrinoma (pancreatic tumor), etc.
The likelihood of developing a peptic ulcer is greatly influenced bypredisposing factors, which are:
- neuro-emotional overstrain (stress);
- violation of daily routine and nutrition, consumption of refined foods and fast food;
- complicated heredity (for example, the presence of peptic ulcer in parents).
If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!
Symptoms of a stomach ulcer
Pain- the most common symptom of gastric ulcer. It is localized in the upper abdomen and can decrease or intensify immediately or after a meal, depending on the location of the ulcer. And if the ulcer is localized in the duodenum, the pain may intensify (or decrease) 30-40 minutes after eating.
The intensity of pain varies from pronounced and transient, which can even lead to reflex vomiting immediately after eating, to weak and constant, which intensifies in the morning and goes away after eating. Sometimes the patient may wake up at night due to a feeling of "sucking in the pit of the stomach" (in the hollow area under the ribs) or pain in the upper abdomen.
Feeling of "early fullness" and heaviness in the stomachare also signs of peptic ulcer disease. A person often begins to reduce portions of food, since the absorption of even a small amount of food that ends up on the inflamed areas of the gastric mucosa and ulcers can cause these unpleasant sensations.
Bad breath, nausea, changes in taste, coating on the tongue- frequent companions of any inflammatory diseases of the upper gastrointestinal tract, including gastritis (inflammation of the stomach), against which ulcers most often appear.
Painless form of peptic ulceris most dangerous for its terrible complications, which sometimes develop at lightning speed in a seemingly healthy person. Sometimes they lead to fatal consequences. For example, at the moment of perforation of an ulcer of the stomach wall, the patient experiences a sharply expressed intense pain, which leads to a shock and disorientation, sometimes with loss of consciousness. It’s scary to imagine what this will lead to if this person turns out to be a car, bus driver or airplane pilot. The same misfortune can befall a person vacationing far from civilization: due to the lack of opportunity to receive emergency medical care, the chances of survival are significantly reduced.
Complications of stomach ulcers
Bleeding from an ulcer- the most common complication. It is dangerous because if the wall of the vessel in the ulcer is damaged and bleeding begins, the person does not feel anything, especially if the ulcer was painless. When the stomach becomes full of blood, reflex vomiting occurs. This is how the disease manifests itself. Then the patient develops symptoms of blood loss:
- blood pressure decreases;
- pulse quickens;
- the skin turns pale and becomes covered with sweat;
- weakness increases;
- shortness of breath appears despite decreased physical activity.
When the ulcerative defect and the source of bleeding are located in the lower parts of the stomach or in the duodenal bulb, then symptoms of blood loss first appear, and then liquid, tarry ("black") stool appears.
Perforation of the stomach wall- the formation of a through hole when the ulcer spreads through all layers of the stomach wall. Through this opening, the contents of the stomach flow into the abdominal cavity and causeperitonitis- total inflammation of the abdominal tissues. The moment of perforation is accompanied by sharp, extremely intense pain, up to painful shock, a decrease in blood pressure, and sharp pallor of the skin. Subsequently, intoxication (symptoms of "poisoning") and multiple organ failure increases. Without emergency medical care, a person dies with such a complication.
Ulcer penetrationcan also complicate the course of the disease. If the ulcer is located on the wall of the stomach, which is adjacent to another organ - the pancreas or intestinal wall, then it can spread to this neighboring organ. Then the first manifestations of gastric ulcer may be gradually increasing symptoms of inflammation in secondary affected organs.
Malignancy- degeneration of a peptic ulcer into stomach cancer with all the ensuing consequences. The risk of such degeneration appears if the ulcer exists for a long time.
Scar stenosis- a dangerous consequence of ulcer healing. As a result of scarring, the lumen of the stomach or duodenum may narrow significantly, to the point where it becomes difficult or impossible for solid and liquid food to pass through it. In this case, the patient loses weight, quickly becomes exhausted and gradually dies from dehydration and hunger.
Diagnosis of stomach ulcers
Diagnosis of a typical ulcerstomach surgery is quite simple, carried out by a therapist or gastroenterologist. During the examination, the doctor determines the general condition of the patient, clarifies complaints, the nature and characteristics of the course of the disease, and during palpation clarifies the boundaries of painful areas and their nature. If necessary, the doctor prescribes blood tests and instrumental examinations in order to form a clear picture of the patient’s health condition and develop the most optimal treatment plan.
It is more difficult to establish a diagnosis whenatypical or painless ulcer, especially when complications arise in the form of penetration - the spread of the ulcer to a neighboring organ.
The first sign of an asymptomatic or "silent ulcer" is often its complication in the form of bleeding, due to which the patient is urgently admitted to a surgical hospital, where a medical examination is carried out, anamnesis is clarified, blood is taken for tests, and, if necessary, EGD, ultrasound, X-ray.
The optimal method for diagnosing peptic ulcer disease (and if it is painless, the only and effective way) isroutine endoscopic examination— esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, lasts several minutes, and is accompanied by unpleasant but completely tolerable sensations. As a result of the examination, comprehensive information appears on the condition of the upper gastrointestinal tract, the presence and nature of inflammatory and erosive-ulcerative processes, as well as the appearance of neoplasms.
Using special technologies during endoscopy, the acidity of gastric juice and the presence of H. Pylori infection are determined, and small fragments of the gastric mucosa are taken from tumors for histological examination to determine the type of tumor.
When a patient presents with signs of gastric bleeding, EGD is used to identify sources of bleeding that can be immediately eliminated, allowing the patient to avoid serious surgical interventions.
Treatment of stomach ulcers
Peptic ulcers are treated by a therapist or gastroenterologist. It aims to eliminate symptoms, heal ulcers and eliminate the cause of this disease through diet, lifestyle changes and medication.
To get rid of the H. pylori infection that causes an ulcer, the doctor prescribes antibiotics, and to reduce the acidity of gastric juice, acid-reducing drugs, etc. If a stomach ulcer is caused by taking painkillers (NSAIDs) or other medications that can trigger the development of an ulcer, the doctor will select other medications for the patientdrugs similar to the "culprits" of the disease, which do not have an ulcer-forming effect.
If you have a peptic ulcer, it is very important to give up bad habits, primarily smoking and excessive alcohol consumption. This will eliminate the risk of complications.
Also, during treatment, you need to adhere to a certain diet - diet No. 1. It involves a nutritious diet, divided into 5-6 meals a day. The consumption of strong irritants of gastric secretion (ketchups, hot spices), coarse foods and dishes is limited. Food is prepared mainly pureed, steamed or boiled in water; fish and lean meats are served in pieces. Very cold and hot dishes are excluded from the diet. Limit your intake of table salt.
After restoring the balance between aggressive and protective factors, ulcers heal on their own within 10-14 days.
In case of complications of peptic ulcer disease (perforation, stenosis, uncontrolled, recurring bleeding) or in case of ineffectiveness of drug therapy, treatment is performed surgically. However, surgery is always a big risk. For peptic ulcers, it is performed as a last resort. If it can be avoided without allowing the disease to develop, then it is better to take advantage of this opportunity.
Forecast. Prevention
The prognosis for peptic ulcer disease depends on the patient himself. With a healthy lifestyle, proper nutrition, and careful attitude towards your health, the likelihood of developing a stomach ulcer is extremely low. Violation of sleep and nutritional patterns, overwork, stress, neglect of routine medical examinations, and ignoring one’s own seemingly minor discomforts often lead to the development of complicated forms.
Preventing peptic ulcer disease is much easier, faster and cheaper than treating its developed forms and complications. For this purpose, the World Health Organization (WHO) recommends that, starting from the age of 25, you undergo annual preventive examinations with a general practitioner or gastroenterologist. If relatives had a peptic ulcer, then, regardless of complaints, endoscopy is recommended with determination of the acidity of gastric juice, clarifying biopsies to determine H. pylori infection and histological examination of suspicious areas. It is held every two years. In the absence of complaints, preventive comprehensive endoscopy is indicated every two years after 35 years. Diseases identified and promptly treated in the early stages - gastritis, duodenitis, H. pylori infection - will avoid the development of not only ulcerative processes, but also cancer.
Varythree stages of prevention:
- primary- when there is no disease, but there is a risk of developing it;
- secondary- aimed at preventing the progression of an already existing disease;
- tertiary- carried out after the development of complications.
Rules of primary prevention:
- Stick to a certain daily calorie intake: carbohydrates - 50% or more, proteins - 30%, fats - 15-20%. It is important to take into account physical activity, height and weight. You need to eat often, in small portions. Eliminate "hungry" and "mono-diets". It is highly undesirable to consume alcohol, soda, fatty, fried, smoked foods, canned food, and fast food. It is recommended to eat cereal porridges, soups, boiled meat and fish, vegetables and fruits. Moderate consumption of baked goods and sweets is allowed.
- Adhere to a healthy lifestyle: give up bad habits, be physically active, sleep at least 7 hours at night. Avoid stressful situations, learn to perceive them correctly.
- Regularly visit a doctor as part of a medical examination and eliminate foci of chronic infection, including timely treatment of caries, as it reduces general immunity, which makes it easier for any infection, including H. Pylori.
- Starting from the age of 25, once every two years, undergo a planned comprehensive endoscopic examination - endoscopy with determination of H. Pylori.
Insecondary and tertiaryprevention to all rules from the first stage are added:
- Strictly follow diet No. 1. Avoid eating hard-to-digest rough foods, meat, fish and mushroom broths, strong tea and coffee, baked goods, chocolate, fresh sour fruits, spicy vegetables - turnips, radishes, radishes, onions. Food should be steamed, boiled or baked (without crust) in pureed form. It should be warm: not cold and not hot. Portions should be small. It is advisable to drink mineral water, which reduces stomach acidity.
- Eliminate any causes of exacerbation of the ulcer, for example, chronic gastritis.
- Carefully follow medical instructions.
From all this it follows that in most cases, the development of peptic ulcer disease and its complications can be easily avoided if you are a medically literate person, listen to the recommendations of doctors, official authoritative medical sources and do not neglect routine examinations.