Problems with the gastrointestinal tract force a person to radically change his eating habits. And this is understandable, because when you experience acute pain, tingling, burning, a feeling of heaviness, tension in the stomach or constant burning, you can not only refuse your favorite foods, but also completely lose your appetite. However, a food boycott can harm the patient even more. Therefore, a clear understanding of how to eat when there are problems with the stomach will help alleviate the acute symptoms of the disease and feel the joy of life again. Today we will take a detailed look at what diet you should follow if you have a stomach ulcer.
Stomach ulcer diet is the most important direction of therapy
Diet certainly has a significant impact on our health. Proper nutrition can speed up the healing of ulcers and prevent the development of complications. Therefore, anyone facing a similar disease should know how to eat properly if they have a stomach ulcer. Of course, diet does not replace treatment, but without a special diet, drug therapy will not be effective.
With an ulcer, the integrity of the mucous membrane is disturbed, so digestion, accompanied by the secretion of hydrochloric acid, causes a lot of pain. What diet for a stomach ulcer will help reduce symptoms and speed up healing? The main purpose of nutrition is to promote rapid closure of the ulcer. But this process is long, and if with the first signs of relief the patient returns to the food products that provoke the development of the disease, then the ulcer will not wait long. In order for this not to happen, medical nutrition should become a way of life for several months or even years.
How to eat if you have a stomach ulcer
What you should not do is to starve, because then the acid starts to corrode the stomach walls even more, which only worsens the course of the disease. Therefore, it is imperative to follow the diet prescribed by the gastroenterologist, avoiding hunger and discomfort. What should you eat if you have a stomach ulcer?
- Food should not irritate the mucous membrane and increase the acidity of gastric juice.
- Consume only easily digestible food in liquid, pureed, crushed form, chewing slowly.
- Hot and cold foods are prohibited, as such foods interfere with the production of enzymes and slow down the regeneration of the mucous membrane. The optimum temperature is between 26 and 33 °C.
- You should eat in small portions with breaks not exceeding three hours. The frequency 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.
That is interesting
The first medical diet for patients with stomach ulcers was developed by Mihail Pevzner, the founder of clinical gastroenterology and dietetics.
Diet has been shown to directly affect 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 in case of exacerbation of stomach ulcer
So, the most important question: what can you eat if you have a stomach ulcer? Medical diet complements pharmacological treatment of ulcers during exacerbations and remissions and lasts from six months to a year. Therapeutic nutrition includes reducing the mechanical, chemical and thermal load on the painful stomach. Food should activate regeneration and healing of damage, reduce inflammation, improve gastric secretion and motility.
Following the therapeutic diet for gastric ulcer, the allowed foods can be boiled, fried or steamed. Meat and fish must be completely free of skin, bones, cartilage, veins, tendons and fat. When cooking meat, the boiled water should be poured twice to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: lean rabbit meat, turkey meat, chicken meat, veal meat, beef meat, lean sea fish, soft-boiled eggs or an omelette. It is necessary to enrich the diet with fat in the form of unsalted butter and add vegetable oils only to ready meals, without using them for heat treatment.
From foods containing carbohydrates, some vegetables are recommended (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked grains (oatmeal, semolina, rice, buckwheat), as well as various pastas, dry white bread, crackers, cookies, unleavened cookies.
Desserts included in the diet are purees, mousses, jellies from soft, sweet berries and fruits, baked fruits, natural marshmallows, marshmallows and marmalade, jam and marmalade. Honey is recommended as it reduces pain and inflammation and helps neutralize acid.
It is useful to drink milk, which surrounds 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 (such as palm oil), which have a negative effect on digestion. Let's say, low-fat cottage cheese in the form of casseroles, acidophilus, fresh (! ) kefir, natural yogurt and cream, unfermented cheese.
Recommended drink: decoctions of chamomile, rosehip, mint, weak tea, compotes, jelly, fruit drinks, diluted sweet juices, as well as water at room temperature. With the doctor's approval, 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. The maximum permissible 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 kept in mind that we also get salt from finished products, for example, cheeses, including processed ones, it is in large quantities.
It is important to understand that many foods are completely unacceptable for patients with ulcers, because they irritate the mucous membrane, take a long time to digest and cause bleeding. All fatty, spicy, salty, sour, smoked, fried and canned, sausages, offal, spices, ketchup, sauces and marinades are excluded. White cabbage, radishes, radishes, turnips, sour greens (sorrel, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard, onions should be avoided.
Also, the list of prohibited items includes strong tea and coffee, citrus fruits, nuts, whole grain bread, any confectionery, including home-baked ones, chocolate, ice cream, alcoholic and carbonated drinks.
Different table nos are used in different stages of the disease. 1 subtypes. What kind of diet should be followed in case of gastric ulcer depends on the patient's well-being and the severity of the symptoms.
So, a stricter diet is recommended to relieve acute exacerbations— table no. 1a. This diet is intended for periods of intense illness accompanied by acute pain. Usually during this time the patient is forced to stay in bed. The goal of the diet is a purely delicate attitude towards digestion and maximum elimination of the impact of food on the stomach.
What can you eat during an exacerbation of a stomach ulcer and what can't you? The diet for acute stomach ulcers includes 6-7 meals a day in very small portions and reduces the 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 liquid or pureed. Creamy soups, liquid and slimy porridges, soufflés 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 that, the patient switches to gentlediet no. 1, whose purpose—not only protects the mucous membrane, but also accelerates its regeneration. The essence of nutrition is generally preserved, while the list of acceptable foods is expanded and the method 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 soufflé from potatoes, beets and carrots. Different putties, jellies, jelly with milk, sweet fruits and juices, honey and sugar are introduced. Steamed dishes from unfermented cottage cheese and egg whites, sour cream, soft 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 of doctor Nizhegorodtsev A. S. , a surgeon with 17 years of experience.
Definition of disease. Causes of the disease
Gastric ulcer(Gastric ulcers) is a chronic, recurrent disease in which defects of the gastric mucosa occur. If left untreated or delayed, it can lead to disability or death.
Causes of stomach ulcer
The most common cause of gastric and duodenal ulcers isHelicobacter pylori infection. It is found in about 70% of patients with gastric ulcer and up to 90% of patients with duodenal ulcer. The prevalence of H. pylori as the main causative agent of gastric and duodenal ulcers has decreased in developed countries in recent years (for example, it is 11% in Sweden). This is usually due to improvements in the quality of medical care, which allows early diagnosis and treatment of infection, as well as improvements in sanitary conditions (for example, the quality of tap water). In our country, the prevalence of infection reaches approximately 70%, while the majority of infected people do not even suspect it and do not complain about anything.
The second main cause of peptic ulcer disease ispain relievers, especially non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of NSAIDs freed people from various pains, on the other hand, due to long-term uncontrolled use of these drugs, "healing" ulcers of the stomach and duodenum began to form more often.
In the third place among the causes of gastric and duodenal ulcer isdiseases 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 (tumor of the pancreas), etc.
The likelihood of peptic ulcer development is greatly affectedpredisposing factors, which are:
- neuro-emotional overload (stress);
- violation of daily routine and diet, consumption of refined foods and fast food;
- complex heredity (for example, the presence of peptic ulcer in parents).
If you experience similar symptoms, consult your doctor. Do not use self-medication - it is dangerous for your health!
Stomach ulcer symptoms
Pain- the most common symptom of a stomach ulcer. It is localized in the upper abdomen and may decrease or increase immediately or after eating, depending on the location of the ulcer. And if the ulcer is localized in the duodenum, the pain may increase (or decrease) 30-40 minutes after eating.
The intensity of the pain varies from severe and transient, which can even cause reflex vomiting immediately after eating, to weak and constant, which increases in the morning and passes after eating. Sometimes the patient may wake up at night with a feeling of "sucking in the abdomen" (in the cavity under the ribs) or pain in the upper abdomen.
Feeling of "early fullness" and heaviness in the stomachthere are also signs of peptic ulcer disease. A person often begins to reduce the portions of food, because the absorption of even a small amount of food, which enters the inflamed areas of the gastric mucosa and ulcers, can cause these unpleasant sensations.
Bad breath, nausea, taste changes, plaque 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 the most dangerous with its terrible complications, which sometimes develop at lightning speed in an apparently healthy person. Sometimes they lead to fatal consequences. For example, at the time of perforation of an ulcer of the stomach wall, the patient experiences sharp intense pain that causes shock and disorientation, sometimes with loss of consciousness. It is scary to imagine what this will lead to if this person turns out to be a car, bus driver or plane pilot. The same misfortune can happen to a person who is on vacation far from civilization: since there is no possibility to receive emergency medical help, the chances of survival are significantly reduced.
Complications of gastric ulcer
Bleeding from an ulcer- the most common complication. This is dangerous, because if the wall of a blood vessel is damaged in an ulcer and bleeding begins, a 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 becomes pale and covered with sweat;
- weakness increases;
- shortness of breath appears despite reduced physical activity.
If the ulcerative defect and the source of bleeding are in the lower part of the stomach or duodenal bulb, then symptoms of blood loss appear first, and then liquid, tarry ("black") stools appear.
Perforation of the stomach wall- the formation of a 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- general inflammation of abdominal tissue. The moment of perforation is accompanied by sharp, extremely intense pain, up to a painful shock, a drop in blood pressure and a sharp pallor of the skin. After that, intoxication (symptoms of "poisoning") and multi-organ failure increase. Without emergency medical help, 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 the intestinal wall, then it can spread to this neighboring organ. Then the first manifestations of a stomach ulcer may be gradually increasing symptoms of inflammation in the secondarily affected organs.
Malignant tumour- degeneration of peptic ulcer into stomach cancer with all the consequences that follow. The risk of such degeneration appears if the ulcer exists for a long time.
Scar stenosis- dangerous consequences of ulcer healing. As a result of scarring, the lumen of the stomach or duodenum can be significantly narrowed to the point where it is difficult or impossible for solid and liquid food to pass through. In this case, the patient loses weight, quickly becomes exhausted and gradually dies from dehydration and starvation.
Diagnosis of gastric ulcer
Diagnosis of a typical ulcergastric surgery is quite simple, it is performed by a therapist or a gastroenterologist. During the examination, the doctor determines the general condition of the patient, specifies the complaints, the nature and peculiarities of the course of the disease, and during palpation finds out the boundaries of the painful areas and their nature. If necessary, the doctor prescribes blood tests and instrumental examinations to form a clear picture of the patient's state of health and develop the most optimal treatment plan.
It is more difficult to diagnose whenatypical or painless ulcer, especially if complications occur 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, anamnesis clarification, and blood sampling are performed. tests, and if necessary, EGD, ultrasound, X-ray.
The optimal method for diagnosing peptic ulcer disease (and if it is painless, then the only and effective way) isregular 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 part of the gastrointestinal tract, the presence and nature of inflammatory and erosion-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 gastric mucosa are taken from tumors for histological examination to determine the type of tumor.
If a patient shows signs of gastric bleeding, EGD is used to identify sources of bleeding that can be addressed immediately, allowing the patient to avoid major surgery.
Treatment of stomach ulcers
Peptic ulcers are treated by a therapist or gastroenterologist. It aims to relieve symptoms, heal ulcers and address the cause of the disease through diet, lifestyle changes and medication.
To get rid of the H. pylori infection that causes the ulcer, the doctor prescribes antibiotics, but to reduce the acidity of the stomach juices, antacids, etc. c. If a stomach ulcer is caused by the use of painkillers (NSAIDs) or other medications that can cause the development of an ulcer, the doctor will prescribe the patient other drugs 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, mainly smoking and excessive alcohol consumption. This will prevent the risk of complications.
Also during the treatment you have to follow a certain diet - diet no. 1. It includes a nutritious diet divided into 5-6 meals a day. The consumption of strong gastric secretion irritants (ketchup, spicy spices), coarse foods and dishes is limited. Food is prepared mainly in puree, steamed or boiled in water, fish and lean meat are served in pieces. Very cold and hot foods are excluded from the diet. Limit your intake of table salt.
By restoring the balance between aggressive and protective factors, ulcers heal on their own within 10-14 days.
In case of complications of peptic ulcer (perforation, stenosis, uncontrolled, repeated bleeding) or in case of ineffectiveness of drug therapy, the treatment is performed surgically. However, surgery is always a big risk. In case of peptic ulcer, it is done as a last resort. If it can be avoided by not allowing the disease to develop, then it is better to take this opportunity.
Forecast. Prevention
The prognosis of peptic ulcer disease depends on the patient himself. With a healthy lifestyle, proper nutrition and a careful attitude to your health, the likelihood of stomach ulcers is extremely low. Violation of sleep and nutritional habits, excessive work, stress, neglecting routine medical examination and ignoring your seemingly minor discomforts often lead to the development of complex forms.
Prevention of peptic ulcer disease is much easier, faster and cheaper than treating its advanced forms and complications. For this purpose, the World Health Organization (WHO) recommends, starting from the age of 25, to undergo an annual preventive examination by a family doctor or a gastroenterologist. If relatives have had a peptic ulcer, regardless of complaints, endoscopy with determination of gastric juice acidity, clarified biopsies for detection of H. pylori infection and histological examination of suspicious areas are recommended. It happens once every two years. If there are no complaints, preventive comprehensive endoscopy is indicated every two years after 35 years. Identified and operatively treated diseases 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 its development;
- secondary- aimed at preventing the progression of an existing disease;
- tertiary- is performed after the development of complications.
Primary prevention rules:
- Observe a certain amount of daily calories: carbohydrates - 50% or more, proteins - 30%, fats - 15-20%. It is important to consider physical activity, height and weight. You should eat often, in small portions. Eliminate "starving" and "mono-diets". It is highly undesirable to use alcohol, soda, fatty, fried, smoked foods, canned food and fast snacks. It is recommended to eat cereal porridge, soups, boiled meat and fish, vegetables and fruits. Moderate consumption of confectionery and sweets is allowed.
- Follow a healthy lifestyle: give up bad habits, be physically active, sleep at least 7 hours a night. Avoid stressful situations, learn to perceive them correctly.
- Visit the doctor regularly as part of a medical examination and eliminate foci of chronic infection, including immediate treatment of caries, because it reduces general immunity, which makes any infection easier, including H. Pylori.
- Starting from the age of 25, a planned comprehensive endoscopic examination - endoscopy with detection of H. Pylori - is performed every two years.
Insecondary and tertiaryprevention is added to all rules from the first stage:
- Strictly follow diet no. 1. Avoid eating hard-to-digest coarse foods, meat, fish and mushroom broths, strong tea and coffee, confectionery, chocolate, fresh sour fruits, spicy vegetables - turnips, radishes, radishes, onions. The food should be steamed, boiled or baked (without the crust) in puree. It should be warm: neither cold nor hot. Portions should be small. It is preferable to drink mineral water, which reduces stomach acidity.
- Eliminate all causes of ulcer exacerbation, such as chronic gastritis.
- Follow medical instructions carefully.
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 educated person, listen to the recommendations of doctors, official authoritative medical sources and do not neglect routine examinations.