Problems with the gastrointestinal tract force a person to radically change their eating habits. And this is understandable, because experiencing sharp 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 in case of stomach problems will help alleviate the acute symptoms of the disease and experience the joy of living again. Today we will look in detail which diet you should follow if you have a stomach ulcer.
Diet for stomach ulcers is the most important therapeutic direction
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, anyone who is faced with a similar disease must know how to eat properly if he has 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 mucosa is impaired, 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 rapid closure of the ulcer. However, this process is long and if, with the first signs of relief, the patient returns to the foods that provoke the development of the disease, the ulcer will not be long in coming. To prevent this from happening, therapeutic nutrition should become a lifestyle for several months or even years.
How to eat if you have a stomach ulcer
What you should not 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 stick 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 mucosa and increase the acidity of gastric juice.
- You should only consume easily digestible foods in liquid, blended and chopped form, chewing them slowly.
- Hot and cold foods are prohibited, as such dishes interfere with the formation of enzymes and slow down the restoration of the mucosa. The optimal temperature is between 26 and 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 varies from five to eight times a day.
- Consumption regime: 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, the key to recovery is strict compliance with the nutritionist's recommendations. 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 drug treatment of ulcers during the decrease of exacerbation and remission and lasts from six months to a year. Therapeutic nutrition involves minimizing the mechanical, chemical and thermal load on the painful 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, allowed foods can be boiled, baked or steamed. Meat and fish must be completely clean 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 useful: lean rabbit meat, turkey, chicken, veal, beef, lean sea fish, soft-boiled eggs or omelette. It is necessary to enrich the diet with fats in the form of unsalted butter and add vegetable oils only to ready-made dishes, without using them for heat treatment.
Among carbohydrate foods, some vegetables are recommended (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, courgettes), well-cooked cereals (oatmeal, semolina, rice, buckwheat), as well as various pasta, white bread dry, crackers, biscuits, unleavened biscuits.
Desserts included in the diet include purees, mousses, jellies from soft and sweet berries and fruits, cooked fruits, natural marshmallows, marshmallows and jam, 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 make sure that they do not contain vegetable fats (for example, palm oil), which have a harmful 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, rosehip, mint, weak tea, compotes, jellies, fruit drinks, diluted sweet juices and 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 the diet n. 1 deserves special mention. The maximum allowed amount of salt is 6 g per day. But the less it enters the body of a person suffering from stomach ulcer, the better. It should be kept in mind that we also obtain salt from finished products, for example it is present in large quantities in cheeses, even processed ones.
It is important to understand that many foods are completely unacceptable for ulcer patients because they cause irritation of the mucosa, take a long time to digest and cause bleeding. All fatty, spicy, salty, acidic, smoked, fried and canned foods, sausages, offal, spices, ketchup, sauces and marinades are excluded. You need to give up white cabbage, radishes, radishes, turnips, sour vegetables (sorrel, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard and onions.
The list of banned items also includes strong tea and coffee, citrus fruits, nuts, wholemeal bread, all baked goods, including homemade baked goods, chocolate, ice cream, alcoholic and carbonated drinks.
At different stages of the disease, different subtypes from table No. are used. 1. The diet to follow for a stomach ulcer depends on the patient's well-being and the severity of the symptoms.
So, to relieve a strong exacerbation, a more stringent diet is recommended— table no. 1a. This diet is prescribed during periods of intense illness, 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 gentle 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 not? The diet for acute gastric ulcer includes 6-7 meals a day divided into very small portions and with 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. The food, boiled and steamed, is served in a liquid or blended state. Creamy soups, liquid and slimy porridges and soufflés are widely used.
In addition to the main list of foods prohibited by 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. Subsequently, the patient switches to sweetnessdiet no. 1, whose purpose—they not only provide protection to the mucosa, but also accelerate its recovery. The essence of the diet as a whole remains the same, while the list of acceptable foods expands and the nature of the preparation changes: from completely liquid and 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. Dry white bread, mashed potatoes or soufflés from potatoes, beets and carrots are allowed. Various mousses, jellies, jelly with milk, fruit and sweet juices, honey and sugar are introduced. Steamed dishes made from unleavened cottage cheese and egg white, sour cream, sweet 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 ulcer) is a chronic relapsing disease in which defects occur in the gastric mucosa. If untreated or prematurely, 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 ulcer and up to 90% of patients with duodenal ulcer. 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 improved quality of medical care, which allows for timely diagnosis and treatment of the infection, as well as improved sanitary conditions (for example, the quality of tap water). In our country the prevalence of infection reaches around 70%, while the majority of those infected do not even suspect it and do not complain about anything.
The second leading cause of peptic ulcer ispainkillers, particularly non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of the action of NSAIDs relieved people from various pains, on the other hand, due to prolonged and uncontrolled use of these drugs, "medicinal" ulcers of the stomach and duodenum began to appear more often.
In third place among the causes of gastric 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 vitamin B12 deficiency anemia, gastrinoma (pancreatic cancer), etc.
The likelihood of developing a peptic ulcer is greatly influenced bypredisposing factors, Which ones are they:
- neuro-emotional overload (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, see your doctor. Do not self-medicate: it is dangerous for your health!
Symptoms of a stomach ulcer
Ache- the most common symptom of gastric ulcer. It is located in the upper abdomen and may diminish or intensify immediately or after a meal, depending on the location of the ulcer. And if the ulcer is located in the duodenum, the pain may intensify (or decrease) 30-40 minutes after eating.
The intensity of the pain varies from pronounced and transient, which can also lead to reflex vomiting immediately after eating, to weak and constant, which intensifies in the morning and disappears after eating. Sometimes the patient may wake up at night due to a "sucking in the pit of the stomach" sensation (in the hollow area under the ribs) or pain in the upper abdomen.
Sensation of "early fullness" and heaviness in the stomachthey are also signs of peptic ulcer. Often a person begins to reduce food portions, since the absorption of even a small amount of food that gets on the inflamed areas of the gastric mucosa and ulcers can cause these unpleasant sensations.
Bad breath, nausea, taste changes, coating on the tongue- frequent companions of any inflammatory disease of the upper gastrointestinal tract, including gastritis (inflammation of the stomach), against which ulcers most often appear.
Painless form of peptic ulcerit is very dangerous due to its terrible complications, which sometimes develop at lightning speed in a seemingly healthy person. Sometimes they lead to fatal consequences. For example, at the time of perforation of an ulcer of the stomach wall, the patient feels intense, sharp pain, leading to 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 or plane pilot. The same misfortune can happen to a person on vacation 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 vessel wall in the ulcer is damaged and bleeding begins, the person does not feel anything, especially if the ulcer was painless. When the stomach fills with blood, reflex vomiting occurs. This is how the disease manifests itself. Then the patient develops symptoms of blood loss:
- blood pressure decreases;
- the pulse accelerates;
- the skin becomes pale and covered in sweat;
- weakness increases;
- shortness of breath appears despite reduced 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, symptoms of blood loss first appear, and then liquid, tarry ("black") stools appear.
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 acute, extremely intense pain, up to painful shock, a decrease in blood pressure and severe paleness of the skin. Subsequently, intoxication ("poisoning" symptoms) and multiorgan failure increase. Without emergency medical care, a person dies with such a complication.
Ulcer penetrationit can also complicate the course of the disease. If the ulcer is located on the stomach wall, which is adjacent to another organ: the pancreas or intestinal wall, it can spread to this neighboring organ. So the first manifestations of gastric ulcer can gradually increase the symptoms of inflammation in the secondary affected organs.
Malignancy- degeneration of peptic ulcer into stomach cancer with all the resulting consequences. The risk of such degeneration appears if the ulcer has existed for a long time.
Scar stenosis- a dangerous consequence of ulcer healing. Due to scarring, the lumen of the stomach or duodenum may narrow significantly, to the point that it becomes difficult or impossible for solid and liquid food to pass through. In this case, the patient loses weight, gets tired quickly and gradually dies from dehydration and starvation.
Diagnosis of stomach ulcers
Diagnosis of a typical ulcerStomach surgery is quite simple, performed by a therapist or gastroenterologist. During the examination, the doctor determines the general condition of the patient, clarifies the complaints, the nature and characteristics of the course of the disease, and during palpation clarifies the boundaries of the 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 draw up 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 nearby organ.
The first sign of an asymptomatic ulcer 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, the anamnesis, blood test is taken and, if necessary, EGD, ultrasound, x-ray.
The optimal method for diagnosing peptic ulcer (and if it is painless, the only and effective one) 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 state 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 surgery.
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 medications.
To eliminate H. pylori infection causing an ulcer, the doctor prescribes antibiotics, and to reduce the acidity of gastric juice, drugs that reduce acidity, etc. If a stomach ulcer is caused by taking painkillers (NSAIDs) or other drugs that can trigger the development of an ulcer, the doctor will select for the patient other drugs drugs similar to the "culprits" of the disease, which do not have a ulcerative effect.
If you have peptic ulcer it is very important to abandon bad habits, especially smoking and excessive alcohol consumption. This will eliminate the risk of complications.
Also, during treatment, it is necessary to adhere to a certain diet: diet No. 1. It is a nutritious diet, divided into 5-6 meals a day. The consumption of strong irritants of gastric secretion (ketchup, hot spices), coarse foods and dishes is limited. Food is mainly prepared 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 re-establishing the balance between aggressive and protective factors, the ulcers heal spontaneously within 10-14 days.
In case of complications of peptic ulcer (perforation, stenosis, uncontrolled, recurrent bleeding) or in case of ineffectiveness of drug therapy, treatment is performed surgically. However, surgery is always a big risk. For peptic ulcer, it is performed as a last resort. If it is possible to avoid this without allowing the disease to develop, it is better to use this opportunity.
Forecast. Prevention
The prognosis for peptic ulcer depends on the patient himself. With a healthy lifestyle, proper nutrition and careful attitude towards health, the probability of developing a stomach ulcer is extremely low. Violation of sleep and nutritional rhythms, overwork, stress, neglect of routine medical examinations and ignoring one's seemingly minor inconveniences often lead to the development of complicated forms.
Preventing peptic ulcer is much simpler, faster and cheaper than treating the developed forms and complications. For this purpose, the World Health Organization (WHO) recommends undergoing preventive visits to your GP or gastroenterologist annually, starting from the age of 25. If relatives had a peptic ulcer, then, regardless of complaints, endoscopy with determination of the acidity of gastric juice, clarifying biopsies to determine H. pylori infection and histological examination of suspicious areas are recommended. It is held every two years. In the absence of complaints, comprehensive preventive endoscopy is indicated every two years after 35 years. Diseases identified and treated timely in the initial stages - gastritis, duodenitis, H. pylori infection - will avoid the development of not only ulcerative processes, but also cancer.
To varythree phases 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.
Primary prevention rules:
- 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 "hunger" 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, fruits and vegetables. Moderate consumption of baked goods and sweets is permitted.
- Stick to a healthy lifestyle: abandon 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 any infection, including H. Pylori, easier.
- Starting from the age of 25, once every two years, undergo a planned comprehensive endoscopic examination - endoscopy with determination of H. Pylori.
Insecondary and tertiaryto all the prevention rules are added from the first phase:
- Strictly follow diet number 1. Avoid eating hard-to-digest raw foods, meat, fish and mushroom broths, strong tea and coffee, baked goods, chocolate, sour fresh fruits, spicy vegetables - turnips, radishes, radishes, onions. Food should be steamed, boiled or baked (without crust) in the form of puree. It should be warm: not cold and not hot. Portions should be small. It is recommended to drink mineral water, which reduces stomach acid.
- Eliminate any cause of exacerbation of the ulcer, for example, chronic gastritis.
- Follow medical instructions carefully.
From all this it follows that in most cases the development of peptic ulcer 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 the routine tests.