Problems with the gastrointestinal tract force a person to radically change his eating habits. And this is understandable, because experiencing sharp pain, numbness, 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, boycotting food can harm the patient even more. Therefore, a clear understanding of how to eat if you have stomach problems will help alleviate the acute symptoms of the disease and you will 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.
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. That is why everyone who is faced with such a disease should 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 broken, 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 healing? The main purpose of feeding 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 foods that provoke the development of the disease, then the ulcer will not be late. In order for this not to happen, 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 should not do is starve, because then the acid begins to corrode the stomach walls even more, which only worsens the course of the disease. Therefore, it is imperative to adhere to the diet prescribed by a gastroenterologist, avoiding the feeling of 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.
- You should consume only easily digestible food in liquid, pureed, crushed form, chewing it slowly.
- Hot and cold foods are prohibited, as such foods interfere with the formation of enzymes and slow down the recovery of the mucous membrane. The optimum temperature is from 26 to 33 °C.
- You should eat in small portions with breaks of no more than three hours. The regularity of feeding is determined by the severity of the condition and varies from five to eight times a day.
- Drinking regime - from 1. 5 to 2 liters per day.
This is interesting
The first therapeutic diet for patients with gastric ulcers was developed by Mikhail Pevzner, the founder of clinical gastroenterology and dietetics.
Diet has been shown to directly affect the course of the disease. That is why strict adherence to the nutritionist's recommendations is the key to recovery. The diet for people with stomach ulcers is called "Table #1". Let's look at the basics of this diet.
Table No. 1 - diet for exacerbation of gastric ulcer
So, the most important question: what can you eat if you have a stomach ulcer? The therapeutic diet accompanies the pharmacological treatment of ulcers during subsiding exacerbations and remissions and lasts from six months to a year. Therapeutic nutrition involves minimizing the mechanical, chemical and thermal load on the inflamed stomach. Food should activate regeneration and healing of injuries, reduce inflammation and improve gastric secretion and motility.
When following a healing diet for stomach ulcers, allowed foods can be boiled, baked or steamed. Meat and fish must be completely cleaned of skin, bones, cartilage, tendons, tendons and fat. When cooking meat, you should drain the boiled water twice to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: lean rabbit, turkey, chicken, beef, veal, lean sea fish, soft-boiled eggs or omelets. It is necessary to enrich the diet with fats in the form of unsalted oil and add vegetable oils only to ready meals without using them for heat treatment.
From carbohydrate foods, some vegetables are recommended (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked cereals (oats, semolina, rice, buckwheat), as well as various pasta products, dry white bread, crackers, biscuits, unleavened biscuits.
Desserts included in the diet include purees, mousses, jellies from soft, sweet berries and fruits, baked fruit, 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 dairy products should be included in the diet with caution and ensure that they do not contain vegetable fats (eg 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, rosehip, 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 #1 deserves special attention. The maximum permissible amount of salt is 6 g per day. But the less of it gets into the body of a stomach ulcer patient, 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 ulcer patients because they irritate the mucous membrane, take a long time to digest and provoke bleeding. Excluded are all fatty, spicy, salty, sour, smoked, fried and canned foods, sausages, offal, spices, ketchups, sauces and marinades. You should give up white cabbage, radishes, radishes, turnips, sour vegetables (sorrel, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard and onions.
Strong tea and coffee, citrus fruits, nuts, wholemeal bread, all types of pasta, including homemade baked goods, chocolate, ice cream, alcoholic and carbonated beverages are also on the list of prohibited items.
At different stages of the disease, different subtypes of table #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, in order to relieve a sharp exacerbation, a stricter 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 stay in bed. The aim of the diet is a purely delicate attitude towards digestion and maximum exclusion of any impact of food on the stomach.
What can you eat during a peptic ulcer flare-up and what can't you? The diet for acute gastric ulcer includes divided 6-7 meals a day into very small portions and reduced energy value (up to 2010 kcal). Absolutely unacceptable are all foods that cause the secretion of gastric juice and irritate the mucous membrane. Salt consumption is significantly reduced. Boiled and steamed food is served in a liquid or pureed state. Creamy soups, liquid and fatty 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 a sparing regimendiet number 1, whose purpose—not only provide protection of the mucous membrane, but also accelerate its recovery. The essence of the diet as a whole is preserved, while the list of permissible foods expands and the nature of preparation changes: from completely liquid, pureed food to a 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 is allowed, as well as mashed potatoes or a soufflé of potatoes, beets and carrots. Various mousses, jellies, jelly with milk, sweet fruits and juices, honey and sugar are introduced. Steamed dishes prepared from unleavened cottage cheese and egg white, 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 methods of treatment 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 stomach lining. If not treated or on time, it can cause disability or death.
Causes of stomach ulcers
The most common cause of stomach and duodenal ulcer isHelicobacter pylori infection. It is found in approximately 70% of gastric ulcer patients and up to 90% of duodenal ulcer patients. 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%). This is usually due to the improvement of the quality of medical care, which allows timely diagnosis and treatment of the infection, as well as the improvement of sanitary conditions (for example, the quality of tap water). In our country, the spread of the infection reaches about 70%, and most of the infected do not even suspect or complain about anything.
The second leading cause of peptic ulcer disease ispain relievers, in particular non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and flexibility of the action of NSAIDs relieves people from various pains, on the other hand, due to the long-term uncontrolled use of these drugs, "healing" ulcers of the stomach and duodenum begin to appear more often.
In third place among the causes of stomach and duodenal ulcers arediseases that increase the production of gastrin- 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 probability of developing a peptic ulcer is strongly influenced bypredisposing factors, which:
- nervous-emotional overstrain (stress);
- violation of the daily routine and diet, consumption of refined foods and fast food;
- complicated heredity (for example, presence of peptic ulcer in parents).
If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!
Stomach ulcer symptoms
pain- the most common symptom of stomach ulcer. It is located 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 located in the duodenum, the pain may increase (or decrease) 30-40 minutes after eating.
The intensity of the pain varies from pronounced and transient, which can even lead to reflex vomiting immediately after eating, to weak and constant, which increases in the morning and disappears 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 below the ribs) or pain in the upper abdomen.
A feeling of "early fullness" and heaviness in the stomachare also signs of a peptic ulcer. A person often begins to reduce food portions, since the absorption of even a small amount of food that falls 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 the background of which ulcers most often appear.
Painless form of peptic ulceris most dangerous with its terrible complications, which sometimes develop rapidly in an apparently healthy person. Sometimes they lead to fatal consequences. For example, at the time of perforation of an ulcer on the stomach wall, the patient experiences sharp, intense pain that leads 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 driver, a bus driver or an airplane pilot. The same misfortune can befall a person who is on vacation far from civilization: due to the lack of an opportunity to receive emergency medical care, the chances of survival are significantly reduced.
Complications of gastric 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 fills with blood, reflex vomiting occurs. This is how the disease manifests itself. The patient then develops symptoms of blood loss:
- blood pressure decreases;
- the pulse quickens;
- the skin becomes pale and covered with sweat;
- weakness increases;
- shortness of breath occurs 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, then symptoms of blood loss first appear, 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 the abdominal tissues. 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. Subsequently, intoxication (symptoms of "poisoning") and multiple organ failure increase. 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 the 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 secondarily affected organs.
A malignant disease- degeneration of peptic ulcer into stomach cancer with all the resulting consequences. The risk of such degeneration occurs 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 can narrow significantly, to the point where it becomes difficult or impossible to pass solid and liquid food through it. In this case, the patient loses weight, quickly becomes exhausted and gradually dies of dehydration and starvation.
Diagnosis of gastric ulcers
Diagnosis 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 tests 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 when 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, which is why the patient is urgently admitted to a surgical hospital, where a medical examination is carried out, the anamnesis is clarified, blood is taken for research and, if necessary, EGD, ultrasound, x-ray.
The optimal method for diagnosing ulcer disease (and if it is painless, the only effective one) isroutine endoscopic examination— esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, lasts a few minutes and is accompanied by unpleasant but completely tolerable sensations. As a result of the study, 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.
With the help of special technologies during endoscopy, the acidity of the 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 has signs of gastric bleeding, EGD is used to identify sources of bleeding that can be immediately eliminated, allowing the patient to avoid major surgical interventions.
Treatment of stomach ulcers
Peptic ulcers are treated by a therapist or gastroenterologist. It aims to relieve symptoms, heal ulcers, and eliminate the cause of the 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 the stomach juice, drugs to reduce acidity, etc. If the stomach ulcer is caused by taking painkillers (NSAIDs) or otherdrugs that can cause the development of an ulcer, the doctor will choose other drugs for the patient, 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, especially smoking and excessive alcohol consumption. This will eliminate the risk of complications.
Also, during treatment, you must adhere to a certain diet - diet No. 1. It includes 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 mostly prepared pureed, steamed or boiled in water, fish and lean meats are served in pieces. Many cold and hot dishes are excluded from the diet. Limit your intake of table salt.
After restoring the balance between aggressive and protective factors, the ulcers heal on their own in 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 without allowing the disease to develop, then it is better to take advantage of this opportunity.
Forecast. Prevention
The prognosis for ulcer disease depends on the patient himself. With a healthy lifestyle, proper nutrition and a careful attitude to your health, the probability of developing a stomach ulcer is extremely low. Sleep and eating disorders, overwork, stress, neglecting routine medical examinations and ignoring one's own seemingly insignificant inconveniences often lead to the development of complicated 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 that from the age of 25 you undergo annual preventive examinations with a general practitioner or a gastroenterologist. If relatives have had peptic ulcer, then, regardless of complaints, endoscopy with determination of acidity of gastric juice, clarification of biopsies to determine H. pylori infection and histological examination of suspicious areas is recommended. 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, helicobacter 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 development;
- second- aimed at preventing the progression of an already existing disease;
- tertiary- performed after the development of complications.
Rules for primary prevention:
- Stick to a certain daily calorie intake: 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. Remove "starvation" and "mono diets". It is extremely undesirable to consume alcohol, carbonated drinks, fatty, fried, smoked foods, canned food and fast food. It is recommended to eat cereals, soups, boiled meat and fish, vegetables and fruits. Moderate consumption of pastries and sweets is allowed.
- Adhere to 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.
- 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 facilitates 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 tertiaryadded prevention to all first stage rules:
- Strictly follow diet No. 1. Avoid eating hard-to-digest coarse 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 a crust) in a puree. It should be warm: not cold and not hot. Portions should be small. It is recommended to drink mineral water, which reduces stomach acidity.
- Eliminate all causes 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 a peptic ulcer 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.