Problems with the gastrointestinal tract force a person to fundamentally change their eating habits. And this is understandable, because of 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 more. Therefore, a clear understanding of how to eat if you have stomach problems will help alleviate the acute symptoms of the disease and once again feel the joy of life. Today we will look in detail at the 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 facing a similar disease must 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, together with 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 foods that encourage the development of the disease, then the ulcer will not be long in coming. To prevent this from happening, therapeutic nutrition should be 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 on the stomach walls starts to erode more, which only contributes to the course of the disease. Therefore, it is essential 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 irritate the mucous membrane and increase the acidity of gastric juice.
- You should only eat easily digestible food in liquid, pure, mashed form, and chew it slowly.
- Hot and cold foods are prohibited, because such dishes interfere with the formation of enzymes and delay the restoration of the mucous membrane. The best temperature is from 26 to 33 °C.
- You must eat in small portions with breaks not longer than three hours. The regularity of the meals is determined by the severity of the condition and between five and eight times a day.
- drinking regime - from 1. 5 to two liters per day.
This is interesting
Mikhail Pevzner, the founder of Clinical Gastroenterology and Dietetics developed the first medical diet for patients with stomach ulcers.
Diet has been proven 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 for worsening 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 exacerbation and subsiding remission and lasts from six months to a year. Therapeutic nutrition involves minimizing the mechanical, chemical and thermal load on the sick stomach. Food should activate regeneration and damage healing, reduce inflammation, and improve gastric secretion and motility.
When following a therapeutic diet for stomach ulcers, approved 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 must drain the cooking water twice to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: lean meat 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 dishes, without 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.
Among the desserts included in the diet are purees, mousses, jellies from berries and soft fruit, sweet, baked fruit, natural marshmallows, marshmallows and marmalade, jam and marmalade. Honey is recommended because it soothes pain and inflammation and helps neutralize acid.
It is useful to drink milk, which covers 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 negative 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 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 salt in diet No. deserves special mention. 1. The maximum allowable amount of salt is 6 g per day. But the less that enters the body of a stomach ulcer sufferer, the better. It should be remembered that we also get salt from finished products; for example, it is in large quantities in cheese, including processed cheeses.
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, that they take a long time to digest and stimulate bleeding. All fatty, spicy, salty, sour, smoked, fried and canned foods, sausages, offal, spices, ketchups, sauces and marinades are excluded. You need to bring up white cabbage, radishes, radishes, turnips, sour greens (November, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard, and onions.
Also on the list of prohibited items are strong tea and coffee, citrus fruits, nuts, crusty bread, any baked goods, including home baked goods, chocolate, ice cream, alcoholic and carbonated drinks.
At different stages of the disease, different subtypes of table No. 1. The diet to be followed for stomach ulcer depends on the health of the patient and the severity of the symptoms.
Therefore, to alleviate acute exacerbation, a stricter diet is recommended— table No. 1a. This diet is prescribed during periods of severe disease, accompanied by acute pain. Usually, at this time the patient is forced to stay in bed. The goal of the diet is a sensitive attitude towards digestion and the maximum exclusion of any influence of food on the stomach.
What can you eat when a stomach ulcer is worse and what can't you? The diet for acute stomach ulcers involves sharing 6-7 meals a day in very small portions with reduced energy value (up to 2010 kcal). All food that causes the secretion of gastric juice and irritation of the mucous membrane is completely unacceptable. Salt consumption is significantly reduced. Food, boiled and steamed, is served in a liquid or purified state. Creamy 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 moves gentlyNo 1 diet, its purpose—not only provide protection to the mucous membrane, but also accelerate its recovery. The essence of the diet is preserved as a whole, and the list of acceptable foods is expanded and the nature of the preparation changes: from whole liquid food, purified to the state of "small pieces".
The energy value increases to 2500 kcal per day, the frequency of food intake decreases 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 fruit and juices, honey and sugar are introduced. Steam dishes made from unleavened cottage cheese and egg whites, sour cream, light 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 ulcerIt is a chronic relapsing disease (stomach ulcers) in which defects occur in the gastric mucosa. If left untreated or untreated, it can cause disability or death.
Causes of stomach ulcers
It is the most common cause of stomach and duodenal ulcersHelicobacter 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%). Usually, this is due to improvements in the quality of medical care, which allows timely diagnosis and treatment of infection, as well as improved sanitary conditions (for example, the quality of tap water). In our country, the prevalence of infection reaches about 70%, although most infected people do not even suspect it and do not complain about anything.
The second main cause of peptic ulcer diseasepainkillers, especially non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and flexibility of the action of NSAIDs gave people relief from various pains, on the other hand, due to the long uncontrolled use of these drugs, "healing" ulcers of the stomach and duodenum began to occur more often.
In third place among the causes of stomach and duodenal ulcersdiseases 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 affectedpredisposing factors, which is:
- neuro-emotional overstrain (stress);
- violation of daily routine and nutrition, consumption of refined foods and fast food;
- complex 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 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 ulna. And if the ulcer is localized 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 may be the result of reflex vomiting immediately after eating, to weak and continuous, which intensifies in the morning and disappears after eating. Sometimes the patient could wake up at night because of a feeling of "sucking in the pit of the stomach" (in the hollow under the ribs) or pain in the upper abdomen.
A feeling of "early fullness" and heaviness in the stomachalso symptoms of peptic ulcer disease. Often a person 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 feelings.
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), on which ulcers are most often seen.
Peptic ulcer form without painit is dangerous because of its terrible complications, which sometimes develop at lightning speed in a seemingly healthy person. Sometimes they lead to fatal consequences. For example, during perforation of the stomach wall ulcer, the patient experiences severe pain, which leaves shock and restlessness, sometimes with loss of consciousness. It is scary to imagine what would follow if this person became a car, bus or plane pilot. The same misfortune can befall a person on vacation far from civilization: due to the lack of opportunity to receive emergency medical care, the chance of survival is 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 starts, 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 reductions;
- pulse quickens;
- the skin turns pale and becomes covered with sweat;
- weakness increases;
- shortness of breath is seen despite a reduction in 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 the signs of blood loss appear first, and then liquid, tarry ("black") stool.
Perforation of the stomach wall- forming a hole through when the ulcer spreads through each layer of the stomach wall. Through this opening, stomach contents flow into the abdominal cavity and cause constipationperitonitis- total inflammation of the abdominal tissues. The moment of perforation is accompanied by sharp, extremely intense pain, up to a painful shock, a decrease in blood pressure, and a sharp pallor of the skin. After that, intoxication (symptoms of "poisoning") and multiple organ failure increase. Without emergency medical care, a person dies with such a complication.
Ulcer penetrationthe course of the disease can also be complicated. If the ulcer is located on the wall of the stomach, which is next 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 signs of inflammation in secondary organs affected.
Malignancy- degeneration of peptic ulcer into stomach cancer and all the consequences that follow. The risk of such degeneration seems to be if the ulcer is there 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 is difficult or impossible for solid and liquid food to pass through. In this case, the patient loses weight, becomes exhausted 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, 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 to make a clear picture of the patient's health condition and develop the best 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.
Often the first symptom is an asymptomatic or "silent ulcer" that is complicated by bleeding, because of which the patient is urgently admitted to a surgical hospital, where a medical examination is performed, an anamnesis is clarified, blood is taken for tests, and, if necessary, EGD, ultrasound, X-ray.
The best way to diagnose peptic ulcer disease (and if it is painless, the only effective way)routine endoscopic examination— esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, lasts a few minutes, and is accompanied by unpleasant but completely acceptable sensations. As a result of the examination, comprehensive information is visible 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 gastric mucosa are taken from tumors for histological examination to determine the type of tumor.
When a patient presents with symptoms of gastric bleeding, EGD is used to identify bleeding sources that can be eliminated immediately, 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, drugs that reduce acid, etc. to reduce. can stimulate the development of an ulcer, the doctor will choose other medications for the patient drugs like the "culprits" of the disease, which do not have the effect of ulcer formation.
If you have a peptic ulcer, it is very important to give up bad habits, mainly 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 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 mostly prepared pureed, fermented or boiled in water; fish and lean meat 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 bleeding, recurrent) or in case of inefficiency of drug therapy, surgical treatment is performed. However, there is always a great risk in surgery. For peptic ulcers, 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 peptic ulcer disease depends on the patient. With a healthy lifestyle, proper nutrition, and a careful attitude towards your health, the likelihood of developing a stomach ulcer is extremely low. Violation of sleeping and eating patterns, overwork, stress, neglect of routine medical examinations, and ignoring one's own discomfort often lead to the development of complex forms.
It is much easier, faster and cheaper to prevent peptic ulcer disease than to treat its forms and complications of development. For this purpose, the World Health Organization (WHO) recommends that, from the age of 25, undergo annual preventive examinations with a general practitioner or gastroenterologist. If relatives have had a peptic ulcer, then, regardless of complaints, endoscopy is recommended to determine 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, comprehensive preventive endoscopy is indicated every two years after 35 years. Diseases identified and promptly treated in the early stages - gastritis, duodenitis, H. pylori infection - will prevent the development of not only ulcerative processes, but also cancer.
Variesthree stages of prevention:
- primary school- when there is no disease, but there is a risk of developing it;
- secondary- aimed at preventing the progression of existing diseases;
- tertiary- performed after the development of complications.
Primary prevention rules:
- Adhere to a certain daily calorie intake: carbohydrates - 50% or more, proteins - 30%, fats - 15-20%. It is important to take physical activity, height and weight into account. You need to eat often, in small portions. Eliminate "starvation" and "mono-diets". It is very undesirable to eat alcohol, soda, fatty, fried, smoked, canned food and fast food. It is recommended to eat cereal porridges, soups, cooked 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 a night. Avoid stressful situations, learn to perceive them correctly.
- Visit a doctor regularly as part of a medical examination and eliminate foci of chronic infection, including timely treatment of caries, because it reduces general immunity, making it easier for any infection, withincluding H. Pylori.
- Starting from the age of 25, once every two years, do a planned comprehensive endoscopic examination - endoscopy with the determination of H. Pylori.
Isecondary and tertiaryall rules are banned from the first step:
- Strictly follow diet No. 1. Avoid coarse food difficult to digest, meat, fish and mushroom broth, strong tea and coffee, baked goods, chocolate, sharp fresh fruits, spicy vegetables - turnips, radishes, radishes, onions. Food should be steamed, boiled or baked (without crust) in pure form. It should be warm: not cold and not hot. Portions should be small. It is advisable to drink mineral water, which reduces the acidity of the stomach.
- Eliminate any causes of exacerbation of the ulcer, for example, chronic gastritis.
- Follow the 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 literate person, listen to the recommendations of doctors, authoritative official medical sources and do not neglect routine examinations.