Problems with the gastrointestinal tract force a person to radically change his 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 if you have stomach problems will help you relieve the acute symptoms of the disease and once again feel the joy of life. Today we will see in detail what diet you should follow if you have a stomach ulcer.
Diet for stomach ulcers is the most important direction of treatment
Diet 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 faces 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 compromised, so digestion, accompanied by the secretion of hydrochloric acid, causes a lot of pain. Which stomach ulcer diet will help relieve symptoms and speed healing? The main goal of nutrition is to promote rapid ulcer closure. 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 appearing. In order for this not to happen, the therapeutic diet 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 yourself, because then the acid begins to erode 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 feelings of hunger and discomfort. What should you eat if you have a stomach ulcer?
- The food should not cause irritation of the mucous membrane and increase the acidity of the gastric juice.
- You should consume only easily digestible foods in liquid, pureed, crushed form, chewing them slowly.
- Hot and cold foods are prohibited, because such dishes interfere with the formation of enzymes and slow down the restoration of the mucous membrane. The optimum temperature is from 26 to 33 °C.
- You must eat in small portions with breaks not exceeding 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 a stomach ulcer 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 a stomach ulcer is called "table No. 1". Let's look at the basics of this diet.
Table No. 1 - diet for exacerbation of stomach ulcer
So, the most important question: what can you eat if you have a stomach ulcer? The medical diet accompanies the pharmacological treatment of ulcers during the remission of the 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 wound healing, 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, veins, tendons and fat. When cooking meat, you should drain the boiling water twice to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: lean meat of rabbit, turkey, chicken, beef, veal, lean sea fish, soft eggs or scrambled eggs. 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, certain vegetables (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked cereals (oatmeal, semolina, rice, buckwheat), as well as various pastas, dried white bread, crackers, cookies, unleavened cookies.
Desserts included in the diet include purees, mousse, jelly from soft, sweet berries and fruits, baked fruit, natural marshmallows, marshmallows and jam, jam and jam. Honey is recommended as it soothes pain and inflammation and helps neutralize acid.
It is useful to drink milk, which wraps the walls of the stomach and protects the mucous membrane. Fermented dairy products should be included in the diet with care 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 a casserole, acidophilus, fresh (! ) kefir, natural yogurt and cream, unleavened cheese.
Recommended drink: decoctions of chamomile, rosehip, mint, weak tea, compotes, jellies, 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 allowed amount of salt is 6 g per day. But the less that enters the body of a person suffering from a stomach ulcer, the better. It should be taken into account 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 cause bleeding. All fatty, spicy, salty, sour, smoked, fried and canned foods, sausages, offal, spices, ketchup, sauces and marinades are excluded. You must give up white cabbage, radishes, radishes, turnips, sour greens (beech, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard and onions.
Also on the list of prohibited items are possible tea and coffee, citrus fruits, nuts, wholemeal bread, any baked goods, including homemade pastries, chocolate, ice cream, alcoholic and carbonated drinks.
At different stages of the disease, different subtypes of table No. 1 are used. Which diet to follow for a stomach ulcer depends on the patient's well-being and the severity of the symptoms.
So, to relieve a sharp flare-up, a stricter diet is recommended— panel No. 1a. This diet is prescribed in 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 subtle attitude towards digestion and the maximum exclusion of any effect of food on the stomach.
What can you eat during a stomach ulcer flare-up and what not? The diet for acute stomach ulcer includes separate 6-7 meals a day in very small portions and reduced energy value (up to 2010 kcal). All foods that cause 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 soufflés are widely used.
In addition to the main list of prohibited foods from the dietNo. 1aBread in any form, fermented dairy products, all vegetables and fruits are completely excluded.
This diet is prescribed until the ulcer begins to heal. After that, the patient switches to milddiet No. 1, the purpose of which—they not only provide protection to the mucous membrane, but also accelerate its recovery. The essence of nutrition as a whole is preserved, while the list of acceptable foods expands and the nature of preparation changes: from completely wet, mashed food 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 soufflé of potatoes, beets and carrots. Various mousses, jellies, jellies with milk, sweet fruits and juices, honey and sugar are presented. Steamed dishes made from unleavened 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 by Dr. Nizhegorodtsev A. S. , a surgeon with 17 years of experience.
Definition of the disease. Causes of the disease
Stomach Ulcer(Stomach ulcer) 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 gastric and duodenal ulcers isHelicobacter pylori infection. It is detected in approximately 70% of gastric ulcer patients and up to 90% of duodenal ulcer patients. The prevalence of Helicobacter 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 early 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 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, especially non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and flexibility of the action of NSAIDs relieved people from various pains, on the other hand, due to the prolonged uncontrolled use of these drugs, "medical" ulcers of the stomach and duodenum began 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 likelihood of developing a peptic ulcer is greatly influenced bypredisposing factors, which are:
- neuro-emotional overload (stress).
- violation of daily routine and diet, consumption of processed food and fast food.
- complex inheritance (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!
Stomach ulcer symptoms
Pain- the most common symptom of gastric ulcer. It is located 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 located in the duodenum, the pain may intensify (or decrease) 30-40 minutes after eating.
The intensity of the pain varies from severe and transient, which can even lead to reflex vomiting immediately after eating, to weak and constant, which intensifies in the morning and subsides after eating. Sometimes the patient may wake up at night due to a feeling of "sucking in the pit of the stomach" (in the cavity under the ribs) or pain in the upper abdomen.
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 ends up in 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), in which ulcers occur more often.
Painless form of peptic ulcerit is more dangerous for its terrible complications, which sometimes develop with 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 a strongly expressed severe pain, which 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, bus driver or airplane pilot. The same misfortune can happen to a person vacationing far from civilization: due to the lack of opportunity to receive emergency medical care, the chances of survival are significantly reduced.
Stomach ulcer complications
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 shows symptoms of blood loss:
- blood pressure decreases.
- The pulse quickens.
- the skin becomes pale and covered with sweat.
- Weakness increases;
- dyspnea 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 appear first, and then liquid, tarry ("black") stools appear.
Perforation of the stomach wall- the formation of a through hole when the ulcer spreads to 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 a sharp pallor of the skin. Subsequently, intoxication (symptoms of "poisoning") and multi-organ failure increase. Without emergency medical care, a person dies with such a complication.
Infiltrating ulcerit can also complicate the course of the disease. If the ulcer is located in 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. Subsequently, the first manifestations of gastric ulcer may be gradually increasing symptoms of inflammation in secondary affected organs.
Malice- degeneration of peptic ulcer into stomach cancer with all the subsequent consequences. The risk of such degeneration occurs if the ulcer exists for a long time.
Scar stricture- a dangerous consequence of ulcer healing. As a result of scarring, the lumen of the stomach or duodenum can become significantly narrowed, to the point where it becomes difficult or impossible for solid and liquid foods to pass through it. In this case, the patient loses weight, quickly becomes exhausted and gradually dies of dehydration and starvation.
Diagnosis of stomach ulcer
Diagnosis of typical ulcerStomach surgery is quite simple, it is done 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 organ tests in order to form a clear picture of the patient's state of health and develop the optimal treatment plan.
It is more difficult to make 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, the history is clarified, blood is taken for tests and, if necessary, EGD, ultrasound, x-ray.
The optimal method for diagnosing peptic ulcer (and if it is painless, the only and effective way) isroutine endoscopic examination— esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, takes 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 occurrence of neoplasms.
Using special technologies during endoscopy, the acidity of the gastric fluid and the presence of Helicobacter 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 shows signs of gastric bleeding, EGD is used to identify sources of bleeding that can be eliminated immediately, allowing the patient to avoid major surgery.
Treatment of stomach ulcer
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 Helicobacter pylori infection that causes an ulcer, the doctor prescribes antibiotics and to reduce the acidity of the gastric juice, antacids, etc. If the stomach ulcer is caused by taking painkillers (NSAIDs) or other drugs that can trigger the development of ulcers, the doctor will choose other drugs for the patient drugs similar to the "culprits" of the disease, which do not have the effect of creating ulcers.
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 need to adhere to a certain diet - diet No. 1. It includes a nutritious diet, divided into 5-6 meals a day. The consumption of strong irritating gastric secretions (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 the balance between aggressive and protective factors is restored, ulcers heal on their own within 10-14 days.
In case of peptic ulcer complications (perforation, stricture, uncontrolled, repeated bleeding) or in case of ineffectiveness of drug treatment, the treatment is carried out surgically. However, surgery is always a big risk. 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 depends on the patient himself. With a healthy lifestyle, proper diet and a careful attitude towards your health, the probability of developing a stomach ulcer is extremely low. Violation of sleep and eating patterns, excessive work, stress, neglect of regular medical examinations and neglect of seemingly insignificant disturbances of the person often lead to the development of complex forms.
The prevention of peptic ulcer disease is much easier, faster and cheaper than the treatment of its developed forms and complications. For this purpose, the World Health Organization (WHO) recommends, from the age of 25, that you undergo annual preventive examinations with a general practitioner or gastroenterologist. If the relatives had a peptic ulcer, then, regardless of complaints, endoscopy with determination of the acidity of the gastric fluid, clarification of biopsies for the determination of Helicobacter pylori infection and histological examination of suspicious areas are recommended. It is held every two years. In the absence of complaints, preventive comprehensive endoscopy is indicated every two years after 35 years. Diseases that are detected and treated in time in the initial stages - gastritis, duodenitis, Helicobacter pylori infection - will prevent 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 it appearing.
- secondary- with the aim of preventing the progression of an already existing disease.
- tertiary- is 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 consider physical activity, height and weight. You should eat often, in small portions. Eliminate "starvation" and "mono-diets". It is extremely undesirable to consume alcohol, soda, fatty, fried, smoked food, canned food and fast food. It is recommended to eat cereal porridges, soups, boiled meat and fish, vegetables and fruits. Moderate consumption of pastries and sweets is allowed.
- Maintain 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 early treatment of tooth decay, as it reduces general immunity, which facilitates any infection, including Helicobacter pylori.
- Starting at the age of 25, once every two years, they undergo a scheduled comprehensive endoscopic examination – endoscopy with Helicobacter pylori determination.
Insecondary and tertiaryprevention to all rules from the first stage are added:
- Strictly follow diet No. 1. Avoid eating hard food, meat, fish and mushroom broths, strong tea and coffee, pastries, 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 recommended to drink mineral water, which reduces the acidity of the stomach.
- Eliminate any causes of ulcer exacerbation, for example, 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 medically educated, listen to the recommendations of doctors, official authoritative medical sources and do not neglect routine examinations.