Problems with the gastrointestinal tract force a person to radically change their eating habits. And this is understandable, because feeling sharp pain, tingling, burning, heaviness, tightness in the stomach or constant heartburn, you can not only give up your favorite dishes, but also losecompletely 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 relieve acute symptoms of the disease and again feel the joy of life. Today we will consider in detail what diet you should follow if you suffer from 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, everyone who faces a similar illness should know how to eat properly when having a stomach ulcer. Of course, diet does not replace treatment, but without special nutrition, drug treatment 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. What diet for stomach ulcers will help relieve symptoms and speed up healing? The main goal of nutrition is to promote rapid ulcer closure. However, this process is long and if, at the first signs of relief, the patient returns to the foods that provoke the development of the disease, the ulcer will not take long to come. To prevent this from happening, 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 don't need to do is starve, because then the acid begins to corrode the stomach walls even more, which only worsens the course of the disease. It is therefore 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?
- Food should not cause irritation of the mucous membrane or increase the acidity of gastric juice.
- You should only consume easily digestible foods in liquid, pureed and crushed form, chewing them slowly.
- Hot and cold foods are prohibited, as these dishes interfere with the formation of enzymes and slow down the restoration of the mucous membrane. The optimal temperature is 26 to 33°C.
- You should 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 ranges from five to eight times per day.
- Drinking regime - from 1. 5 to two liters per day.
It's interesting
The first medical diet for patients with stomach ulcers was developed by Mikhail Pevzner, 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 of people suffering from 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 the pharmacological treatment of ulcers during exacerbations and remissions and lasts from six months to a year. Therapeutic nutrition consists of minimizing the mechanical, chemical and thermal load on the upset 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, permitted foods can be boiled, baked or steamed. Meat and fish must be completely stripped of skin, bones, cartilage, veins, tendons and fat. When cooking meat, you need to drain the boiled water twice in order to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: lean meat of rabbit, turkey, chicken, veal, beef, lean sea fish, 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 cooked dishes, without using them for heat treatment.
Among carbohydrate foods, some vegetables are recommended (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked cereals (oatmeal, semolina, rice, buckwheat), as well as various pastas, white breaddried, crackers, biscuits, unleavened biscuits.
Desserts included in the diet include purees, mousses, soft and sweet berry and fruit jellies, baked fruits, 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 envelops 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 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, 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 enzymatic processing of food and promotes healing of damaged stomach walls.
The role of salt in diet #1 deserves special mention. The maximum allowable amount of salt is 6 g per day. But the less it enters the body of a person suffering from a stomach ulcer, the better. We must not forget that salt also comes from finished products: for example, it is present in large quantities in cheeses, including processed cheeses.
It is important to understand that many foods are completely unacceptable for patients suffering from ulcers because they cause irritation of the mucous membrane, take a long time to digest and cause 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 greens (sorrel, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard and onions.
Also on the list of prohibited products are strong tea and coffee, citrus fruits, nuts, wholemeal bread, all baked goods, including homemade pastries, chocolate, ice cream, alcoholic and carbonated drinks.
At different stages of the disease, different subtypes from table No. 1 are used. The diet to follow for a stomach ulcer depends on the patient's well-being and the severity of the symptoms.
So, to alleviate a strong 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 goal of the diet is a purely delicate attitude towards digestion and the maximum exclusion of any effects of food on the stomach.
What can you eat during an exacerbation of a stomach ulcer and what can you not eat? The diet for acute stomach ulcers involves dividing 6-7 meals per day into very small portions and reduced energy value (up to 2010 kcal). Any foods that provoke the secretion of gastric juice and irritate the mucous membranes are absolutely unacceptable. Salt consumption is significantly reduced. Foods, boiled and steamed, are served in liquid or pureed form. Cream soups, liquid and glutinous porridges and soufflés are widely used.
In addition to the main list of foods prohibited in 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 gentle treatmentdiet #1, whose purpose—not only protect the mucous membrane, but also accelerate its recovery. The essence of the diet as a whole is preserved, while the list of acceptable foods expands and the nature of the preparation changes: from completely liquid foods in puree to the state of "small pieces".
The energy value increases up to 2500 kcal per day, the frequency of meals is reduced to six times a day. Dried white bread is allowed, as well as mashed potatoes or potato, beet and carrot soufflés. Various mousses, jellies, milk jellies, sweet fruits and juices, honey and sugar are introduced. 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. , surgeon with 17 years of experience.
Definition of disease. Causes of disease
Stomach ulcer(Stomach ulcers) is a chronic, relapsing disease in which defects occur in the stomach lining. If left untreated or untimely, it can lead to 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 patients with gastric ulcers and up to 90% of patients with duodenal ulcers. The prevalence of H. pylori, 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 improved quality of medical care, which allows for rapid diagnosis and treatment of infections, as well as better sanitation conditions (e. g. tap water quality). In our country, the prevalence of infection reaches around 70%, while most infected people do not even suspect it and do not complain about anything.
The second cause of peptic ulcer ispainkillers, especially nonsteroidal 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 the prolonged and uncontrolled use of these drugs, "medicinal" ulcers of thestomach and duodenum began to appear more often.
Third among the causes of gastric and duodenal ulcers are:diseases 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 tumor), etc.
The likelihood of developing a peptic ulcer is strongly influenced bypredisposing factors, which are:
- neuro-emotional overwork (stress);
- violation of daily routine and nutrition, 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 treat yourself, it is dangerous for your health!
Symptoms of a stomach ulcer
Pain- the most common symptom of gastric ulcer. It is located in the upper part of the abdomen and can decrease or intensify immediately or after a meal, depending on the location of the ulcer. 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 can even 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 feeling in the pit of the stomach" (in the hollow area under the ribs) or pain in the upper abdomen.
Feeling of "early fullness" and heaviness in the stomachare also signs of peptic ulcer. A person often begins to reduce his food portions, because the absorption of even a small amount of food that ends up on inflamed areas of the stomach mucosa and ulcers can cause these unpleasant sensations.
Bad breath, nausea, taste changes, coating 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 for its terrible complications, which sometimes develop with 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 and pronounced pain, which leads to shock and disorientation, sometimes accompanied by loss of consciousness. It is scary to imagine what it would lead to if this person turned out to be a car driver, bus driver or airplane pilot. The same misfortune can happen to a person on vacation far from civilization: due to the lack of the possibility of receiving emergency medical care, the chances of survival are significantly reduced.
Complications of stomach ulcers
Bleeding from an ulcer- the most common complication. This 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 quickens;
- the skin turns pale and becomes covered with sweat;
- weakness increases;
- shortness of breath appears despite a reduction in physical activity.
When the ulcer 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 watery, tarry ("black") stools appear.
Perforation of the stomach wall- the formation of a through hole when the ulcer spreads to all layers of the gastric 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 and extremely intense pain, up to painful shock, a decrease in blood pressure and acute pallor of the skin. Subsequently, intoxication ("poisoning" symptoms) and multiple organ failure increase. Without emergency medical care, a person dies with such a complication.
Ulcer penetrationcan also complicate the progression of the disease. If the ulcer is located on the stomach wall, adjacent to another organ - the pancreas or intestinal wall, then it can spread to this neighboring organ. Then the first manifestations of gastric ulcer may be a gradual increase in symptoms of inflammation in the affected secondary organs.
Malignancy- degeneration of a 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. Because of the scarring, the lumen of the stomach or duodenum can narrow significantly, to the point that it becomes difficult or impossible to pass solid and liquid foods. In this case, the patient loses weight, quickly becomes exhausted and gradually dies from dehydration and hunger.
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 features 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 an accurate picture of the patient's health status and develop the most optimal treatment plan.
It is more difficult to make a diagnosis whenatypical or painless ulcer, especially when complications arise in the form of penetration - 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, because of which the patient is urgently admitted to a surgical hospital, where a medical examination is carried out, the anamnesis is clarified, blood is taken for testing 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 quite tolerable sensations. As a result of the examination, comprehensive information appears about 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 gastric mucosa are taken from the tumors for histological examination in orderto determine the type of tumor.
When a patient shows signs of gastric hemorrhage, EGD is used to identify sources of bleeding that can be immediately eliminated, allowing the patient to avoid serious surgical procedures.
Treatment of stomach ulcers
Peptic ulcers are treated by a therapist or gastroenterologist. Its goal is to eliminate symptoms, heal ulcers and eliminate the cause of this disease through diet, lifestyle changes and medications.
To get rid of H. pylori infection that causes ulcer, the doctor prescribes antibiotics, and to reduce the acidity of gastric juice, acidity-reducing drugs, 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 similar to the "culprits" of the disease, which do not have an ulcerative effect.
If you suffer from peptic ulcer disease, it is very important to give up bad habits, primarily smoking and excessive alcohol consumption. This will eliminate the risk of complications.
In addition, during treatment, you must adhere to a certain diet - diet No. 1. This is a nutritious diet, divided into 5-6 meals per day. Consumption of strong irritants of gastric secretion (ketchups, hot spices), coarse foods and dishes is limited. Foods are prepared mainly mashed, 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 consumption 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 (perforation, stenosis, uncontrolled and recurrent bleeding) or in case of ineffectiveness of drug treatment, treatment is carried out surgically. However, surgery still poses a significant risk. For peptic ulcers, it is performed as a last resort. If this can be avoided without allowing the disease to develop, then it is best to take advantage of this opportunity.
Forecast. Prevention
The prognosis for peptic ulcer disease depends on the patient himself. With a healthy lifestyle, proper nutrition and a careful attitude towards your health, the risk of developing a stomach ulcer is extremely low. Violation of sleeping and eating habits, overwork, stress, neglect of routine medical examinations and ignoring one's own seemingly minor discomforts often lead to the development of complicated forms.
Prevention of peptic ulcer disease is much easier, faster and less expensive than the treatment of its developed forms and complications. To this end, the World Health Organization (WHO) recommends undergoing annual preventive examinations by a general practitioner or a gastroenterologist from the age of 25. If relatives have had a peptic ulcer, regardless of the complaints, endoscopy is recommended with determination of the acidity of gastric juice, clarification of biopsies to determine H. pylori infection and histological examination of suspicious areas. It takes place every two years. In the absence of complaints, a complete preventive endoscopy is indicated every two years after 35 years. Diseases identified and treated promptly 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 developing it;
- secondary- aimed at preventing the progression of an already existing disease;
- tertiary- carried out after the appearance 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 "hungers" and "mono-diets". It is strongly recommended not to consume alcohol, soda, fatty, fried, smoked foods, canned foods and fast food. It is recommended to eat cereal porridges, soups, boiled meat and fish, vegetables and fruits. Moderate consumption of bakery products and sweets is allowed.
- Adhere to a healthy lifestyle: give up bad habits, be physically active, sleep at least 7 hours at 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, as this reduces general immunity, which facilitates any infection, including H. Pylori.
- From the age of 25, once every two years, undergo a planned comprehensive endoscopic examination - endoscopy with determination of H. Pylori.
Insecondary and tertiaryprevention to all the rules of the first stage are added:
- Strictly follow diet #1. Avoid eating coarse, difficult-to-digest 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 puree form. It must be lukewarm: neither cold nor hot. Portions should be small. It is advisable to drink mineral water, which reduces gastric acidity.
- Eliminate all 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 a medically competent person, listen to the recommendations of doctors, authoritative official medical sources anddo not neglect routine checkups.