Problems with the digestive tract force a person to drastically change their eating habits. And this is understandable, because if you feel acute pain, tingling, burning, heaviness, tightening in the stomach or constant heartburn, you can not only refuse 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 with stomach problems will help to alleviate the acute symptoms of the disease and to 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 in gastric ulcer is the most important direction of treatment
Nutrition really has a big impact on our health. A properly formulated diet can speed up the healing of ulcers and prevent the development of complications. Therefore, anyone who has encountered a similar disease must know how to eat properly when suffering from 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, accompanied by the release of hydrochloric acid, causes a lot of pain. What diet for a stomach ulcer will help relieve symptoms and speed healing? The main purpose of nutrition is to promote rapid ulcer closure. But this process is long, and if after the first signs of relief the patient returns to the food that provokes the development of the disease, then the ulcer will not last long. 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 to starve, because then the acid starts to break down the stomach walls even more, which only complicates the course of the disease. Therefore, it is necessary to follow the diet prescribed by the gastroenterologist, avoid hunger and discomfort. What to eat if you have a stomach ulcer?
- Food should not irritate the mucous membrane and increase the acidity of gastric juice.
- Eat only easily digestible food, liquid, pureed, chopped, chewing slowly.
- Hot and cold food is prohibited, because such dishes interfere with the formation of enzymes and slow down the recovery of the mucous membrane. The optimum temperature is between 26 and 33 °C.
- You need to eat in small portions with breaks of no longer than three hours. The frequency of eating depends on the severity of the condition and ranges from five to eight times a day.
- Drinking regime - from 1. 5 to two liters per day.
It's interesting
The first medical diet for patients with stomach ulcers was created by Mikhail Pevzneris, the founder of clinical gastroenterology and dietetics.
Diet has been shown to directly affect the course of the disease. Therefore, strict adherence to the nutritionist's recommendations is the key to recovery. The diet of 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? Medicated diet accompanies pharmacological treatment of ulcers during exacerbation and remission and lasts from six months to a year. Therapeutic nutrition includes reducing the mechanical, chemical and thermal load on the painful stomach. Food should activate regeneration and healing of lesions, reduce inflammation, improve gastric secretion and motility.
As part of the gastric ulcer healing diet, allowed foods can be boiled, fried or steamed. Meat and fish must be completely cleaned of skin, bones, cartilage, veins, tendons and fat. When frying meat, the boiled water should be drained twice to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: lean rabbit, turkey, chicken, veal, beef, lean sea fish, soft-boiled eggs or an omelette. It is necessary to enrich the diet with fat in the form of unsalted butter, and add vegetable oils only to prepared dishes, without using them for heat treatment.
Some vegetables (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-heated grains (oatmeal, semolina, rice, buckwheat), as well as various pastas, dried white bread, crackers, cookies, unleavened cookies.
Desserts included in the diet are purees, mousses, jelly from soft, sweet berries and fruits, baked fruit, natural marshmallows, marshmallows and marmalade, jam and marmalade. Honey is recommended as it relieves 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 carefully and ensure that they do not contain vegetable fats (for example, palm oil), which negatively affect digestion. Let's say low-fat cottage cheese in the form of stews, acidophilus, fresh (! ) kefir, natural yogurt and sour cream, non-fermented cheese.
Recommended drink: decoctions of chamomile, rosehip, mint, weak tea, compotes, jelly, fruit drinks, diluted sweet juices, as well as room temperature water. 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 role of salt in diet no. 1. The maximum permissible amount of salt is 6 g per day. However, the less it enters the body of a person with a stomach ulcer, the better. It should be remembered that we also get salt from ready-made products, for example, in cheeses, as well as processed ones, they are in large quantities.
It is important to understand that many foods are completely unacceptable for ulcer patients due to the fact that 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. White cabbage, radishes, radishes, turnips, sour greens (sorrel, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard, onions should be avoided.
Also on the list of prohibited items are strong tea and coffee, citrus fruits, nuts, wholemeal bread, any baked goods, including homemade baked goods, chocolate, ice cream, alcoholic and carbonated drinks.
Different table numbers are used in different stages of the disease. 1 subtypes. What kind of diet to follow when suffering from a stomach ulcer depends on the patient's condition and the severity of the symptoms.
So, a stricter diet is recommended to mitigate a sudden flare-up- table no. 1a. This diet is prescribed during the period of intense illness accompanied by acute pain. Usually at this time the patient is forced to stay in bed. The goal of the diet is a purely subtle approach to digestion and maximum elimination of any food impact on the stomach.
What can and cannot be eaten during an exacerbation of a stomach ulcer? The diet for acute gastric ulcers includes 6-7 meals a day in very small portions and reduced energy value (up to 2010 kcal). All foods that cause the release of gastric juice and irritate the mucous membrane are completely unacceptable. Salt consumption is significantly reduced. Food, boiled and steamed, served liquid or pureed. Creamy soups, liquid and slimy porridges, souffles are widely used.
In addition to the main list of foods prohibited 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 milddiet no. 1, the purpose of which—not only protects the mucous membrane, but also accelerates its recovery. The essence of the whole diet is preserved, the list of acceptable foods is expanded and the nature of preparation changes: from completely liquid, pure food to the state of "small pieces".
The energy value increases to 2500 kcal per day, the frequency of food consumption is reduced to six times a day. Dried white bread is allowed, as well as mashed potatoes or souffles made from potatoes, beets and carrots. Various mousses, jellies, jelly with milk, sweet fruits and juices, honey and sugar are introduced. Dishes made from unfermented 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 cause, 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
Ulcer(stomach ulcers) is a chronic relapsing disease in which defects of the gastric mucosa appear. If not treated or treated in time, 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 found 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 causative agent of gastric and duodenal ulcers, has decreased in recent years in developed countries (for example, in Sweden - 11%). This is usually due to improved 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 is about 70%. , while most of the infected do not even suspect it and do not complain about anything.
The second main cause of peptic ulcer ispain relievers, especially non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of NSAIDs relieved people from various pains, on the other hand, due to the long-term uncontrolled use of these drugs, "medical" ulcers of the stomach and duodenum appeared more often.
In third place among the causes of gastric and duodenal ulcers isdiseases that increase gastrin production- a hormone that increases the production of hydrochloric acid and increases the aggressiveness of gastric juices. These include B12 deficiency anemia, gastrinoma (tumor of the pancreas), and more.
A peptic ulcer has a significant impact on the likelihood of developing a peptic ulcerpredisposing factors, which are:
- neuro-emotional overwork (stress);
- violation of daily routine and diet, consumption of refined food and fast food;
- complex heredity (for example, peptic ulcer in parents).
If you notice similar symptoms, see your doctor. Do not self-medicate - it is dangerous for your health!
Stomach ulcer symptoms
Pain- the most common symptom of a stomach ulcer. It is localized 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 localized in the duodenum, the pain may increase (or decrease) 30-40 minutes after eating.
The intensity of the pain varies - from sharp and short-lived, which can even cause reflex vomiting immediately after eating, to weak and constant, which is stronger in the morning and goes away 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 under the ribs) or because of pain in the upper abdomen.
A feeling of "early fullness" and heaviness in the stomachthere are also signs of peptic ulcer disease. A person often begins to reduce food portions, because after absorbing even a small amount of food that gets into the inflamed areas of the gastric mucosa and ulcers, such unpleasant sensations can occur.
Bad breath, nausea, changes in taste, plaque on the tongue- common companions of any inflammatory diseases of the upper digestive tract, including gastritis (inflammation of the stomach), which usually leads to ulcers.
Painless form of peptic ulceris most dangerous because of its terrible complications, which sometimes develop with lightning speed in an apparently healthy person. Sometimes they cause fatal consequences. For example, during the perforation of an ulcer of the stomach wall, the patient experiences sudden severe pain that causes shock and disorientation, sometimes with loss of consciousness. It is scary to imagine what this will lead to if this person is a car driver, bus driver or airplane pilot. The same disaster can happen to a person on vacation far from civilization: in the absence of access to emergency medical assistance, the chances of survival are significantly reduced.
Complications of stomach ulcers
Bleeding from the ulcer- the most common complication. This is dangerous, because when the wall of the blood vessel in the ulcer is damaged and bleeding begins, a 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;
- 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 the bleeding are in the lower parts of the stomach or duodenal bulb, symptoms of blood loss appear first, followed by liquid, tarry ("black") stools.
Perforation of the stomach wall- formation of a hole when the ulcer spreads through all layers of the stomach wall. Through this opening, the contents of the stomach enter the abdominal cavity and causeperitonitis- complete inflammation of the abdominal tissues. The moment of perforation is accompanied by a sharp, extremely strong pain, up to a painful shock, a drop in blood pressure, and a sharp pallor of the skin. Later, intoxication (symptoms of "poisoning") and failure of many organs increase. Without immediate medical help, a person dies with such a complication.
Ulcer penetrationcan also complicate the course of the disease. If the ulcer is on the wall of the stomach, which is adjacent to another organ - the wall of the pancreas or intestine, then it can spread to this neighboring organ. Then the first manifestations of a stomach ulcer may be gradually increasing symptoms of inflammation in secondary affected organs.
Malignant tumor- degeneration of peptic ulcer into stomach cancer with all the consequences arising from it. The risk of such degeneration occurs if the ulcer exists for a long time.
Scar stenosis- a dangerous consequence of ulcer healing. Scarring can cause the lumen of the stomach or duodenum to become very narrow to the point where it becomes difficult or impossible for solid and liquid food to pass through. 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 relatively simple and is performed by a therapist or gastroenterologist. During the examination, the doctor determines the general condition of the patient, finds out complaints, the nature and characteristics of the course of the disease, and during palpation finds out the boundaries of painful places and their nature. If necessary, the doctor prescribes blood and instrumental tests to get a clear picture of the patient's state of health and prepare the most optimal treatment plan.
It is more difficult to make a diagnosis whenan atypical or painless ulcer, especially when there are complications in the form of penetration - the spread of the ulcer to the adjacent organ.
The first sign of an asymptomatic or "silent ulcer" is often its complication in the form of bleeding, which causes the patient to be urgently admitted to a surgical hospital, where a medical examination is performed, the anamnesis is clarified, blood is taken, and if necessary, EGD, ultrasound, X-ray.
The optimal method of diagnosing a peptic ulcer (and if it is painless - the only and effective method)routine endoscopic examination- esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, lasts a few minutes, and is accompanied by unpleasant but completely tolerable sensations. The examination provides detailed information about the condition of the upper digestive tract, the presence and nature of inflammatory and erosive-ulcerative processes, as well as the occurrence of neoplasms.
Special technologies are used during endoscopy to determine the acidity of gastric juice and the presence of H. Pylori infection, and small fragments of gastric mucosa are taken from tumors for histological examination in order to determine the type of tumor.
When a patient shows signs of bleeding from the stomach, EGD is used to identify sources of bleeding that can be removed immediately, thereby avoiding serious surgical interventions.
Treatment of stomach ulcers
Peptic ulcers are treated by a therapist or gastroenterologist. It aims to relieve symptoms, heal ulcers and address the cause of the disease through diet, lifestyle changes and medication.
To get rid of the H. pylori infection that causes the ulcer, the doctor prescribes antibiotics, and to reduce the acidity of the stomach juices, antacids, etc. If the stomach ulcer is caused by the use of pain relievers (NSAIDs) or other drugs. that can cause the appearance of an ulcer, the doctor will choose other drugs for the patient, 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.
In addition, a certain diet must be followed during the treatment - diet no. 1. This includes a nutritious diet divided into 5-6 meals a day. The use of strong substances that irritate gastric secretion (ketchup, spicy spices), rough food and dishes is limited. Food is mainly prepared in a pan, steamed or in water, fish and lean meat are served in slices. Very cold and hot dishes are not included in the diet. Limit your intake of table salt.
When 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, stenosis, uncontrolled, repeated bleeding) or in case of ineffective medical treatment, the treatment is performed surgically. But surgery is always a big risk. In peptic ulcers, this is done as a last resort. If it can be avoided by preventing the development of the disease, it is better to take this opportunity.
Prognosis. Prevention
The prognosis of peptic ulcer disease depends on the patient himself. If you follow a healthy lifestyle, proper nutrition and a careful approach to your health, the probability of getting a stomach ulcer is extremely low. Violation of the sleep and nutrition regime, overwork, stress, neglecting regular medical examinations, ignoring one's seemingly minor inconveniences often lead to the development of complex forms.
Preventing a peptic ulcer is much easier, faster and cheaper than treating its developed forms and complications. To that end, the World Health Organization (WHO) recommends annual preventive check-ups with a general practitioner or gastroenterologist from the age of 25. If relatives have had a peptic ulcer, then, regardless of complaints, it is recommended to perform an endoscopy to determine the acidity of gastric juice, refine biopsies to detect H. pylori infection and histologically examine suspicious areas. It is held every two years. In the absence of complaints, prophylactic comprehensive endoscopy is indicated every two years after the age of 35. Diseases identified in the early stages and promptly treated - gastritis, duodenitis, H. pylori infection - will prevent not only ulcerative processes, but also the development of cancer.
drivethree stages of prevention:
- primary- when there is no disease, but there is a risk of contracting it;
- secondary- intended to prevent the progression of an existing disease;
- tertiary- performed after the occurrence of complications.
Primary prevention rules:
- Stick to a certain daily calorie rate: carbohydrates - 50% or more, proteins - 30%, fats - 15-20%. It is important to consider physical activity, height and weight. You need to eat often, in small portions. Remove "hungry" and "mono diet". It is highly 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 baked goods 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 your doctor regularly as part of your medical check-up and eliminate foci of chronic infection, including early treatment of caries, as this lowers overall immunity, making it easier to get any infection, including H. Pylori.
- From the age of 25, a planned complex endoscopic examination is performed once every two years - endoscopy with H. Pylori detection.
Tosecondary and tertiaryPrevention is added to all rules from the first stage:
- Strictly follow diet no. 1. Avoid eating hard-to-digest coarse food, 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 fried (without crust) in puree 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 ulcer exacerbation, such as chronic gastritis.
- Follow medical instructions carefully.
It follows from all this 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, official authoritative medical sources and do not neglect routine tests.