Problems with the gastrointestinal tract force a person to radically change his eating habits. And this is understandable, because in case of acute pain, tingling, burning sensation, heaviness, tightness in the stomach or constant heartburn, you can not only give up your favorite foods, but also completely lose your appetite. However, a food boycott can harm the patient even more. Therefore, in the case of stomach problems, a clear understanding of eating habits helps 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.
The diet of gastric ulcer is the most important direction of therapy
Nutrition, of course, has a significant impact on our health. A properly prepared 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 special nutrition, drug therapy will not be effective.
In the case of an ulcer, the integrity of the mucous membrane is damaged, so digestion together with the secretion of hydrochloric acid causes a lot of pain. What gastric ulcer diet helps relieve symptoms and speed up healing? The main purpose of nutrition is to promote the rapid closure of the ulcer. However, this process is long, and if, with the first signs of relief, the patient returns to the foods that triggered the development of the disease, then the ulcer will not wait long. In order to avoid this, therapeutic nutrition must become a way of life for several months or even years.
How to eat if you have a stomach ulcer
You don't need to starve, because then the acid will start to corrode the stomach wall even more, which only worsens the course of the disease. Therefore, it is imperative to follow the diet prescribed by the gastroenterologist, avoiding hunger and discomfort. What to eat if you have a stomach ulcer?
- The food must not cause irritation of the mucous membrane or increase the acidity of the gastric juice.
- Only eat easily digestible food in liquid, pureed, crushed form, chewed slowly.
- The consumption of hot and cold foods is prohibited, because such foods interfere with enzyme formation and slow down the recovery of the mucous membrane. The optimal temperature is 26-33 °C.
- 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 varies between five and eight times a day.
- Drinking system - 1. 5-2 liters per day.
This is interesting
The first medical diet for patients with gastric ulcers 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 of people suffering from stomach ulcers is "1. it's called "table". Let's look at the basics of this diet.
Table No. 1 - diet for exacerbation of gastric ulcer
So the most important question is: what can you eat if you have a stomach ulcer? Medicinal diet accompanies drug treatment of ulcers during exacerbation and remission and lasts from six months to a year. Therapeutic nutrition includes minimizing the mechanical, chemical and thermal load on the painful stomach. Food should activate regeneration and healing of damage, reduce inflammation, improve gastric secretion and motility.
When following a therapeutic diet for gastric ulcer, permitted foods can be boiled, fried or steamed. Meat and fish must be completely cleaned of skin, bones, cartilage, veins, tendons and fat. When cooking meat, the boiled water must 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 eggs or omelets. The diet should be enriched with fats in the form of unsalted butter, and vegetable oils should only be added to ready meals, not for heat treatment.
Among the carbohydrate-containing foods are some vegetables (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked cereals (oatmeal, semolina, rice, buckwheat), as well as various pastas, dried white bread, crackers, crackers, unleavened crackers.
Desserts included in the diet include purees, mousses, soft, sweet jellies made from berries and fruits, baked fruits, natural marshmallows, marshmallows and jams, jams and jams. Honey is recommended as it soothes pain and inflammation and helps neutralize acids.
It is useful to drink milk, which coats the stomach wall and protects the mucous membrane. Fermented milk products should be introduced into the diet with care and care should be taken to ensure that they do not contain vegetable fats (such as palm oil) which have a detrimental effect on digestion. Let's say low-fat cottage cheese in casserole form, acidophilus, fresh (! ) kefir, natural yogurt and sour cream, unleavened cheese.
Recommended drink: chamomile, rosehip, mint decoctions, weak tea, compotes, jelly, fruit drinks, diluted sweet fruit juices, and 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 a special mention. The maximum permissible amount of salt is 6 g per day. But the less of it gets into the body of a person with a stomach ulcer, the better. It should not be forgotten that we also get salt from finished products, for example, it is present in large quantities in cheeses, including bulk ones.
It is important to understand that many foods are completely unacceptable for ulcer patients, as 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 should give up white cabbage, radishes, radishes, turnips, sour greens (sorrel, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard and onions.
The list of prohibited goods also includes strong tea and coffee, citrus fruits, nuts, wholemeal bread, all kinds of baked goods, including homemade baked goods, chocolate, ice cream, alcoholic and carbonated drinks.
At different stages of the disease, different subtypes of Table No. 1 are used. What kind of diet to follow in case of stomach ulcer depends on the patient's well-being and the severity of the symptoms.
So, a stricter diet is recommended to alleviate a sharp exacerbation— Table No. 1a. This diet is prescribed during periods of intense illness accompanied by acute pain. As a general rule, at this time the patient is forced to stay in bed. The goal of the diet is a purely delicate approach to digestion and the maximum exclusion of the effect of food on the stomach.
What can you eat when a stomach ulcer gets worse and what can't you eat? The acute gastric ulcer diet consists of 6-7 meals a day, in very small portions, with reduced energy content (up to 2010 kcal). Any food that causes secretion of gastric juice and irritates the mucous membrane is completely unacceptable. Salt consumption is significantly reduced. Boiled and steamed foods are served in a liquid or pureed state. They are widely used in cream soups, liquid and slimy porridges, and soufflés.
Apart from the main list of foods prohibited from the diet1a nobread in any form, fermented milk products, all vegetables and fruits are completely excluded.
This diet is prescribed until the ulcer heals. After that, the patient became docileDiet number 1, the purpose of which—not only protects the mucous membrane, but also speeds up recovery. The essence of the diet remains unchanged as a whole, while the list of acceptable foods expands and the nature of preparation also changes: from completely liquid, pureed food to "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 souffle made from potatoes, beets and carrots. Various foams, jellies, milk jellies, sweet fruits and juices, honey and sugar are introduced. Steamed dishes made from unleavened cottage cheese and egg whites, sour cream, mild cheese and butter are allowed.
Stomach ulcer - symptoms and treatment
What is a stomach ulcer? The causes, diagnosis and treatment methods are discussed in the article by Dr. Nizhegorodtsev A. S. , a surgeon with 17 years of experience.
Definition of the disease. Causes of the disease
Peptic ulcer(gastric ulcer) is a chronic, relapsing disease in which defects of the gastric mucosa occur. If left untreated or not treated in time, it can cause disability or death.
Causes of gastric ulcer
It is the most common cause of stomach and duodenal ulcersHelicobacter pylori infection. It can be detected in about 70% of patients with gastric ulcers and up to 90% of patients with duodenal ulcers. The incidence of H. pylori, as the main cause of gastric and duodenal ulcers, has decreased in recent years in developed countries (e. g. 11% in Sweden). This is typically due to improvements in the quality of medical care, which allows for timely diagnosis and treatment of infection, as well as improvements in hygienic conditions (for example, the quality of tap water). In our country, the prevalence of infection reaches 70%, while the majority of those infected do not even suspect it and do not complain about anything.
The second leading cause of peptic ulcer disease ispain relievers, especially non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of the action of NSAIDs relieved people from various pains, and on the other hand, due to the long-term uncontrolled use of these drugs, "medicinal" ulcers of gastric and duodenal ulcers occurred more often.
It ranks third 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-deficient anemia, gastrinoma (pancreatic tumor), etc.
It greatly affects the likelihood of developing a peptic ulcerpredisposing factors, which:
- neuro-emotional overvoltage (stress);
- violation of the daily routine and nutrition, consumption of refined foods and fast food;
- complex inheritance (for example, the presence of peptic ulcer in parents).
If you experience similar symptoms, contact 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 localized in the upper part of the abdomen, and depending on the location of the ulcer, it may decrease or increase immediately or after eating. 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 ranges from pronounced and transient, which can lead to reflex vomiting even immediately after eating, to weak and constant, which increases in the morning and disappears after eating. Sometimes the patient may wake up at night because of "stomach aspiration" (in the hollow area below the ribs) or upper abdominal pain.
"Early fullness" and heaviness in the stomachalso signs of peptic ulcer disease. A person often starts to reduce food portions, since the absorption of even small amounts of food reaching the inflamed areas of the gastric mucosa and ulcers can cause such unpleasant sensations.
Bad breath, nausea, changes in taste, coating on the tongue- it is a frequent accompaniment of any inflammatory disease of the upper gastrointestinal tract, including gastritis (stomach inflammation), which most often causes ulcers.
Painless form of peptic ulcermost dangerous because of its terrible complications, which sometimes develop with lightning speed in an apparently healthy person. Sometimes they have fatal consequences. For example, at the moment of perforation of an ulcer of the stomach wall, the patient experiences sharply expressed intense 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 becomes a car, bus driver or airplane pilot. The same misfortune can befall a person vacationing far from civilization: the chance of survival is significantly reduced due to the lack of emergency medical care.
Complications of gastric ulcer
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, then 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 appears despite reduced physical activity.
If the source of ulcerative defect and bleeding is in the lower part of the stomach or duodenum, symptoms of blood loss appear first, followed by liquid, tarry ("black") stools.
Perforation of the stomach wall- formation of a through 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- complete inflammation of the abdominal tissues. The moment of perforation is accompanied by a sharp, extremely intense pain, up to a painful shock, a drop 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 will die from such a complication.
Ulcer penetrationit can 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 manifestation of gastric ulcer may be gradually increasing inflammatory symptoms in secondary affected organs.
Cancer- degeneration of peptic ulcer into gastric cancer with all the resulting consequences. The danger of such degeneration occurs when the ulcer persists 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 narrow significantly, to the point where solid and liquid food becomes difficult or impossible. In this case, the patient loses weight, quickly becomes exhausted, and gradually dies of dehydration and hunger.
Diagnosis of gastric ulcer
Diagnosis of a typical ulcerStomach surgery is quite simple and is 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 the palpation he clarifies the boundaries and nature of the painful areas. If necessary, the doctor prescribes blood tests and instrumental tests in order to create a clear picture of the patient's state of health and develop the most optimal treatment plan.
It is more difficult to make a diagnosis whenatypical or painless ulcer, especially if complications occur in the form of penetration - the spread of the ulcer to the adjacent organ.
The first symptom of an asymptomatic or "silent ulcer" is often a complication in the form of bleeding, as a result of which the patient is urgently transported to a surgical hospital, where a medical examination is performed, the anamnesis is clarified, blood is taken, tests, if necessary, EGD, ultrasound, X-ray.
The optimal method of diagnosing peptic ulcer (and if it is painless, then the only and effective method)routine 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 state of the upper gastrointestinal tract, the presence and nature of inflammatory and erosive-ulcerative processes, as well as the appearance of tumors.
During the endoscopy, the acidity of the gastric juice and the presence of H. Pylori infection are determined with the help of special technologies, and small fragments of the gastric mucosa are taken from the tumors for histological examination to determine the type of tumor.
If the patient shows signs of gastric bleeding, EGD is used to identify bleeding sources that can be stopped immediately, so that the patient can avoid major surgical interventions.
Treatment of gastric ulcers
Peptic ulcers are treated by a therapist or gastroenterologist. Its goal is to eliminate symptoms, cure ulcers, and eliminate the cause of the disease with diet, lifestyle changes, and medication.
In order to get rid of the H. pylori infection that causes ulcers, the doctor prescribes antibiotics, antacids, etc. to reduce the acidity of gastric juice. writes down. If the stomach ulcer is caused by taking pain relievers (NSAIDs) or other medicines. which can trigger the formation of an ulcer, the doctor chooses other medicines for the patient, similar to the "culprits" of the disease, which do not have an ulcer-forming effect.
If you have a stomach ulcer, it is very important to give up bad habits, especially smoking and excessive alcohol consumption. This eliminates the risk of complications.
In addition, during treatment, you must adhere to a certain diet - diet number 1. This includes a nutritious diet divided into 5-6 meals a day. The consumption of substances that strongly irritate gastric secretion (ketchups, hot spices), coarse foods and foods is limited. Food is mainly pureed, steamed or boiled in water, and fish and lean meat are served in pieces. Very cold and hot foods 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 within 10-14 days.
In the case of peptic ulcer complications (perforation, stricture, uncontrolled, recurrent bleeding) or ineffectiveness of drug therapy, the treatment is performed surgically. However, surgery always carries a high risk. It is performed as a last resort in case of peptic ulcer. If this can be avoided without allowing the disease to develop, then it is better to take advantage of this opportunity.
Forecast. Prevention
The prognosis of peptic ulcer disease depends on the patient. With a healthy lifestyle, proper nutrition and a careful attitude to health, the probability of developing a stomach ulcer is extremely low. Violation of sleeping and eating habits, overwork, stress, neglecting routine medical examinations, ignoring one's own seemingly minor discomforts often lead to the development of complicated 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 that from the age of 25 you attend a preventive examination by a family doctor or a gastroenterologist every year. If the relatives had gastric ulcers, regardless of complaints, endoscopy is recommended to determine the acidity of the gastric juice, to clarify the biopsies for the determination of H. pylori infection and to histologically examine the suspicious areas. It is held every two years. In the absence of complaints, a preventive comprehensive endoscopy is recommended every two years after the age of 35. Diseases identified in the early stages and treated immediately - gastritis, duodenitis, H. pylori infection - can avoid not only ulcerative processes, but also the development of cancer.
Crowthree 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- performed after the development of complications.
The rules of 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. Eat often, in small portions. Eliminate "starvation" and "mono-diets". It is highly undesirable to consume alcohol, soda, fatty, fried, smoked foods, canned food, and fast food. Recommended consumption of cereals, soups, cooked meat and fish, vegetables and fruits. Moderate consumption of baked goods and sweets is allowed.
- Follow 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 dental caries, as this reduces general immunity, which facilitates all infections, including H. Pylori infection.
- From the age of 25, every two years at a planned comprehensive endoscopic examination - endoscopy - with the determination of H. Pylori.
Insecondary and tertiaryPrevention is added to all rules from the first stage:
- Strictly follow diet number 1. Avoid eating hard-to-digest coarse foods, meat, fish and mushroom soups, 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 pureed 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 all causes of ulcer exacerbation, such as chronic gastritis.
- Follow your doctor's instructions carefully.
It follows from all of this that in most cases, the development and complications of stomach ulcers can be easily avoided if you are a medically educated person, listen to the recommendations of doctors, official, reliable medical sources and do not neglect routine examinations.