Gastrointestinal tract problems force a person to radically change their eating habits. And this is understandable, because due to acute pain, tingling, burning, heaviness, stomach tightness 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 if you have stomach problems will help you alleviate the acute symptoms of the disease and once again feel the joy of life. Today we will discuss in detail what diet you should follow if you have a stomach ulcer.
The diet of gastric ulcer is the most important direction of therapy
Of course, nutrition has a significant impact on our health. A properly formed diet can accelerate the healing of ulcers and prevent the development of complications. Therefore, everyone who is facing such a disease should know how to eat properly if they have a stomach ulcer. Of course, the diet does not change the treatment, but without special nutrition drug therapy will not be effective.
During an ulcer, the integrity of the mucous membrane is disturbed, so digestion, accompanied by the secretion of hydrochloric acid, causes great pain. Which stomach ulcer diet can help relieve symptoms and speed healing? The main purpose of nutrition is to facilitate the rapid closure of the ulcer. However, this process is long, and if with the first signs of relief, the patient returns to the food that provokes the development of the disease, then the ulcer will not heal for a long time. To avoid this, 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 is starvation, because then the acid begins to corrode the stomach walls even more, which only aggravates the course of the disease. Therefore, it is necessary to follow the diet prescribed by the gastroenterologist, to avoid 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 eat only easily digestible food in liquid, ground form, chew slowly.
- Hot and cold food is prohibited, because such dishes prevent the production of enzymes and slow down the recovery of the mucous membrane. The optimum temperature is from 26 to 33 °C.
- You should eat in small portions, with a break of no more than three hours. The frequency of feeding 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 stomach ulcers was developed by Mikhail Pevzner, the founder of clinical gastroenterology and dietetics.
It has been proven that diet has a direct effect on 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 ulcer
So, the most important question: what can you eat if you have a stomach ulcer? Medical diet accompanies pharmacological treatment of ulcers during exacerbation and remission and lasts from six months to one year. Therapeutic nutrition involves minimizing the mechanical, chemical and thermal load on the stomach. Food should stimulate regeneration and healing of damage, reduce inflammation and improve gastric secretion and motility.
When following a diet for the treatment of 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, the boiling water should be drained twice in order to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: rabbit, turkey, chicken, veal, beef, lean sea fish, soft-boiled eggs or omelets. It is necessary to enrich the diet with fats in the form of unsalted butter, and vegetable oils should only be added to ready meals, not used for heat treatment.
Among the foods containing carbohydrates, some vegetables (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked cereals (oatmeal, semolina, rice, buckwheat), as well as various pastas, dry white bread, crackers, biscuits, Unleavened biscuits.
Desserts included in the diet include purees, mousses, jellies from soft, sweet berries and fruits, 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 covers the walls of the stomach and protects the mucous membrane. Fermented milk products should be included in the diet with caution and make sure that they do not contain vegetable fats (for example, palm oil), which have a harmful effect on digestion. Let's say low-fat cottage cheese in the form of casserole, acidophilus, fresh (! ) kefir, natural yogurt and sour cream, unfermented cheese.
Recommended drinks: chamomile, rose hip, 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 helps to heal the damaged walls of the stomach.
The role of salt in diet No. 1 deserves special mention. The maximum permissible amount of salt is 6 g per day. But the less that gets into the body of a person with a stomach ulcer, the better. It should be taken into account that we also get salt from ready-made products, for example, it is in large quantities in cheese, 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 provoke 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 (sour, spinach), cucumbers, legumes, mushrooms, garlic, onions, mustard and onions.
Also on the list of prohibited products are strong tea and coffee, citrus fruits, nuts, whole bread, any baked goods, including homemade baked goods, chocolate, ice cream, alcoholic and carbonated drinks.
Different subtypes of Table No. 1 are used at different stages of the disease. What kind of diet to follow in case of a stomach ulcer depends on the patient's well-being and the severity of the symptoms.
Therefore, a stricter diet is recommended to alleviate acute exacerbations- Table No. 1a. This diet is prescribed for intensive illness accompanied by severe 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 to digestion and the maximum exclusion of any impact of food on the stomach.
What can you eat during an exacerbation of a stomach ulcer and what can't you eat? The diet for acute stomach ulcers includes 6-7 meals a day with very small portions and reducing the energy value (up to 2010 kcal). All foods that cause the secretion of gastric juice and irritate the mucous membrane are absolutely unacceptable. Salt consumption has been significantly reduced. Food, boiled and steamed, is eaten liquid or pureed. Cream soups, liquid and slimy porridges and soufflés 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 is transferred to gentleDiet No. 1, whose purpose-It not only protects the mucous membrane, but also accelerates its recovery. In general, the essence of the diet is preserved, while the list of acceptable foods expands and the nature of preparation changes: from completely liquid, ground food to the state of "small pieces".
The energy value increases to 2500 kcal per day, the frequency of food intake is reduced to six times a day. Dried white bread is allowed, as well as mashed potatoes or soufflés from potatoes, beets and carrots. There are various mousses, jellies, jelly with milk, sweet fruits and juices, honey and sugar. Steamed dishes made of unleavened cottage cheese and egg white, sour cream, soft cheese and butter are allowed.
Stomach ulcer - symptoms and treatment
What is a stomach ulcer? The reasons, diagnosis and treatment methods will be discussed by Dr. Nizhegorodtsevi, a surgeon with 17 years of experience. S. in the article of
Definition of the disease. Causes of the disease
Stomach ulcer(Gastric ulcer) is a chronic, recurring disease in which defects appear in the stomach lining. If left untreated or untimely, it can lead to disability or death.
Causes of stomach ulcer
It is the most common cause of gastric and duodenal ulcersHelicobacter pylori infection. It is found in approximately 70% of gastric ulcer patients and up to 90% of duodenal ulcer patients. The prevalence of H. pylori as a major cause of gastric and duodenal ulcers has decreased in recent years in developed countries (for example, 11% in Sweden). As a rule, this is due to the improvement of the quality of medical care, which allows timely diagnosis and treatment of infection, as well as the improvement of sanitary conditions (for example, the quality of tap water). The spread of infection in our country reaches about 70%, and most of the infected people do not even suspect and complain about nothing.
It is the second leading cause of peptic ulcer diseasePainkillersIn particular, non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and variety of action of non-steroidal anti-inflammatory drugs freed people from various pains, on the other hand, due to prolonged uncontrolled use of these drugs, "healing" ulcers of the stomach and duodenum occur more often.
The causes of gastric and duodenal ulcers are on the third placeDiseases that increase gastrin production- a hormone that increases the production of hydrochloric acid and increases the aggressiveness of gastric juice. Among them are B12 deficiency anemia, gastrinoma (pancreatic tumor), etc. Sh.
It has a great influence on the probability of peptic ulcer developmentPredisposing factors, which are:
- neuro-emotional overload (stress);
- Violation of daily routine and diet, consumption of refined food and fast food;
- Complicated inheritance (for example, the presence of peptic ulcer in parents).
If you notice similar symptoms, consult a doctor. Do not self-medicate - it is dangerous for your health!
Stomach ulcer symptoms
pain- is the most common symptom of stomach ulcer. It is localized in the upper part of the abdomen and can 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 pronounced and transient, which can even cause reflex vomiting after eating, to weak and constant, which is stronger in the morning and disappears after eating. Sometimes the patient may wake up at night with "sucking in the pit of the stomach" (in the hollow area under the ribs) or 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 the portion of food, since the absorption of even a small amount of food, which ends up in inflamed areas of the gastric mucosa and ulcers, can cause these unpleasant sensations.
Bad breath, nausea, change in taste, coating on the tongue- frequent concomitants of any inflammatory disease of the upper gastrointestinal tract, including gastritis (inflammation of the stomach), against which ulcers most often appear.
Painless form of peptic ulcerThe most dangerous is its terrible complications, which sometimes develop with lightning speed in a seemingly healthy person. Sometimes they lead to fatal consequences. For example, at the moment of perforation of the ulcer of the stomach wall, the patient experiences severe pain, which causes shock and disorientation, sometimes loss of consciousness. It is scary to imagine what this would lead to if this person turns out to be a car, bus or airplane pilot. The same misfortune can happen to a person who is far from civilization: due to the lack of access to emergency medical care, the chances of survival are significantly reduced.
Complications of stomach 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, a person does not feel anything, especially if the ulcer was painless. When the stomach is filled 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 becomes pale and covered with sweat;
- weakness increases;
- Shortness of breath occurs despite a decrease in physical activity.
When the ulcerative defect and the source of bleeding are located in the lower part 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 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- Complete inflammation of abdominal tissues. The moment of perforation is accompanied by sharp, extremely strong pain, up to a painful shock, a decrease in blood pressure and a sharp pallor of the skin. Subsequently, intoxication ("poisoning" symptoms) and multiple organ failure increase. Without emergency medical help, a person dies from such a complication.
Ulcer penetrationIt can also complicate the course of the disease. If the ulcer is placed 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 stomach ulcer may be symptoms of gradually increasing inflammation of secondary damaged organs.
Malignant tumor- Degeneration of peptic ulcer in stomach cancer with all subsequent consequences. The risk of such degeneration occurs if the ulcer exists for a long time.
Cicatricial stenosis- A dangerous consequence of ulcer healing. As a result of scarring, the lumen of the stomach or duodenum can be significantly narrowed, to the point that it becomes difficult or impossible to pass solid and liquid food through it. In this case, the patient loses weight, gets tired quickly and gradually dies from dehydration and hunger.
Diagnosis of stomach ulcers
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, explains the complaints, the nature and peculiarities of the course of the disease, and during palpation specifies the boundaries of the painful areas and their nature. If necessary, the doctor prescribes blood tests and instrumental examinations to form a clear picture of the patient's health and develop the most optimal treatment plan.
It is more difficult to diagnose whenAtypical or painless ulcer, especially when complications arise in the form of penetration - the spread of an ulcer to a neighboring organ.
The first sign of an asymptomatic or "silent ulcer" is often its complication in the form of bleeding, which is why the patient is urgently admitted to a surgical hospital, where a medical examination is performed, anamnesis is determined, blood is taken, tests and, if necessary, EGD, ultrasound, X-ray.
The optimal method of diagnosing peptic ulcer disease (and if it is painless, it is the only and effective way)Routine endoscopic examination- Esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, lasts a few minutes and is accompanied by unpleasant but completely 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 occurrence of neoplasms.
During endoscopy, using special technologies, 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 shows signs of gastric bleeding, EGD is used to identify sources of bleeding that can be immediately eliminated, allowing the patient to avoid major surgical interventions.
Treatment of stomach ulcers
Peptic ulcer is treated by a therapist or a gastroenterologist. It aims to relieve symptoms, heal ulcers, and address the underlying cause of the disease through diet, lifestyle changes, and medication.
To get rid of the H. pylori infection that causes the ulcer, the doctor will prescribe antibiotics and to reduce the acidity of the stomach juice, antacids, etc. Sh. which can cause 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 ulcer-causing effect.
If you have a peptic ulcer, it is very important to give up bad habits, primarily smoking and excessive alcohol consumption. This eliminates the risk of complications.
Also, during the treatment, it is necessary to follow a certain diet - diet No. 1. It implies a nutritious diet divided into 5-6 meals. The consumption of strong gastric secretion irritants (ketchups, hot spices), rough food and dishes is limited. Food is mainly pureed, steamed or boiled in water, fish and lean meat are eaten in portions. 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 in 10-14 days.
In case of complications of peptic ulcer disease (perforation, stenosis, uncontrolled, repeated bleeding) or in case of ineffectiveness of medical therapy, treatment is carried out surgically. However, surgery is always a big risk. It is used as a last resort for peptic ulcer. If it can be avoided without developing the disease, then it is better to take advantage of this opportunity.
forecast. Prevention
The prognosis of peptic ulcer disease depends on the patient himself. With a healthy lifestyle, proper nutrition and a careful attitude to your health, the probability of developing a stomach ulcer is extremely low. Disturbances in sleep and eating patterns, overwork, stress, neglecting routine medical examinations and ignoring one's own seemingly insignificant discomfort often lead to the development of complicated forms.
Prevention of peptic ulcer disease is much easier, faster and cheaper than treating its advanced forms and complications. For this purpose, the World Health Organization (WHO) recommends that from the age of 25 you undergo preventive examinations with a general practitioner or a gastroenterologist every year. If relatives had a peptic ulcer, then, despite complaints, endoscopy is recommended to determine the acidity of gastric juice, biopsy to determine H. pylori infection and histological examination of suspicious areas. It is held once in two years. In the absence of complaints, preventive comprehensive endoscopy is indicated every two years after 35 years. Early detection and timely treatment - gastritis, duodenum, H. pylori infection - prevents the development of not only ulcerative processes, but also cancer.
changeableThree stages of prevention:
- Primary- when there is no disease, but there is a risk of its development;
- secondary- aims to prevent the progression of an existing disease;
- Tertiary- It is carried out after the development of complications.
Primary prevention rules:
- Follow 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. It is necessary to eat often, in small portions. Exclude "hungry" 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, 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.
- Regularly visit the doctor for a medical examination and eliminate foci of chronic infection, including timely treatment of caries, because it reduces general immunity, which facilitates any infection, including H. Pylori.
- Starting from the age of 25, every two years, undergo a planned comprehensive endoscopic examination - endoscopy with determination of H. Pylori.
Insecondary and tertiaryPrevention is added to all rules from the first stage:
- Strictly follow diet No. 1. Avoid hard-to-digest coarse foods, 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 baked (without the crust) in minced form. It should be warm: neither cold nor hot. Portions should be small. It is recommended to drink mineral water, which reduces stomach acidity.
- Eliminate any cause of ulcer exacerbation, for example, chronic gastritis.
- Carefully follow medical instructions.
It follows from all this that in most cases the development of peptic ulcer disease and its complications can be avoided if you are a medically educated person, listen to the recommendations of doctors, official authoritative medical sources and do not neglect routine examinations.