Gastrointestinal problems force a person to radically change their eating habits. And this is understandable, because when you feel acute pain, tingling, burning, heaviness, heaviness in the stomach or constant heartburn, you can not only skip your favorite dishes, but also completely lose your appetite. However, skipping meals can harm the patient even more. Therefore, a clear understanding of how to eat if you have stomach problems will help relieve the acute symptoms of the disease and once again find the joy of life. Today we will take a detailed look at what diet you should follow if you have a peptic ulcer.
Diet for peptic ulcers is the most important way of treatment
Nutrition certainly has a significant impact on our health. A properly composed diet can speed up the healing of wounds and prevent the development of complications. That's why anyone suffering from a similar disease needs to 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.
With an ulcer, the integrity of the mucous membrane is compromised, so the digestion, accompanied by the secretion of hydrochloric acid, causes great pain. What Diet for Peptic Ulcers Will Help Relieve Symptoms and Speed Up Healing? The main goal of nutrition is to promote rapid closure of the wound. However, this process is long, and if the patient, at the first sign of relief, 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, even years.
How to eat if you have a stomach ulcer
What you don't need to do is starve, because then the acid starts to corrode the walls of the stomach even more, which only increases the course of the disease. Therefore, it is important to follow the diet prescribed by the gastroenterologist and avoid feeling hungry and uncomfortable. 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 only consume easily digestible food in liquid, pureed, crushed form, chew it slowly.
- Hot and cold foods are prohibited, because such dishes interfere with enzyme synthesis and slow down the recovery of the mucous membrane. The best temperature is from 26 to 33 °C.
- You need to eat in small portions with a break of no more than three hours. The frequency of meals depends on the severity of the condition and is between five and eight times a day.
- Drinking schedule - from 1. 5 to two liters per day.
This is interesting
The first medical diet for patients with peptic ulcers was developed by Mikhail Pevzner, the founder of clinical gastroenterology and nutrition.
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. Diet for 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 gastric 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 involves minimizing mechanical, chemical, and thermal stress on the painful stomach. Food should activate regeneration and healing of damage, reduce inflammation and improve gastric secretion and motility.
When following a healing diet for peptic ulcers, permitted foods may be boiled, baked or steamed. Meat and fish must be completely cleaned of skin, bones, cartilage, veins, tendons and fat. When cooking meat, you need to drain the cooking water twice to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: lean meat from rabbit, turkey, chicken, veal, beef, lean marine fish, soft-boiled eggs or omelets. It is necessary to enrich the diet with fat in the form of unsalted butter and add vegetable oils only to prepared dishes, do not use them for heat treatment.
Carbohydrate foods include some vegetables (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked grains (oatmeal, buckwheat, rice, buckwheat), as well as various pastas, dry white bread, crackers, crackers, unleavenedbiscuit
Desserts included in the diet are puree, mousse, jelly made from soft, sweet berries and fruit, baked fruit, natural marshmallows, marshmallows and marmalade, jam and marmalade. Honey is recommended as it soothes pain and inflammation and helps neutralize acid.
It is useful to drink milk, which surrounds the walls of the stomach and protects the mucous membrane. Processed dairy 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 stews, acidophilus, fresh (! ) kefir, natural yogurt and sour cream, non-acidified cheese.
Recommended drink: decoctions of chamomile, roses, mint, weak tea, compotes, jelly, fruit drinks, diluted sweet juices, as well as water at room temperature. 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 the diet no. 1 needs special mention. The maximum permissible amount of salt is 6 g per day. But the less it gets into the body of a person suffering from a peptic ulcer, the better. It should be borne in mind that we also get salt from finished products, it is for example in large quantities in cheeses, including processed ones.
It is important to understand that many foods are completely unacceptable to ulcer patients for the reason that they irritate the mucous membrane, take a long time to digest and cause bleeding. All fatty, spicy, salted, sour, smoked, fried and canned food, sausages, offal, spices, ketchup, sauces and marinades are excluded. You need to give up cabbage, radishes, radishes, beets, sour vegetables (sours, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard and onions.
Also on the list of prohibited items are strong tea and coffee, citrus fruits, nuts, wholemeal bread, all kinds of baked goods, including homemade pastries, chocolate, ice cream, alcohol and carbonated drinks.
At different stages of the disease, different subtypes of table no. Which diet to follow for stomach ulcers depends on the patient's condition and the severity of the symptoms.
So, to reduce sharp exacerbations, a stricter diet is recommended— table no. 1a. This diet is prescribed during periods of severe illness, accompanied by acute pain. As a rule, the patient is forced to stay in bed during this time. The goal of the diet is a purely sensitive attitude to digestion and exclude the maximum effect of food on the stomach.
What can you eat when a stomach ulcer gets worse and what can't you? A diet for acute peptic ulcer involves dividing 6-7 meals a day into very small portions and reduced energy value (up to 2010 kcal). All foods that cause the secretion of gastric juice and irritate the mucous membrane are completely unacceptable. Salt consumption is significantly reduced. Food, boiled and steamed, is served in a liquid or pureed state. Creamy 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 milk products, all vegetables and fruits are completely excluded.
This diet is prescribed until the wound begins to heal. After this, the patient switches to gentlediet number 1, but the purpose of it—not only provides protection for the mucous membrane, but also accelerates its recovery. The essence of the diet as a whole is preserved while the list of acceptable foods is expanded and the nature of preparation changes: from completely liquid, pureed food to the state of "small bites".
The energy value increases to 2500 kcal per day, the frequency of food intake decreases to six times a day. It is allowed to dry white bread as well as mashed potatoes or soufflé made from potatoes, beets and carrots. Various types of mousse, jelly, jelly with milk, sweet fruit and juice, honey and sugar are introduced. It is permissible to make the steamed stew from unleavened cottage cheese and egg whites, sour cream, mild cheese and butter.
Stomach ulcers - symptoms and treatment
What is a peptic ulcer? We will discuss the causes, diagnosis and treatment methods in an article by Dr. Nizhegorodtsev A. S. , a surgeon with 17 years of experience.
Definition of disease. Causes of the disease
Stomach ulcer(Ulcer) is a chronic, relapsing disease in which defects occur in the stomach lining. If left untreated or prematurely, it can cause disability or death.
Causes of peptic ulcers
The most common cause of peptic and duodenal ulcers isHelicobacter pylori infection. It is diagnosed in approximately 70% of patients with gastric ulcers and up to 90% of patients with duodenal ulcers. The incidence of H. pylori, which is 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 improvements in the 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 infection rate reaches about 70%, while most infected people do not even suspect it and do not complain about anything.
Another major cause of peptic ulcer disease ispain medication, especially non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of the action of NSAIDs relieves people of various pains, on the other hand, due to the long-term uncontrolled use of these drugs, "healing" ulcers in the stomach and duodenum began to appear more often.
In third place among the causes of gastric and duodenal ulcers arediseases 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, stomach tumors (pancreatic tumors), etc.
The chances of getting a stomach ulcer are greatly influenceddominant factors, that are:
- neuro-emotional overexertion (stress);
- violation of daily routine and nutrition, consumption of refined foods and fast food;
- complex inheritance (eg presence of peptic ulcer in parents).
If you experience similar symptoms, consult your doctor. Do not self-medicate - it is dangerous to your health!
Symptoms of peptic ulcer
Pain- the most common symptom of peptic ulcer. It is localized in the upper abdomen and may decrease or increase immediately or after a meal, 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 temporary, which can even lead to reactive vomiting immediately after a meal, to weak and constant, which is worse in the morning and disappears after eating. Sometimes the patient may wake up at night because of a feeling of "sucking in the stomach" (in the hollow area under the ribs) or pain in the upper abdomen.
A feeling of "early fullness" and heaviness in the stomachare also signs of peptic ulcer disease. A person often begins to reduce portions of food, since the absorption of even a small amount of food that ends up in inflamed areas of the gastric mucosa and ulcers can cause these unpleasant sensations.
Bad breath, nausea, changes in taste, coating on the tongue- frequent side effects of any inflammatory diseases of the upper gastrointestinal tract, including gastritis (inflammation of the stomach), which most often cause 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 have fatal consequences. For example, at the moment a wound in the stomach wall is ruptured, the patient experiences significant 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, bus driver or pilot. The same misfortune can befall a person who is on vacation far from civilization: due to the lack of opportunities to receive emergency medical care, the chances of survival are significantly reduced.
Complications of peptic ulcers
Bleeding from a wound- the most common complication. It is dangerous because if the blood vessel wall in the wound is damaged and bleeding starts, the person does not feel anything, especially if the wound was painless. When the stomach becomes full of blood, reflex vomiting occurs. This is how the disease manifests itself. Then the patient gets symptoms of blood loss:
- blood pressure drops;
- the pulse quickens;
- the skin becomes pale and covered with sweat;
- weakness increases;
- shortness of breath occurs despite reduced exercise.
When the gallbladder and the source of bleeding are located in the lower abdomen or in the duodenal cyst, symptoms of blood loss first appear, followed by liquid, tarry ("black") stools.
Rupture of the stomach wall- formation through a hole when the ulcer spreads through all the layers of the stomach wall. Through this opening, stomach contents 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 painful shock, a drop in blood pressure and a sharp pallor of the skin. As a result, intoxication (symptoms of "poisoning") and organ failure increase. Without an emergency doctor, a person dies with such complications.
Wound penetrationcan also complicate the course of the disease. If the ulcer is located on the wall of the stomach, which is next to another organ - the pancreas or the intestinal wall, it can spread to a nearby organ. Then the first symptoms of a stomach ulcer may be gradually increasing symptoms of inflammation in secondary infected organs.
Malignant disease- degeneration of a gastric ulcer into gastric cancer with all the consequences that follow. The risk of such degeneration occurs if the wound is present for a long time.
Micro-congestion- a dangerous consequence of wound healing. As a result of scarring, the lumen of the stomach or duodenum can become significantly narrowed, to the extent that 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 of dehydration and starvation.
Diagnosing peptic ulcers
Diagnosis of a typical woundgastric bypass surgery is quite simple, performed by a therapist or gastroenterologist. During the examination, the doctor determines the general condition of the patient, explains the complaints, nature and symptoms of the disease process, and during palpation, explains the boundaries of the painful areas and their nature. If necessary, the doctor prescribes blood tests and equipment tests to get a clear picture of the patient's health and develop the best possible treatment plan.
It is more difficult to establish a diagnosis whenan atypical or painless ulcer, especially when complications arise in the form of penetration - the spread of the wound to a nearby organ.
The first sign of an asymptomatic or "acoustic ulcer" is often its complication in the form of bleeding, during which the patient is immediately admitted to a surgical hospital, where a medical examination is carried out, anemia is clarified, blood is taken for testing, and, if necessary, EGD, ultrasound, x-ray.
The best way to diagnose peptic ulcer disease (and if it's painless, the only effective way) isroutine endoscopic examination— esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, takes a few minutes and is accompanied by unpleasant but completely tolerable sensations. As a result of the study, comprehensive information about the condition of the upper digestive tract, the presence and nature of inflammatory and erosive-ulcer processes, as well as the appearance of tumors appears.
Using a special endoscopy technique, the acidity of gastric juice and the presence of H. Pylori infection are determined, and small pieces of the gastric mucosa are removed from tumors for histological examination to determine the type of tumor.
When a patient shows signs of gastrointestinal bleeding, EGD is used to identify bleeding sources that can be eliminated immediately, allowing the patient to avoid major surgery.
Treatment of stomach ulcers
Peptic ulcers are treated by a therapist or gastroenterologist. It aims to eliminate symptoms, heal wounds and eliminate the cause of this 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 gastric juice, antacids, etc. s. etc. If a peptic ulcer is caused by oral painkillers (NSAIDs) or other drugs that can lead to the development of an ulcer, the doctor will choose other drugs for the patient, drugs similar to the "culprit" of the disease, which do not have an ulcer-forming effect.
If you have a stomach ulcer, it is very important to stop bad habits, primarily smoking and excessive alcohol consumption. This will eliminate the risk of complications.
Also, during treatment, you need to follow a certain diet - diet no. 1. It includes a nutritious diet, divided into 5-6 meals a day. Consumption of strong irritants from gastric secretions (ketchup, hot spices), coarse foods and dishes is limited. Food is mainly prepared pureed, steamed or boiled in water; fish and lean meat are served in pieces. Very cold and hot dishes are excluded from the diet. Limit your intake of table salt.
After a balance has been achieved between aggressive and protective factors, wounds heal spontaneously within 10-14 days.
In case of complications of peptic ulcer (perforation, stenosis, uncontrolled, recurrent bleeding) or if drug treatment is ineffective, treatment is carried out by surgery. However, surgery is always a high risk. For peptic ulcer 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.
ForecastPrevention
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 chances of getting a stomach ulcer are extremely low. Violations of sleep and nutrition patterns, excessive work, stress, neglect of routine medical examinations and ignoring one's own, seemingly minor discomforts often lead to the development of complex forms.
It is much easier, faster and cheaper to prevent peptic ulcer disease than to treat the advanced form and complications. For this purpose, the World Health Organization (WHO) recommends that starting at the age of 25, you undergo annual preventive examinations by a general practitioner or a gastroenterologist. If relatives had peptic ulcers, an endoscopy is recommended, regardless of complaints, by determining the acidity of gastric juice, explaining a biopsy to determine H. pylori infection, and biopsy of suspicious areas. It is held every two years. If there are no complaints, there is a preventive comprehensive endoscopy every two years after 35 years. Diseases that are identified and treated in the early stages - gastritis, duodenitis, H. pylori infection - will avoid the development of not only ulcer processes, but also cancer.
Differentthree levels of prevention:
- main- when there is no disease present but there is a risk that he will get it;
- secondary matter- aims to prevent the progression of an already existing disease;
- university level- performed after the development of complications.
Rules of primary prevention:
- Stick to a certain daily calorie intake: carbohydrates - 50% or more, protein - 30%, fat - 15-20%. It is important to take into account movement, height and weight. You need to eat often, in small portions. Eliminate "hungry" and "single diet". It is highly undesirable to consume alcohol, soda, fatty, fried, smoked foods, canned food and fast food. It is recommended to eat porridge, soups, boiled meat and fish, vegetables and fruits. Moderate consumption of pastries 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 your doctor regularly as part of a medical check-up and eliminate the focus of chronic infection, including timely treatment of dental caries, as it reduces general immunity, which facilitates any type of infection, including H. Pylori.
- From the age of 25, once every two years, undergo a planned comprehensive endoscopy - an endoscopy with the determination of H. Pylori.
Insecondary and tertiary levelprevention of all rules from the first level is added:
- Follow diet no. 1. Avoid eating hard-to-digest coarse food, meat, fish and mushroom broths, strong tea and coffee, pastries, chocolate, fresh sour fruits, spicy vegetables - beets, 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 advisable to drink mineral water, which reduces stomach acidity.
- Eliminate all causes of ulcer aggravation, for example, chronic gastritis.
- Follow your doctor's instructions carefully.
From all this it follows that in most cases it is easy to avoid the development of peptic ulcer disease and its complications if you are medically literate, listen to the advice of doctors, consult authoritative medical sources and do not neglect routine examinations.