Problems with the gastrointestinal tract force a person to radically change their eating habits. And this is understandable, because feeling sharp pains, tingling, burning, heaviness, tightness in the stomach or constant heartburn, you can not only give up 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 alleviate the acute symptoms of the disease and help you feel the joy of life again. Today we will see in detail what diet you should follow if you have a stomach ulcer.
Diet for stomach ulcers is the most important direction of therapy
Nutrition certainly has a significant impact on our health. A well-formulated diet can accelerate the healing of ulcers and prevent the development of complications. Therefore, everyone who is faced with 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.
In ulcers, the integrity of the mucosa is compromised, which is why digestion, accompanied by the secretion of hydrochloric acid, causes a lot of pain. What diet for stomach ulcers will help relieve symptoms and speed healing? The main objective 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 cause the development of the disease, the ulcer will soon appear. To prevent this from happening, therapeutic nutrition must become a way of life for several months, or even years.
How to eat if you have a stomach ulcer
What is not necessary is to go hungry, because then the acid begins to eat away at the walls of the stomach even more, which only worsens the course of the disease. Therefore, it is essential 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 mucosal irritation and increase the acidity of gastric juice.
- You should only consume easily digestible foods in liquid, pureed and crushed form, chewing slowly.
- Hot and cold foods are prohibited, as they interfere with the formation of enzymes and slow down the restoration of the mucous membrane. The ideal temperature is 26 to 33 °C.
- You need to eat in small portions at intervals of no more than three hours. The regularity of meals is determined by the severity of the condition and varies 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 directly affects the course of the disease. Therefore, strict adherence to the nutritionist's recommendations is the key to recovery. The diet for people with stomach ulcers is called "table No. 1". Let's look at the basic principles 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 exacerbation and remission and lasts from six months to a year. Therapeutic nutrition involves minimizing the mechanical, chemical and thermal load on stomach pain. 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 cleaned of skin, bones, cartilage, veins, tendons and fat. When cooking meat, it is necessary to drain the boiled water twice to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: lean rabbit meat, turkey, chicken, veal, beef, lean sea fish, boiled eggs or omelet. It is necessary to enrich the diet with fats in the form of unsalted butter, and add vegetable oils only to ready-made dishes, not using them for heat treatment.
Among foods rich in carbohydrates, some vegetables are recommended (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked grains (oats, semolina, rice, buckwheat), as well as various pastas, white bread dry, biscuits, biscuits, yeast-free biscuits.
Desserts included in the diet include purees, mousses, fruit jellies and soft and sweet fruits, baked fruits, natural marshmallows, marshmallows and marmalades, jellies and marmalades. Honey is recommended because 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 dairy products should be included in the diet with caution and ensure that they do not contain vegetable fats (for example, palm oil), which impair 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, rose hips, 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 the enzymatic processing of food and promotes the 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 gets into the body of a person suffering from a stomach ulcer, the better. It must be remembered that we also obtain salt from finished products, for example, it is present in large quantities in cheeses, including processed ones.
It is important to understand that many foods are completely unacceptable for patients with ulcers, as they cause irritation to the mucosa, take time to digest and cause bleeding. All fatty, spicy, salty, sour, smoked, fried and canned foods, sausages, offal, spices, ketchups, sauces and marinades are excluded. You need to 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 items are tea and strong coffee, citrus fruits, nuts, wholemeal bread, any bakery products, including homemade baked goods, chocolate, ice cream, alcoholic and carbonated drinks.
At different stages of the disease, different subtypes from table No. 1 are used. What diet to follow for a stomach ulcer depends on the patient's well-being and the severity of the symptoms.
Therefore, to alleviate a sharp 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 remain in bed. The purpose of the diet is a purely delicate attitude towards 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 cannot? The diet for acute stomach ulcers involves dividing 6-7 meals a day into very small portions and reduced energy value (up to 2, 010 kcal). All foods that cause secretion of gastric juice and irritate the mucous membrane are absolutely unacceptable. Salt consumption is significantly reduced. Boiled and steamed foods are served in liquid or pureed form. Creamy soups, liquid and viscous porridges and soufflés are widely used.
In addition to the main list of foods prohibited in the diet#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 gentlediet #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 is expanded and the nature of preparation changes: from completely liquid, pureed foods to the state of "small pieces".
The energy value increases to 2, 500 kcal per day, the frequency of food intake is reduced to six times a day. Dry white bread, mashed potatoes or potato soufflé, beets and carrots are allowed. Various mousses, jellies, jellies with milk, fruit and sweet 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. , a surgeon with 17 years of experience.
Definition of disease. Causes of the disease
Stomach ulcer(Stomach ulcers) is a chronic and relapsing disease in which defects occur in the gastric mucosa. In the absence or late treatment, it can cause disability or death.
Causes of stomach ulcers
The most common cause of stomach 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, as the main cause of gastric and duodenal ulcers, has decreased in recent years in developed countries (for example, in Sweden it is 11%). Typically, this is due to improvements in the quality of medical care, which allow for timely diagnosis and treatment of infection, as well as improved sanitation conditions (e. g. , the quality of tap water). In our country, the prevalence of infection reaches around 70%, while the majority of those infected do not even suspect it and do not complain about anything.
The second leading cause of peptic ulcers isanalgesics, in particular non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of action of NSAIDs relieved people of various pains, on the other hand, due to the prolonged and uncontrolled use of these drugs, "medicinal" ulcers of the stomach and duodenum began to occur more frequently.
In third place among the causes of stomach and duodenal ulcers arediseases that increase gastrin production- hormone that increases the production of hydrochloric acid and increases the aggressiveness of gastric juice. These include B12 deficiency anemia, gastrinoma (pancreatic tumor), etc.
The likelihood of developing a peptic ulcer is greatly influenced bypredisposing factors, that are:
- neuroemotional overload (stress);
- violation of the daily and nutritional routine, consumption of refined foods and fast food;
- complicated heredity (for example, presence of peptic ulcers in parents).
If you notice similar symptoms, see your doctor. Do not self-medicate - it is dangerous to your health!
Stomach ulcer symptoms
Pain- the most common symptom of gastric ulcer. It is located in the upper part of the abdomen and may decrease or intensify immediately or after a meal, depending on the location of the ulcer. And if the ulcer is located 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 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 in the pit of the stomach" sensation (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 ulcers. People often begin to reduce portions of food, as 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 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 ulcerit is most dangerous for its terrible complications, which sometimes develop with lightning speed in an apparently healthy person. Sometimes they lead to fatal consequences. For example, when an ulcer perforates in the stomach wall, the patient feels intense and pronounced pain, which leads to shock and disorientation, sometimes with loss of consciousness. It's scary to imagine what this will lead to if that person is a car, bus driver or airline pilot. The same misfortune can happen to those who are on vacation far from civilization: due to the lack of opportunity to receive emergency medical care, the chances of survival are significantly reduced.
Complications of stomach ulcers
Bleeding from an ulcer- the most common complication. It is dangerous because if the wall of the ulcer vessel is damaged and bleeding begins, the person does not feel anything, especially if the ulcer is 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 becomes pale and covered with sweat;
- weakness increases;
- shortness of breath appears despite decreased physical activity.
When the ulcerative defect and the source of bleeding are located in the lower parts of the stomach or in the duodenal bulb, 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 through all layers of the stomach 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 sharp and extremely intense pain, up to painful shock, decreased blood pressure and marked paleness of the skin. Subsequently, intoxication ("poisoning" symptoms) and multiple organ failure increase. Without emergency medical care, a person dies from this complication.
Ulcer penetrationit can also complicate the course of the disease. If the ulcer is located in the stomach wall, adjacent to another organ - the pancreas or intestinal wall, it can spread to that neighboring organ. Then the first manifestations of gastric ulcer may gradually increase symptoms of inflammation in the affected secondary organs.
Malignancy- degeneration of peptic ulcer into stomach cancer with all the ensuing consequences. The risk of such degeneration appears if the ulcer exists for a long time.
Scar stenosis- a dangerous consequence of ulcer healing. As a result of scarring, the lumen of the stomach or duodenum may narrow significantly, to the point where it becomes difficult or impossible for solid foods and liquids 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 quite simple, performed by a therapist or gastroenterologist. During the examination, the doctor determines the general condition of the patient, clarifies the complaints, nature and features of the course of the disease, and during palpation clarifies the boundaries of 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 status and develop the most appropriate treatment plan.
It is more difficult to establish a diagnosis whenatypical or painless ulcer, especially when complications arise in the form of penetration - the 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, as a result 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 examinations and, if necessary, EGD, ultrasound, X-ray.
The ideal method to diagnose peptic ulcers (and if it is painless, the only and effective way) isroutine endoscopic examination— esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, lasts several 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 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 removed from tumors for histological examination to determine the type of tumor.
When a patient presents with signs of gastric bleeding, EGD is used to identify sources of bleeding that can be eliminated immediately, allowing the patient to avoid serious surgical interventions.
Treatment of stomach ulcers
Peptic ulcers are treated by a therapist or gastroenterologist. It aims to eliminate symptoms, cure ulcers and eliminate the cause of this disease through diet, lifestyle changes and medication.
To get rid of H. pylori infection that causes ulcer, the doctor prescribes antibiotics and to reduce the acidity of gastric juice, acid-reducing medicines, etc. If a stomach ulcer is caused by the use of analgesics (NSAIDs) or other medications that can trigger the development of an ulcer, the doctor will select other medications for the patient, medications 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.
Also, during treatment, you need to adhere to a certain diet - diet No. 1. It involves a nutritious diet, divided into 5-6 meals a day. The consumption of strong irritants of gastric secretion (ketchups, hot seasonings), coarse foods and dishes is limited. The food is mainly prepared by pureeing, steaming or boiling in water; fish and lean meats are served in pieces. 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 within 10 to 14 days.
In case of complications of peptic ulcer disease (perforation, stenosis, uncontrolled and recurrent bleeding) or in case of ineffectiveness of drug therapy, treatment is carried out surgically. However, surgery is always a big risk. For peptic ulcers, it is performed as a last resort. If it 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 ulcers depends on the patient. With a healthy lifestyle, proper nutrition and careful attitude to your health, the likelihood of developing a stomach ulcer is extremely low. Disturbances in sleeping and eating patterns, overwork, stress, neglecting routine medical checkups, and ignoring one's own seemingly minor discomforts often lead to the development of complicated forms.
Preventing peptic ulcers is much easier, faster and cheaper than treating the forms and complications that develop. To this end, the World Health Organization (WHO) recommends that, from the age of 25, you undergo annual preventive exams with a general practitioner or gastroenterologist. If family members had a peptic ulcer, then, regardless of complaints, endoscopy is recommended with determination of the acidity of gastric juice, clarifying biopsies to determine H. pylori infection and histological examination of suspicious areas. It is held every two years. In the absence of complaints, comprehensive preventive endoscopy is indicated every two years from the age of 35. Diseases identified and promptly treated in the early stages - gastritis, duodenitis, H. pylori infection - will prevent the development of not only ulcerative processes, but also cancer.
Varythree steps of prevention:
- primary- when there is no disease, but there is a risk of developing it;
- secondary- intended to prevent the progression of an already existing disease;
- tertiary- carried out after the development 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 "starvation" and "mono-diets". It is highly undesirable to consume alcohol, carbonated drinks, fatty, fried, smoked, canned foods and fast food. It is recommended to eat cereal porridge, soups, boiled meat and fish, vegetables and fruits. Moderate consumption of baked goods and sweets is permitted.
- Follow 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.
- Regularly visit a doctor as part of a medical examination and eliminate foci of chronic infection, including timely treatment of caries, as it 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 first phase rules are added:
- Strictly follow diet No. 1. Avoid eating rough and difficult to digest foods, meat, fish and mushroom broths, strong tea and coffee, baked goods, chocolate, fresh and sour fruits, spicy vegetables - turnips, radishes, radishes, onions. Food must be steamed, boiled or baked (without crust) in puree form. It should be warm: neither cold nor hot. Portions should be small. It is advisable to drink mineral water, which reduces stomach acidity.
- Eliminate any causes of ulcer exacerbation, for example, chronic gastritis.
- Follow your doctor's instructions carefully.
From all of the above, it follows that in most cases, the development of peptic ulcer disease and its complications can be easily avoided if you are a person with medical knowledge, listen to the recommendations of doctors, official medical sources and do not neglect medical examinations. routine.