Problems with the gastrointestinal tract force a person to radically change eating habits. And this is understandable, because experiencing acute pain, 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 relieve the acute symptoms of the disease and once again feel the joy of life. 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
Food certainly has a significant impact on our health. A properly formulated diet can accelerate 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 food, drug therapy will not be effective.
With an ulcer, the integrity of the mucosa is compromised, so 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 purpose of nutrition is to promote 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 provoke the development of the disease, then the ulcer will not be 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 should not do is starve yourself, because then the acid begins to erode the stomach walls even more, which only worsens the course of the disease. Therefore, it is necessary to adhere to 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 irritation of the mucous membrane and increase the acidity of the gastric juice.
- You should consume only easily digestible food in liquid form, pureed, crushed, chewing it slowly.
- Hot and cold foods are forbidden, because such dishes interfere with the formation of enzymes and slow down the restoration of the mucosa. The optimum temperature is from 26 to 33 °C.
- You should 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 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 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 basics of this diet.
Table no. 1 - diet for aggravation of stomach ulcer
So, the most important question: what can you eat if you have a stomach ulcer? A medical diet accompanies the pharmacological treatment of the ulcer during exacerbation and mild remission and lasts from six months to a year. Therapeutic nutrition involves minimizing the mechanical, chemical and thermal load on the injured stomach. Food should activate regeneration and healing of injuries, reduce inflammation and improve gastric secretion and motility.
When following a therapeutic diet for 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, you should drain the boiling water twice to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: lean meat of rabbit, turkey, chicken, beef, veal, lean seafood, soft-boiled eggs or omelets. It is necessary to enrich the diet with fats in the form of unsalted butter and add vegetable oils only to ready meals, not using them for heat treatment.
Among carbohydrate foods, some vegetables are recommended (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-boiled cereals (oatmeal, semolina, rice, buckwheat), as well as various pastas, dry white bread, crackers, cookies, unleavened cookies.
Sweets included in the diet include puree, foam, jelly from berries and soft, sweet 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 envelops the walls of the stomach and protects the mucosa. Fermented milk products should be included in the diet carefully and ensure 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 pan, acidophilus, fresh kefir (! ), natural yogurt and sour cream, cheese without yeast.
Recommended drink: decoction with chamomile, rose hips, mint, weak tea, compote, 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 diet no. 1 deserves special mention. The maximum allowed amount of salt is 6 g per day. But the less that enters the body of a person suffering from a stomach ulcer, the better. It should be taken into account that we also get salt from ready-made 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 ulcer patients because they cause mucosal irritation, take a long time to digest and provoke bleeding. All fatty, spicy, salty, sour, smoked, fried and canned foods, sausages, offal, spices, ketchups, sauces and marinades are excluded. You should give up white cabbage, radishes, radishes, turnips, sour greens (chickpeas, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard and onions.
Also on the list of banned items are strong tea and coffee, citrus fruits, nuts, wholemeal bread, any baked goods, including home baked goods, chocolate, ice cream, alcoholic and carbonated beverages.
In different stages of the disease, different subtypes of table no. 1. What diet to follow for stomach ulcers depends on the patient's well-being and the severity of the symptoms.
So, to alleviate a sharp deterioration, 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 stay in bed. The aim of the diet is a purely delicate attitude towards digestion and the maximum exclusion of any influence of food on the stomach.
What can you eat during an exacerbation of a stomach ulcer and what not? The diet for acute stomach ulcers includes 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 absolutely unacceptable. Salt consumption is significantly reduced. Food, boiled and steamed, is served in a liquid or pureed state. Creamy soups, runny and slippery 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 recommended until the ulcer begins to heal. After that, the patient goes to mildDiet no. 1, the purpose of which-they not only provide protection for the mucosa, but also accelerate its recovery. The essence of the diet as a whole remains the same, while the list of acceptable foods expands and the nature of preparation changes: from completely liquid food, cleaned to a state of "small pieces".
The energy value increases to 2500 kcal per day, the frequency of food intake decreases to six times a day. Dry white bread is allowed, as well as mashed potatoes or soufflés from potatoes, beets and carrots. Various foams, jellies, jellies with milk, fruits and sweet juices, honey and sugar are presented. 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 Dr. Nizhegorodtsev A. S. , a surgeon with 17 years of experience.
Definition of disease. Causes of the disease
Stomach ulcer(Gastric ulcer) is a chronic, recurrent disease in which defects appear in the gastric mucosa. If left untreated or in time, it can cause disability or death.
Causes of stomach ulcer
The most common cause of stomach and duodenal ulcers isHelicobacter pylori infection. It is detected 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 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 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 reaches about 70%, while most of the infected do not even suspect it and do not complain about anything.
The second leading cause of peptic ulcer disease ispain reliever, in particular non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of the action of NSAIDs relieved people from various pains, on the other hand, due to the prolonged uncontrolled use of these drugs, "medical" ulcers of the stomach and duodenum began to appear more often.
In the third place among the causes of stomach and duodenal ulcers arediseases that increase the production of gastrin- a 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 possibility of developing peptic ulcer is greatly influenced bypredisposing factors, which are:
- neuro-emotional overstrain (stress);
- violation of daily routine and nutrition, consumption of refined foods and fast food;
- complicated inheritance (for example, the presence of peptic ulcer in parents).
If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!
Stomach ulcer symptoms
Pain- the most common symptom of gastric ulcer. It is located in the upper part of the abdomen and can 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 intensify (or decrease) 30-40 minutes after eating.
The intensity of the pain varies from pronounced and transitory, which can also lead to reflex vomiting immediately after eating, to weak and constant, which intensifies 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 pain in the upper abdomen.
Feeling of "early satiety" and heaviness in the stomachare also signs of peptic ulcer. A person often begins to reduce the portions of food, since inhaling even a small amount of food that ends up in the 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 disease of the upper gastrointestinal tract, including gastritis (inflammation of the stomach), with which ulcers appear more often.
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, at the time of perforation of an ulcer of the stomach wall, the patient experiences an intense, sharply expressed 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 or plane pilot. The same disaster can happen to a person vacationing far from civilization: due to the lack of opportunity to receive emergency medical care, the chances of survival are significantly reduced.
Complications of gastric ulcer
Bleeding from ulcers- the most frequent complication. It is dangerous because if the wall of the vessel in the ulcer is damaged and bleeding begins, 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 appears. 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 a decrease in 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, then first the symptoms of blood loss appear, and then liquid, hard ("black") stool appears.
Perforation of the stomach wall- the formation of an internal hole when the ulcer spreads to all layers of the stomach wall. Through this opening, the contents of the stomach spill into the abdominal cavity and causeperitonitis- total inflammation of the abdominal tissues. The moment of perforation is accompanied by sharp, extremely strong pains, up to painful shocks, a drop in blood pressure and a sharp pallor of the skin. Then, intoxication (symptoms of "poisoning") and multiple organ failure increase. Without urgent medical attention, a person dies with 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 manifestations of gastric ulcer may be the gradually increasing symptoms of inflammation in the affected secondary organs.
malignancies- degeneration of a peptic ulcer into stomach cancer with all the consequences that follow. 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 can become significantly narrowed, to the point that it becomes difficult or impossible for solid and liquid food to pass through it. In this case, the patient loses weight, gets tired quickly and gradually dies of dehydration and starvation.
Diagnosis of stomach ulcer
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 characteristics of the course of the disease, and during palpation clarifies the boundaries of the painful areas and their nature. If necessary, the doctor prescribes blood tests and instrumental examinations 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 ulcers, especially when complications arise in the form of penetration - spread of the ulcer to a neighboring organ.
The first sign of an asymptomatic ulcer or "silent ulcer" is often its complication in the form of bleeding, due to which the patient is urgently admitted to a surgical hospital, where a medical examination is performed, the anamnesis is clarified, blood is taken for analysis, and, if necessary, EGD, ultrasound, X-ray.
The optimal method for diagnosing peptic ulcer (and if it is painless, the only and effective way) isroutine endoscopic examination— esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, takes a few minutes and is accompanied by unpleasant sensations, but completely tolerable. As a result of the examination, complete information about the condition of the upper gastrointestinal tract, the presence and nature of inflammatory and erosive-ulcerative processes, as well as the occurrence of neoplasms is revealed.
By means of special technologies during endoscopy, the acidity of the gastric juice and the presence of H. Pylori infection are determined, and small fragments of the gastric mucosa are taken from the 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 immediately eliminated, allowing the patient to avoid serious surgical interventions.
Stomach ulcer treatment
Peptic ulcer is treated by a therapist or gastroenterologist. It aims to eliminate symptoms, heal ulcers and eliminate the cause of this disease through diet, lifestyle changes and medication.
To get rid of the H. pylori infection that causes ulcers, the doctor prescribes antibiotics and to reduce the acidity of the gastric juice, acid-reducing medications, etc. If the stomach ulcer is caused by taking sedatives (NSAIDs) or other medications that can promote the development of an ulcer, the doctor will choose other medications for the patient, drugs similar to the "culprits" of the disease, which do not have aulcerative 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 the treatment, you should adhere to a certain diet - diet no. 1. It includes a nutritious diet, divided into 5-6 meals a day. The consumption of strong irritants of gastric secretion (ketchup, hot spices), food and thick 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 restoring the balance between aggressive and protective factors, ulcers heal on their own within 10-14 days.
In case of complications of peptic ulcer (perforation, stenosis, uncontrolled, repeated bleeding) or in case of ineffectiveness of drug therapy, the treatment is performed 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 better to take advantage of this opportunity.
Forecast. Preventing
The prognosis for peptic ulcer disease depends on the patient himself. With a healthy lifestyle, proper nutrition and a careful attitude to your health, the likelihood of developing a stomach ulcer is extremely low. Violation of sleeping and eating patterns, overwork, stress, neglect of routine medical examinations and ignoring one's own seemingly minor concerns often lead to the development of complicated forms.
Prevention of peptic ulcer disease is much easier, faster and cheaper than treating its developed forms and complications. For this purpose, the World Health Organization (WHO) recommends that, starting at the age of 25, undergo annual preventive examinations with a general practitioner or gastroenterologist. If the relatives had peptic ulcer, then, despite the complaints, endoscopy is recommended with the determination of the acidity of the gastric juice, clarification of 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 after 35 years. Diseases identified and treated immediately in the early stages - gastritis, duodenitis, H. pylori infection - will avoid the development of not only ulcerative processes, but also cancer.
varythree stages of prevention:
- PRIMARY- when there is no disease, but there is a risk of its development;
- side- aimed at preventing the progression of an already existing disease;
- TERTIARY- performed 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 consider physical activity, height and weight. You should eat often, in small portions. Eliminate "starving" and "mono-diets". It is very undesirable to consume alcohol, soda, fatty, fried, smoked foods, canned foods and fast foods. It is recommended to eat porridge with cereals, soups, boiled 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 the doctor regularly as part of a medical examination and eliminate foci of chronic infection, including timely treatment of caries, as it lowers general immunity, which makes it easier for any infection, including H. Pylori.
- Starting from the age of 25, once every two years, undergo a comprehensive planned endoscopic examination - endoscopy with the determination of H. Pylori.
INsecondary and tertiaryprevention is added to all rules from the first stage:
- Strictly follow diet no. 1. Avoid eating digestible food, meat, fish and mushroom juices, strong tea and coffee, baked goods, chocolate, sour fresh fruits, spicy vegetables - turnips, radishes, radishes, onions. Food should be steamed, boiled or baked (without crust) in puree form. It should be warm: not cold and not hot. Portions should be small. It is recommended to drink mineral water, which reduces the acidity of the stomach.
- Eliminate any cause of ulcer aggravation, for example, chronic gastritis.
- Follow medical instructions carefully.
From all this 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 authoritative medical sources and do not neglect routine examinations.