Problems with the gastrointestinal tract force a person to radically change their eating habits. And this is understandable, because of acute pain, tingling, burning, heaviness, tightness in the stomach or persistent heartburn, you can not only give up your favorite dishes, but also lose your appetite completely. However, food boycotts can harm patients 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 look in detail at 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 big impact on our health. A properly formulated diet can speed up the healing of ulcers and prevent the development of complications. Therefore, everyone who is facing the same disease needs to know the right way to eat 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 affected, 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 up healing? The main goal of nutrition is to promote rapid closure of ulcers. However, this process is long, and if, with the first signs of relief, the patient returns to the food that triggered the development of the disease, then the ulcer will not be long. To prevent this from happening, therapeutic nutrition should be 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, because then the acid begins to erode the stomach wall even more, which only worsens the course of the disease. Therefore, it is important to adhere to the diet prescribed by the gastroenterologist, avoiding 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 gastric juice.
- You should take only easily digestible food in liquid, pure, crushed form, chewing it slowly.
- Hot and cold food is prohibited, because such dishes interfere with the formation of enzymes and delay the recovery of the mucous membrane. The optimum 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 eating 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 a day.
This is interesting
The first medical diet for stomach ulcer patients 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 nutritionist 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 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 exacerbations and remissions decrease and last from six months to a year. Therapeutic nutrition involves minimizing the mechanical, chemical and thermal load on the sick stomach. Food should activate regeneration and damage healing, reduce inflammation, and increase 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, tendons, veins 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 of rabbit, turkey, chicken, veal, beef, lean sea fish, boiled eggs or omelets. It is necessary to enrich the diet with fat in the form of unsalted butter, and add vegetable oil only for ready meals, not to use it for heat treatment.
Among carbohydrate foods, some vegetables are recommended (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked grains (oats, semolina, rice, buckwheat), as well as various pastas, dry white bread, crackers, biscuits, unleavened biscuits.
Desserts included in the diet include purees, mousses, soft, sweet berries and fruit jellies, baked fruits, natural marshmallows, marshmallows and marmalade, jam and marmalade. Honey is recommended because it relieves pain and inflammation and helps neutralize acid.
It is useful to drink milk, which envelops the stomach wall and protects the mucous membrane. Fermented milk products should be included in the diet with caution and ensure that they do not contain vegetable fats (for example, palm oil), which have an adverse effect on digestion. Let's say low-fat cottage cheese in the form of a casserole, acidophilus, fresh kefir (! ), natural yogurt and sour cream, cheese without yeast.
Recommended drinks: decoction of 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 attention. The maximum amount of salt allowed is 6 g per day. But the less it enters the body of a person with a stomach ulcer, the better. Keep in mind that we also get salt from finished products; for example, it is found in large quantities in cheese, including processed ones.
It is important to understand that many foods are completely unacceptable for patients with ulcers because they irritate the mucous membrane, take a long time to digest and trigger bleeding. All fatty, spicy, salty, sour, smoked, fried and canned foods, sausages, offal, spices, ketchup, sauces and marinades are excluded. You need to give up white cabbage, turnips, turnips, turnips, sour vegetables (cabbage, spinach), cucumbers, beans, mushrooms, garlic, horseradish, mustard and onions.
Also on the list of prohibited items are strong tea and coffee, citrus fruits, nuts, wheat bread, any baked goods, including homemade baked goods, chocolate, ice cream, alcoholic and carbonated drinks.
At different stages of the disease, different subtypes table No. 1 is used. What diet to follow for stomach ulcers depends on the patient's well-being and the severity of the symptoms.
Therefore, to reduce the sharp severity, 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 had to remain in bed. The goal of the diet is a purely subtle 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 can't you eat? Diet for acute stomach ulcers involves dividing 6-7 times a day in 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 completely unacceptable. Salt consumption is significantly reduced. Food, boiled and steamed, served in a liquid or pure state. Creamy soups, runny and slimy porridges, and souffles 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 this, the patient turns to softdiet number 1, the purpose—not only provides protection to 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, pure food to the state of "small pieces".
The energy value increased to 2500 kcal per day, the frequency of food consumption was reduced to six times a day. Dry white bread is allowed, as well as mashed potatoes or soufflé from potatoes, beets and carrots. 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 an article by Dr. Nizhegorodtsev A. S. , a surgeon with 17 years of experience.
Definition of disease. Cause of disease
Stomach ulcer(stomach ulcer) is a recurring chronic disease in which defects occur in the gastric mucosa. If left untreated or not treated in time, 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 about 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%). Usually, this is due to an improvement in the quality of medical care, which allows timely diagnosis and treatment of infections, as well as better sanitary conditions (for example, the quality of tap water). In our country, the prevalence of infection reaches about 70%, while most infected people do not suspect it and do not complain about anything.
The second main cause of peptic ulcer disease ispainkillers, specifically non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and variety of action of NSAIDs relieves people from various pains, on the other hand, as a result of prolonged uncontrolled use of these drugs, "drug" ulcers of the stomach and duodenum begin to occur more often.
In third place among the causes of stomach and duodenal ulcers isdiseases that increase gastrin production- 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 likelihood of getting a peptic ulcer is greatly influenced bypredisposing factors, which one:
- neuro-emotional overstrain (stress);
- violation of daily routine and diet, consumption of refined food and fast food;
- complicated heredity (for example, the presence of peptic ulcer in the parents).
If you find similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!
Stomach ulcer symptoms
ill- the most common symptom of gastric 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 sharp and temporary, which can even cause reflex vomiting immediately after eating, to weak and persistent, which increases in the morning and disappears after eating. Sometimes the patient may wake up at night because of a feeling of "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 stomachare also signs of peptic ulcer disease. A person often begins to reduce the portion of food, because the absorption of even a small amount of food that ends up in the inflamed area of the gastric mucosa and ulcers can cause this unpleasant sensation.
Bad breath, nausea, taste changes, coating on the tongue- a frequent companion of any inflammatory disease of the upper gastrointestinal tract, including gastritis (inflammation of the stomach), in which ulcers most often appear.
A painless form of peptic ulceris most dangerous for its terrible complications, which sometimes develop at lightning speed in seemingly healthy people. Sometimes they lead to fatal consequences. For example, at the moment of penetration of an ulcer of the abdominal wall, the patient experiences severe pain significantly, which leads to shock and confusion, sometimes with loss of consciousness. It is scary to imagine what would happen if this person became a car, bus driver or airplane pilot. The same misfortune can befall a person on vacation away from civilization: due to the lack of opportunities to receive emergency medical care, the chances of survival are significantly reduced.
Stomach ulcer complications
Bleeding from an ulcer- the most common complication. It is dangerous because if the wall of the channel in the ulcer is damaged and bleeding begins, the person does not feel anything, especially if the ulcer is painless. When the stomach is full of blood, reflex vomiting occurs. This is how the disease manifests itself. Then the patient experiences symptoms of blood loss:
- blood pressure drops;
- pulse quickens;
- the skin becomes pale and becomes covered with sweat;
- increased weakness;
- Shortness of breath appears despite reduced 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 first appear, and then liquid, ("black") stools appear.
Abdominal wall perforation- the formation of a perforated hole when the ulcer spreads through all layers of the abdominal wall. Through this opening, stomach contents flow into the abdominal cavity and causeperitonitis- inflammation of the entire abdominal tissue. The moment of penetration is accompanied by a sharp pain, very strong, until a painful shock, a drop in blood pressure, and a sharp pale skin. After that, intoxication (symptoms of "poisoning") and various organ failures increase. Without emergency medical treatment, a person dies of such complications.
Ulcer penetrationcan 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 these neighboring organs. Then the first manifestation of gastric ulcer may gradually increase the symptoms of inflammation in secondary affected organs.
Violence- deterioration of peptic ulcer to stomach cancer with all its consequences. The risk of such degeneration appears if the ulcer exists for a long time.
Scar stenosis- dangerous consequences 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 and liquid food to pass through. In this case, the patient loses weight, quickly becomes tired and gradually dies of dehydration and starvation.
Diagnosis of stomach ulcers
Common ulcer diagnosisStomach surgery is relatively simple, carried out by a therapist or gastroenterologist. During the examination, the doctor determines the general condition of the patient, explains the complaints, the nature and characteristics of the course of the disease, and during palpation explains the boundaries of the painful area and its nature. If necessary, the doctor prescribes blood tests and instrumental examinations to form 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 - the spread of ulcers to neighboring organs.
The first symptom of an asymptomatic or "silent ulcer" is often its complication in the form of bleeding, which causes the patient to be admitted immediately to a surgical hospital, where a medical examination is carried out, the anamnesis is explained, blood is taken for testing, and, if necessary, EGD, ultrasound, X-ray.
The optimal method for diagnosing peptic ulcer disease (and if it is painless, the only effective method) isroutine endoscopic examination- esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, lasts a few minutes, and is accompanied by unpleasant but completely acceptable 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 neoplasms.
Using special technology during endoscopy, the acidity of gastric juice and the presence of H. Pylori infection are determined, and small fragments of gastric mucosa are taken from the tumor for histological examination to determine the type of tumor.
When a patient shows signs of gastric bleeding, EGD is used to identify the cause of the bleeding which can be eliminated immediately, allowing the patient to avoid serious surgical intervention.
Stomach ulcer treatment
Peptic ulcers are treated by a therapist or gastroenterologist. It aims to eliminate symptoms, heal ulcers and eliminate the cause of the disease through diet, lifestyle changes and medication.
To eliminate H. pylori infection that causes ulcers, doctors prescribe antibiotics, and to reduce the acidity of gastric juice, acid-reducing drugs, etc. If stomach ulcers are caused by taking painkillers (NSAIDs) or other drugs that can trigger the development of ulcers, the doctor will choose another drug for the patient's drug that is similar to the "cause" of the disease, which does not have the effect of ulcer formation.
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 use of strong irritants of gastric secretion (ketchup, hot spices), coarse food and dishes is limited. Food is prepared mainly pureed, steamed or boiled in water; lean fish and meat served in slices. Very cold and hot dishes are excluded from the diet. Limit your table salt intake.
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 disease (perforation, stenosis, uncontrollable, recurrent bleeding) or in case of ineffective drug therapy, treatment is performed surgically. However, surgery is always a big risk. For peptic ulcers, it is done as a last resort. If it can be avoided without letting the disease develop, then it is better to take advantage of this opportunity.
Prediction. Prevention
The prognosis for peptic ulcer disease depends on the patient himself. With a healthy lifestyle, proper nutrition, and a careful attitude towards your health, the chances of getting a stomach ulcer are very low. Violation of sleeping and eating patterns, overwork, stress, neglecting routine medical examinations, and ignoring one's own seemingly minor discomforts often lead to the development of complicated forms.
Preventing peptic ulcer disease is easier, faster and cheaper than treating its form and complications. For this purpose, the World Health Organization (WHO) recommends, starting from the age of 25, that you undergo an annual preventive examination with a general practitioner or a gastroenterologist. If relatives have peptic ulcers, then, regardless of the complaint, endoscopy is recommended with determination of the acidity of gastric juice, clarifying biopsy to determine H. pylori infection and histological examination of suspicious areas. It is held every two years. If there are no complaints, preventive comprehensive endoscopy is indicated every two years after 35 years. Diseases that are identified and immediately treated at an early stage - gastritis, duodenitis, H. pylori infection - will prevent the development of not only the ulcerative process, but also cancer.
diversifyingthree levels of prevention:
- main- when there is no disease, but there is a risk of developing it;
- secondary- aims to prevent the development of existing diseases;
- tertiary- carried out after the development of complications.
The main preventive rule:
- Stick to a certain daily calorie intake: carbohydrates - 50% or more, protein - 30%, fat - 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-dieting". It is very undesirable to consume alcohol, soda, fatty foods, fried, smoked, canned food and fast food. It is recommended to eat cereal porridge, soup, 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 understand them correctly.
- Visit the doctor regularly as part of a medical examination and eliminate the focus 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, once every two years, undergo a planned comprehensive endoscopic examination - endoscopy with the determination of H. Pylori.
Insecondary and tertiaryprevention to all rules from the first level added:
- Adhere to diet No. 1. Avoid eating coarse foods that are difficult to digest, meat soups, fish and mushrooms, strong tea and coffee, baked foods, chocolate, fresh sour fruits, spicy vegetables - turnips, turnips, turnips, onions. Food should be steamed, boiled or baked (without the crust) in puree 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 any cause of exacerbation of ulcers, for example, chronic gastritis.
- Carefully follow medical instructions.
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 medically literate person, listen to the recommendations of doctors, authoritative official medical sources and do not neglect routine examinations.