Problems of the gastrointestinal tract force people to radically change their eating habits. And this is understandable, because feeling sharp pain, tingling, burning, heaviness, tightness in the stomach or constant heartburn, you can not only refuse your favorite foods, but also completely lose your appetite. But a food boycott can cause more harm to the patient. Therefore, if you have a stomach problem, understanding exactly how to eat will help you to eliminate the acute symptoms of the disease and feel the joy of life again. Today we will consider in detail what diet you should follow if you have a stomach ulcer.
Diet is the most important direction of therapy for gastric ulcer
Nutrition undoubtedly has a significant impact on our health. A properly designed diet can speed up the healing of ulcers and prevent the development of complications. Therefore, anyone who has 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 nutrition, drug treatment will not be effective.
With an ulcer, the integrity of the mucous membrane is disturbed, 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 purpose of nutrition is to help the ulcer to close quickly. However, this process takes a long time, and if with the first signs of relief, the patient returns to the foods that caused 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 or even years.
How to eat if you have a stomach ulcer
What you should not do is starve, because then the acid starts to damage the walls of the stomach even more, which makes the course of the disease worse. Therefore, it is important to follow the diet prescribed by the gastroenterologist, avoiding feelings of hunger and discomfort. What to eat if you have a stomach ulcer?
- Food should not irritate the mucous membrane and should not increase the acidity of gastric juice.
- You should only consume easily digestible foods in liquid, mashed, crushed form, slowly chewing.
- Hot and cold foods are prohibited, because such dishes prevent the formation of enzymes and slow down the regeneration of the mucous membrane. The optimum temperature is between 26 and 33 °C.
- You need to eat in small portions with intervals of no more than three hours. The frequency of meals is determined by the severity of the condition and ranges from five to eight times a day.
- Drinking regime - from 1. 5 liters to two liters per day.
This is interesting
The first medical diet for patients with gastric ulcers was developed by Mikhail Pevzner, the founder of clinical gastroenterology and dietetics.
Diet has been proven to have a direct effect on 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 take a 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? Medical diet accompanies 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 the painful stomach. Food should activate injury recovery and healing, reduce inflammation, and improve gastric secretion and motility.
When following a therapeutic diet for gastric ulcer, allowed foods can be boiled, baked or steamed. Meat and fish must be completely free 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, turkey, chicken, veal, beef, lean seafood, soft-boiled eggs or scrambled eggs. It is necessary to enrich the diet with fats in the form of unsalted oil and add vegetable oils only to ready meals without using them for heat treatment.
Carbohydrate foods include some vegetables (potatoes, beets, carrots, cauliflower, broccoli, squash, zucchini), well-cooked grains (oatmeal, semolina, rice, buckwheat), as well as various pastas, dry white bread, crackers, biscuits, unleavened breadbiscuits.
Desserts in the diet include soft, sweet berry and fruit puree, mousse, jelly, baked fruit, natural marshmallow, marshmallow 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 dairy products should be included in the diet with caution and care should be taken that they do not contain vegetable oils (for example, palm oil) that have a harmful effect on digestion. Let's say stew, acidophilus, fresh (! ) kefir, natural yogurt and sour cream, low-fat cottage cheese in the form of yeast-free cheese.
Recommended drink: chamomile, rose hips, mint, weak tea, compotes, jelly, fruit drinks, diluted sweet juices, as well as water at room temperature. With the doctor's permission, you can drink fresh cabbage juice, which has an antibacterial effect, normalizes the enzymatic processing of food, and helps to heal damaged stomach walls.
The role of salt in diet No. 1 should be specially mentioned. The maximum allowed amount of salt is 6 grams per day. But the less it 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, there is a lot of salt in cheeses, including processed ones.
It is important to understand that many foods are completely unacceptable for patients with ulcers due to the fact that they irritate the mucous membrane, take a long 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 should give up white cabbage, radishes, radishes, turnips, sour greens (sorrel, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard, onions.
The list of prohibited products also includes any bakery products, including strong tea and coffee, citrus fruits, nuts, wholemeal bread, homemade baked goods, chocolate, ice cream, alcoholic and carbonated beverages.
Different subtypes of table No. 1 are used at different stages of the disease. Which diet to follow for peptic ulcer depends on the patient's well-being and the severity of the symptoms.
Thus, a stricter diet is recommended to alleviate an acute flare-up— 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 goal of the diet is to be gentle on digestion and exclude any impact of food on the stomach as much as possible.
What can you eat and what can't you eat during an exacerbation of a stomach ulcer? Diet for acute peptic ulcer involves reducing the energy value (up to 2010 kcal) by dividing it into very small portions 6-7 times a day. All foods that cause the secretion of gastric juice and irritate the mucous membrane are absolutely unacceptable. Salt consumption is significantly reduced. Boiled and steamed food is served in liquid or pureed form. Creamy soups, liquid and slimy porridges, 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 goes to tendernessdiet #1, the purpose of—not only protects the mucous membrane, but also accelerates its recovery. The essence of the diet is preserved as a whole, the list of acceptable foods expands, and the nature of the preparation changes: from completely liquid, pureed food to the 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 souffle from potatoes, beets and carrots. A variety of mousses, jellies, milk jellies, sweet fruits and juices, honey and sugar are offered. 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 A. S. Nizhegorodtsev, a surgeon with 17 years of experience.
Definition of disease. Causes of the disease
Stomach ulcer(Gastric ulcer) is a chronic, recurring disease in which defects occur in the gastric mucosa. If left untreated or not treated in time, 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 detected in about 70% of patients with gastric ulcer and up to 90% of patients with duodenal ulcer. The prevalence of H. pylori as a major cause of gastric and duodenal ulcers has decreased in recent years in developed countries (e. g. , 11% in Sweden). As a rule, this is related 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 prevalence of infection in our country reaches about 70%, while the majority of infected people do not suspect it and do not complain about anything.
It is the second leading cause of peptic ulcer diseasepain relievers, especially non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of the effect of NSAIDs freed people from various pains, on the other hand, due to the long-term uncontrolled use of these drugs, "drug" ulcers of the stomach and duodenum began to occur more often.
It ranks third among the causes of gastric and duodenal ulcersdiseases 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 (tumor of the pancreas), etc.
The probability of developing peptic ulcer is greatly affectedpredisposing factors, these are:
- neuro-emotional overstrain (stress);
- violation of daily routine and nutrition, consumption of refined foods and fast foods;
- complex heredity (for example, the presence of gastric 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 stomach ulcer. It is localized in the upper abdomen and depending on the location of the ulcer, it can decrease or increase immediately or after eating. 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 transient, which can even cause reflex vomiting immediately after eating, to weak and constant, intensifies 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 below the ribs) or pain in the upper abdomen.
Feeling of "early fullness" and heaviness in the stomachare also symptoms of stomach ulcer disease. A person often begins to reduce portions of food, because the absorption of 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, taste changes, tongue coating- frequent companions of any inflammatory diseases of the upper gastrointestinal tract, including gastritis (inflammation of the stomach).
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 have fatal consequences. For example, during the perforation of an ulcer of the stomach wall, the patient experiences acute severe pain, which sometimes causes shock and disorientation with loss of consciousness. If this person turns out to be a car, bus driver or airplane pilot, it is scary to imagine what will happen. The same misfortune can happen to a person vacationing far from civilization: the chance of survival is significantly reduced due to the lack of access to emergency medical care.
Complications of gastric ulcer
Bleeding from an ulcer- the most common complication. This is dangerous, because if the vessel wall is damaged in an ulcer and bleeding begins, a person does not feel anything, especially if the ulcer was painless. Reflex vomiting occurs when the stomach is filled with blood. The disease manifests itself in this way. 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 appears despite a decrease in physical activity.
When the ulcerative defect and the source of bleeding are in the lower part of the stomach or duodenum, first signs of blood loss appear, and then liquid, tarry ("black") stools appear.
Perforation of the stomach wall- the formation of a permeable 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- general inflammation of abdominal tissues. The moment of perforation is accompanied by a sharp, extremely severe pain, up to a painful shock, a drop in blood pressure and a sharp pallor of the skin. Subsequently, intoxication (symptoms of "poisoning") and multi-organ failure increase. Without emergency medical help, a person dies with such a complication.
Ulcer penetrationit can also complicate the course of the disease. If the ulcer is on the stomach wall, adjacent to another organ - the pancreas or intestinal wall, then it can spread to the neighboring organ. Then the first manifestations of peptic ulcer may be signs of a gradual increase in inflammation in secondary affected organs.
Malignancy- transformation of peptic ulcer into stomach cancer with all subsequent consequences. The risk of such degeneration occurs when 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 narrows significantly, making it difficult or impossible for solid and liquid food to pass through it. At this time, the patient loses weight, quickly becomes exhausted and gradually dies of thirst and hunger.
Diagnosis of stomach ulcers
Diagnosis of a typical ulcerstomach surgery is quite simple, it is performed by a therapist or a gastroenterologist. During the examination, the doctor determines the general condition of the patient, clarifies complaints, the nature and characteristics of the course of the disease, and during palpation clarifies the boundaries and nature of painful areas. If necessary, the doctor prescribes blood tests and instrumental examinations to create a clear picture of the patient's state of health and prepare the most optimal treatment plan.
Time is more difficult to diagnoseatypical or painless ulcer, especially when complications arise in the form of penetration - the spread of the ulcer to neighboring organs.
The first sign of an asymptomatic or "silent ulcer" is often its complications in the form of bleeding, so the patient is urgently admitted to a surgical hospital, where a medical examination is performed, the anamnesis is clarified, and blood is taken. tests and, if necessary, EGD, ultrasound, X-ray.
The optimal method of diagnosing peptic ulcer disease (if it is painless, it is the only and effective method)regular 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 about the condition of the upper gastrointestinal tract, the presence and nature of inflammatory and erosive-ulcerative processes, as well as the appearance of neoplasms is visible.
During endoscopy, the acidity of gastric juice and the presence of H. Pylori infection are determined using special technologies, and small fragments of gastric mucosa are taken from tumors for histological examination to determine the type of tumor.
When a patient presents with symptoms of gastric bleeding, EGD is used to identify bleeding sources that can be immediately eliminated, allowing the patient to avoid serious surgical interventions.
Treatment of stomach ulcers
Peptic ulcers are treated by a therapist or gastroenterologist. Diet, lifestyle changes, and medications aim to relieve symptoms, heal ulcers, and address the cause of this disease.
To get rid of the H. pylori infection that causes ulcers, the doctor prescribes antibiotics, and to reduce the acidity of the gastric juice, antacids, etc. If the stomach ulcer was caused by taking painkillers (NSAID) or other drugs. which can stimulate the development of ulcers, the doctor will choose other drugs for the patient, similar to the "culprits" of the disease, which do not have an ulcer-forming effect.
If you have a stomach ulcer, it is very important to give up bad habits, primarily smoking and excessive alcohol consumption. This will eliminate the risk of complications.
Also, during treatment, it is necessary to follow 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 (ketchups, hot spices), coarse foods and dishes is limited. Food is mainly prepared in the form of puree, steamed or boiled in water, fish and lean meat are served in portions. Very cold and hot foods are excluded from the diet. Limit your intake of table salt.
Ulcers heal on their own within 10-14 days after restoring the balance between aggressive and protective factors.
In case of complications of peptic ulcer disease (perforation, stenosis, uncontrolled, repeated bleeding) or in case of drug treatment being ineffective, the treatment is carried out surgically. But surgery is always a big risk. It is used as a last resort for peptic ulcers. If it can be prevented without allowing the disease to develop, it is better to use this opportunity.
Forecast. Prevention
The prognosis of peptic ulcer depends on the patient. With a healthy lifestyle, proper nutrition and a careful attitude to your health, the probability of developing a stomach ulcer is extremely low. Violations of sleep and eating patterns, overwork, stress, neglecting routine medical examinations and ignoring one's seemingly small concerns often lead to the development of complex forms.
Prevention of peptic ulcer disease is easier, faster and cheaper than treating its advanced forms and complications. For this purpose, the World Health Organization (WHO) recommends that, starting at the age of 25, you undergo preventive examinations by a general practitioner or a gastroenterologist every year. If relatives have had gastric ulcer, then regardless of complaints, endoscopy with determination of acidity of gastric juice, clarification of biopsies to determine H. pylori infection and histological examination of suspicious areas is recommended. It is held every two years. If there are no complaints, preventive complex endoscopy is indicated every two years after 35 years. Diseases detected at an early stage and treated in time - gastritis, duodenitis, H. pylori infection - will prevent not only ulcerative processes, but also the development of cancer.
Differentthree stages of prevention:
- initially- if there is no disease, but there is a risk of its development;
- secondary- aimed at preventing the development of an already existing disease;
- higher- is 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 consider physical activity, height and weight. You need to eat often, in small portions. Eliminate "starvation" and "mono-diets". Alcohol, soda, fatty, fried, smoked foods, canned foods, and fast food are highly undesirable. It is recommended to eat cereal porridges, soups, boiled meat and fish, vegetables and fruits. Moderate consumption of bread 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 accept them correctly.
- Visit a doctor as part of a regular medical examination and eliminate chronic infection foci, including timely treatment of caries, because this reduces general immunity, which makes it easier for any infection, including H. Pylori.
- Starting at the age of 25, undergo a planned comprehensive endoscopic examination once every two years - endoscopy with H. Pylori determination.
Inmiddle and highPrevention is added to all rules from the first stage:
- Follow diet number 1 strictly. Avoid eating rough foods that are difficult to digest, meat, fish and mushroom broth, strong tea and coffee, baked goods, chocolate, fresh sour fruits, spicy vegetables - turnips, radishes, radishes, onions. Food should be steamed, boiled or baked (without skin) in pureed form. It should be warm: not cold and not hot. Portions should be small. It is recommended to drink mineral water that reduces the acidity of the stomach.
- Eliminate any cause of exacerbation of the ulcer, for example, chronic gastritis.
- Follow medical instructions carefully.
The conclusion of all this is that if you are a medically literate person, if you listen to the recommendations of doctors, official reliable medical sources and do not neglect regular examinations, in most cases, the development of peptic ulcer disease and its complications can be easily prevented.