Problems with the gastrointestinal tract force a person to radically change his eating habits. And this is understandable, because with 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 cause even more harm to the patient. Therefore, a clear understanding of nutrition for stomach problems helps to alleviate acute symptoms of the disease and to feel joy in life again. Today we'll take a closer look at what diet you should follow if you have a stomach ulcer.
Diet for stomach ulcers is the most important direction of therapy
Diet 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 is faced with a similar disease needs to know how to eat properly with a stomach ulcer. Of course, diet does not replace treatment, but without special nutrition, drug therapy is not effective.
With an ulcer, the integrity of the mucous membrane is impaired, so digestion, accompanied by the secretion of hydrochloric acid, causes severe pain. What diet for stomach ulcers will help relieve symptoms and speed healing? The main goal of the diet is to promote rapid closure of the ulcer. However, this process is lengthy, and if at the first signs of relief the patient returns to foods that trigger the development of the disease, the ulcer will not be long in coming. To prevent this, therapeutic nutrition should become a lifestyle for several months or even years.
How to eat when you have a stomach ulcer
What you don't need to do is starve yourself, because then the acid will begin to attack the stomach walls even more, which will only worsen the course of the disease. Therefore, it is imperative to follow the diet prescribed by the gastroenterologist and avoid feelings of hunger and discomfort. 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 eat easily digestible food in liquid, pureed, crushed form and chew it slowly.
- Hot and cold foods are prohibited, as such dishes impair the formation of enzymes and slow down the recovery of the mucous membrane. The optimal temperature is between 26 and 33 °C.
- You need to eat in small portions with breaks of no more than three hours. The regularity of meals depends on the severity of the disease and is between five and eight times a day.
- Drinking regime - from 1. 5 to two liters per day.
That 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 has a direct influence 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 look at the basics of this diet.
Table No. 1 – Diet for exacerbation of stomach ulcers
So the most important question is: what can you eat if you have a stomach ulcer? A medical diet accompanies the pharmacological treatment of ulcers during subsiding exacerbation and remission and lasts six months to a year. Therapeutic nutrition is about minimizing the mechanical, chemical and thermal stress on the painful stomach. Food is said to activate regeneration and healing of damage, reduce inflammation, and improve gastric secretion and motility.
In a therapeutic diet for stomach ulcers, the permitted foods can be boiled, baked or stewed. Meat and fish must be completely removed from skin, bones, cartilage, veins, tendons and fat. When cooking meat, you need to drain the boiled water twice to reduce the concentration of animal fat as much as possible.
Protein-containing foods are healthy: lean meat of rabbit, turkey, chicken, veal, beef, lean sea fish, soft-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 meals and not use them for heat treatment.
Among the carbohydrate-containing foods are some vegetables (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked cereals (oatmeal, semolina, rice, buckwheat), as well as various pasta, dried white bread, crackers, cookies, unleavened cookies.
Desserts included in the diet include purees, mousses, jellies made from soft, sweet berries and fruits, baked fruits, natural marshmallows, marshmallows and jam, jam and jam. Honey is recommended as it reduces pain and inflammation and helps neutralize acids.
It is useful to drink milk, which envelops the walls of the stomach and protects the mucous membrane. Fermented milk products should be introduced into the diet with caution, ensuring that they do not contain vegetable fats (e. g. palm oil), which have a detrimental effect on digestion. Let's take low-fat cottage cheese in the form of casseroles, acidophilus, fresh (! ) kefir, natural yogurt and sour cream, unleavened cheese.
Recommended drink: decoctions of chamomile, rosehip, mint, weak tea, compote, jelly, fruit drinks, diluted sweet juices, as well as water at room temperature. With the permission of a doctor, you can drink fresh cabbage juice, which has an antibacterial effect, normalizes enzymatic processing of food and promotes healing of damaged stomach walls.
Particularly noteworthy is the role of salt in diet No. 1. The maximum allowable amount of salt is 6 g per day. But the less of it gets into the body of a person suffering from a stomach ulcer, the better. It should be borne in mind that we also get salt from finished products; For example, it is found in large quantities in cheese, including processed cheese.
It is important to understand that many foods are completely unacceptable for patients with ulcers, as they irritate the mucous membrane, take a long time to digest and cause bleeding. All fatty, spicy, salty, sour, smoked, fried and preserved foods, sausages, offal, spices, ketchups, sauces and marinades are excluded. You need to avoid white cabbage, radishes, radishes, beets, sour vegetables (sorrel, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard and onions.
The list of prohibited items also includes strong tea and coffee, citrus fruits, nuts, whole grain bread, all baked goods, including homemade baked goods, chocolate, ice cream, alcoholic and carbonated drinks.
At different stages of the disease, different subtypes of 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 relieve severe 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, the patient is forced to remain in bed at this point. The aim of the diet is a purely gentle approach to digestion and the greatest possible exclusion of any effects of food on the stomach.
What can and cannot be eaten during an exacerbation of a stomach ulcer? The diet for acute stomach ulcers involves dividing 6-7 meals per day into very small portions and a reduced energy value (up to 2010 kcal). All foods that cause gastric secretion and irritate the mucous membrane are absolutely unacceptable. Salt consumption is significantly reduced. Boiled and steamed foods are served in a liquid or pureed state. Cream soups, liquid and slimy porridges and soufflés are widespread.
In addition to the main list of foods prohibited by the dietNo. 1aBread in any form, fermented milk products, and all vegetables and fruits are completely excluded.
This diet is prescribed until the ulcer begins to heal. The patient then switches to gentleDiet #1, their purpose—Not only protect the mucous membrane, but also accelerate its recovery. The essence of the entire diet remains intact, while the list of acceptable foods expands and the method of preparation changes: from completely liquid, pureed foods to the state of "small pieces".
The energy value increases to 2500 kcal per day, the frequency of food intake is reduced to six times a day. Dried white bread is allowed, as are mashed potatoes or soufflés made from potatoes, beets and carrots. Various mousses, jellies, jelly with milk, sweet fruits and juices, honey and sugar are presented. Steamed dishes made from unleavened cottage cheese and egg whites, sour cream, mild cheese and butter are allowed.
Stomach ulcer – symptoms and treatment
What is a stomach ulcer? We discuss the causes, diagnosis and treatment methods in the article by Dr. Nizhegorodtsev A. S. , a surgeon with 17 years of experience.
Definition of illness. Causes of the disease
Stomach ulcer(Stomach ulcers) is a chronic, recurrent disease that causes defects in the stomach lining. If not treated or not treated in a timely manner, it can lead to disability or death.
Causes of stomach ulcers
The most common cause of stomach and duodenal ulcers isHelicobacter pylori infection. It is found 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 developed countries in recent years (in Sweden, for example, it is 11%). This is usually due to improvements in the quality of medical care, allowing timely diagnosis and treatment of infections, as well as improved sanitary conditions (e. g. the quality of tap water). In our country, the prevalence of infection reaches about 70%, while most of those infected do not even suspect it and do not complain about anything.
The second most common cause of stomach ulcers isPainkiller, especially nonsteroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of the action of NSAIDs relieved people of various pains, on the other hand, due to the prolonged uncontrolled use of these drugs, "medical" stomach and duodenal ulcers appeared more often.
Ranked third among the causes of stomach 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 (pancreatic tumor), etc.
The likelihood of developing a stomach ulcer is greatly influenced bypredisposing factors, which are:
- neuroemotional overload (stress);
- Violation of the daily routine and diet, consumption of refined foods and fast food;
- complicated heredity (for example, the presence of stomach ulcers in the parents).
If you notice similar symptoms, contact your doctor. Do not self-medicate - it is dangerous to your health!
Symptoms of a stomach ulcer
pain- the most common symptom of stomach ulcer. It is localized in the upper abdomen and, depending on the location of the ulcer, may decrease or increase immediately or after a meal. 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 pronounced and transient, which can even lead to reflex vomiting immediately after eating, to weak and constant, which increases in the morning and disappears after eating. Sometimes the patient wakes up at night because he feels a "sucking feeling in the pit of the stomach" (the space under the ribs) or pain in the upper abdomen.
Feeling of "early fullness" and heaviness in the stomachare also signs of stomach ulcer disease. A person often begins to reduce food portions, since the intake of even a small amount of food, getting on the inflamed areas of the gastric mucosa and ulcers, can cause these unpleasant sensations.
Bad breath, nausea, taste changes, coating on the tongue- common accompaniments of inflammatory diseases of the upper gastrointestinal tract, including gastritis (inflammation of the stomach), in which ulcers most often occur.
Painless form of stomach 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 of perforation of a gastric wall ulcer, the patient feels a very pronounced, intense pain, which leads to shock and disorientation, sometimes with loss of consciousness. It's scary to imagine what this will lead to if this person turns out to be a car, bus or airplane pilot. The same misfortune can happen to a person vacationing far from civilization: due to the inability 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 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 manifests itself. Then the patient develops symptoms of blood loss:
- blood pressure drops;
- pulse quickens;
- the skin becomes pale and covered with sweat;
- weakness increases;
- Shortness of breath occurs despite reduced physical activity.
If the ulcerative defect and the source of bleeding are in the lower part of the stomach or in the duodenal bulb, symptoms of blood loss and then liquid, tarry ("black") stools appear first.
Perforation of the stomach wall- the formation of a through hole when the ulcer spreads through all layers of the stomach wall. Through this opening the stomach contents flow into the abdominal cavity and causePeritonitis- total inflammation of the abdominal tissue. The moment of perforation is accompanied by sharp, extremely severe pain, up to painful shock, a drop in blood pressure and sharp pallor of the skin. Poisoning (symptoms of poisoning) and multi-organ failure then increase. Without emergency medical care, a person dies from such a complication.
Penetration of ulcerscan also complicate the course of the disease. If the ulcer is on the stomach wall that is adjacent to another organ - the pancreas or the intestinal wall - it can spread to this neighboring organ. Then the first manifestations of a stomach ulcer may be gradually increasing inflammatory symptoms in secondarily affected organs.
malignancy- Degeneration of a stomach ulcer into stomach cancer with all the resulting consequences. The risk of such degeneration occurs if the ulcer persists for a long period of time.
Cicatricial stenosis- a dangerous consequence of ulcer healing. As a result of scarring, the lumen of the stomach or duodenum may narrow significantly until it becomes difficult or impossible for solid and liquid food to pass through the lumen. In this case, the patient loses weight, quickly becomes exhausted and gradually dies from dehydration and starvation.
Diagnosis of stomach ulcers
Diagnosis of a typical ulcerStomach surgery is quite simple and is performed by a therapist or 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, using palpation, clarifies the boundaries of painful areas and their nature. If necessary, the doctor prescribes blood tests and instrumental examinations to get a clear picture of the patient's health and develop the most optimal treatment plan.
It's harder to make a diagnosis ifatypical or painless ulcer, especially if complications occur 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, which is why the patient is urgently admitted to a surgical hospital, where a medical examination is carried out, anamnesis is clarified, blood tests are taken and, if necessary, EGD, ultrasound, x-ray.
The optimal method for diagnosing stomach ulcers (and if it is painless, the only and effective method) isroutine endoscopic examination— Esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, takes several minutes and is accompanied by unpleasant, but completely tolerable sensations. As a result of the examination, comprehensive information is obtained 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.
Using special technologies during endoscopy, the acidity of gastric juice and the presence of H. pylori infection are determined, and small fragments of the gastric mucosa are removed from tumors for histological examination to determine the type of tumor.
If a patient has signs of stomach bleeding, EGD is used to identify sources of bleeding that can be addressed immediately, allowing the patient to avoid serious surgical procedures.
Treatment of stomach ulcers
Stomach ulcers are treated by a therapist or gastroenterologist. The goal is 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 an ulcer, the doctor prescribes antibiotics, and to reduce the acidity of the gastric juice, acid-reducing drugs, etc. If a stomach ulcer is caused by taking painkillers (NSAIDs) or other drugs that cause the development of acan cause an ulcer, the doctor selects other medications for the patient that are similar to the "culprits" of the disease and do not have an ulcer-forming effect.
If you suffer from a stomach ulcer, it is very important to give up bad habits, especially smoking and excessive alcohol consumption. This eliminates the risk of complications.
You will also need to follow a specific diet during treatment - Diet No. 1. This is a nutritious diet divided into 5-6 meals per day. The consumption of strong irritants of gastric secretion (ketchups, hot spices), coarse foods and dishes is limited. The dishes are mainly prepared pureed, steamed or boiled in water; fish and lean meat are served in pieces. Very cold and hot foods are excluded from the menu. 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.
If there are complications of peptic ulcer disease (perforation, stenosis, uncontrolled, recurrent bleeding) or if drug therapy is ineffective, treatment is carried out surgically. However, surgery is always associated with great risk. For stomach ulcers, it is done as a last resort. If it can be avoided without spreading the disease, it is better to take advantage of this opportunity.
Forecast. prevention
The prognosis of peptic ulcer disease depends on the patient himself. With a healthy lifestyle, proper nutrition and careful management of your health, the likelihood of developing a stomach ulcer is extremely low. Disturbances in sleep and eating habits, overwork, stress, neglect of routine medical examinations and ignoring one's own seemingly minor ailments often lead to the development of more complicated forms.
Prevention of stomach ulcers is much easier, faster and cheaper than treatment of its developed forms and complications. For this purpose, the World Health Organization (WHO) recommends carrying out annual check-ups with a family doctor or gastroenterologist from the age of 25. If relatives have had a stomach ulcer, regardless of the symptoms, an endoscopy with determination of gastric juice acidity, clarifying biopsies to detect H. pylori infection and histological examination of suspicious areas is recommended. It takes place every two years. If there are no symptoms, a preventive comprehensive endoscopy is indicated every two years after 35 years. Diseases that are detected in the early stages and promptly treated - gastritis, duodenitis, H. pylori infection - prevent not only the development of ulcerative processes, but also cancer.
Varythree levels of prevention:
- primary- if there is no disease, but there is a risk of developing it;
- secondary- aims to prevent the progression of an already existing disease;
- Tertiary-- carried out after the occurrence of complications.
Rules of primary prevention:
- 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 often need to eat in small portions. Eliminate "hunger" and "mono diets". It is highly undesirable to consume alcohol, soda, fatty, fried, smoked foods, canned food 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.
- Adhere to 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.
- As part of a medical examination, visit a doctor regularly and eliminate foci of chronic infection, including timely treatment of tooth decay, as this reduces general immunity, which facilitates the development of infections, including H. Pylori.
- From the age of 25, undergo a scheduled comprehensive endoscopic examination every two years - endoscopy with the determination of H. pylori.
Insecondary and tertiaryPrevention added to all rules from the first level:
- Strictly adhere to diet No. 1. Avoid eating hard-to-digest, coarse foods, meat, fish and mushroom broths, strong tea and coffee, baked goods, 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 recommended to drink mineral water, which reduces stomach acid.
- Eliminate all causes of ulcer exacerbation, for example chronic gastritis.
- Follow medical instructions carefully.
It follows that the development of peptic ulcer disease and its complications in most cases can be easily avoided if you are a medically literate person, listen to the recommendations of doctors and official, authoritative medical sources and do not neglect routine examinations.