Problems with the gastrointestinal tract force a person to radically change his eating habits. And this is understandable, because if you experience acute pain, tingling, burning, heaviness, tension in the stomach or constant heartburn, you not only give up your favorite dishes, but also completely lose your appetite. However, a food boycott may cause even more harm to the patient. Therefore, a clear understanding of how you should eat if you have stomach problems will help relieve 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 aspect of treatment
Nutrition certainly has a significant impact on our health. A properly formulated diet can speed the healing of ulcers and prevent the development of complications. Therefore, everyone who is faced with 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 therapy will not be effective.
In an ulcer, the integrity of the mucous membrane is compromised, so digestion along with the secretion of hydrochloric acid causes a lot of pain. What diet for stomach ulcer will help relieve symptoms and speed up healing? The main purpose of nutrition is to ensure rapid closure of the ulcer. However, this process is long, and if the patient returns to the foods that triggered the development of the disease with the first signs of relief, it will not take long for the ulcer to appear. To prevent this from happening, therapeutic nutrition needs to become a way of life for several months or even years.
How should you eat if you have a stomach ulcer?
There is no need to starve, because then the acid will begin to erode the walls of the stomach even more, which will further worsen the course of the disease. Therefore, it is imperative to adhere to the diet determined by the gastroenterologist, avoiding the feeling 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 gastric juice.
- You should only consume easily digestible foods in liquid, pureed or crushed form, by chewing slowly.
- Hot and cold foods are prohibited, because such dishes interfere with the formation of enzymes and slow down the restoration of the mucous membrane. The optimum temperature is between 26 and 33 °C.
- You should eat in small portions without a break for 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 regimen - 1. 5 to two liters per day.
That's 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, strictly following the nutritionist's recommendations is the key to recovery. The diet of people with stomach ulcers is called "table 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 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 sore stomach. Foods should stimulate regeneration and healing of damage, reduce inflammation, and improve gastric secretion and motility.
Foods allowed when following a therapeutic diet for stomach ulcers can be boiled, baked or steamed. Meat and fish must be completely free of skin, bones, cartilage, veins, tendons and fat. When cooking meat, you need to drain the boiling 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, soft-boiled eggs or omelets. It is necessary to enrich the diet with fats in the form of unsalted butter, and vegetable oils should only be added to ready-made dishes, without using them for heat treatment.
Carbohydrate foods include some vegetables (potatoes, beets, carrots, cauliflower, broccoli, zucchini, zucchini), well-cooked cereals (oatmeal, semolina, rice, buckwheat), as well as various pastas, dried white bread, crackers, biscuits, unleavened biscuits.
Desserts included in the diet include purees, mousses, jellies from soft, sweet fruits and berries, baked fruits, natural marshmallows, marshmallows and marmalade, jam and marmalade. Honey is recommended as it relieves pain and inflammation and helps neutralize acid.
It is beneficial to drink milk that surrounds the walls of the stomach and protects the mucous membrane. Fermented milk products should be included in the diet with caution, making sure that they do not contain vegetable oils (for example, palm oil) that negatively affect digestion. Let's say low-fat cottage cheese in the form of casserole, acidophilus, fresh (! ) kefir, natural yoghurt and sour cream, unleavened cheese.
Recommended drink: decoction of chamomile, rosehip, mint, weak tea, compotes, jelly, fruit drinks, diluted sweet waters and water at room temperature. You can drink fresh cabbage juice, which has an antibacterial effect, normalizes the enzymatic processing of food, and supports the healing of damaged stomach walls, with the approval of a doctor.
The role of salt in diet No. 1 deserves special mention. The maximum allowable amount of salt is 6 g per day. But the less it enters the body of a person with a stomach ulcer, the better. We must not forget that we also get salt from finished products, for example, it is found 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 of the mucous membrane, 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 (sorrel, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard and onions.
The list of prohibited products also includes strong tea and coffee, citrus fruits, nuts, whole wheat bread, all kinds of pastries, including homemade pastries, chocolate, ice cream, alcoholic and carbonated drinks.
Different subtypes of table number 1 are used at different stages of the disease. Which diet to follow for stomach ulcers depends on the patient's health condition and the severity of the symptoms.
Therefore, to alleviate a sharp exacerbation, a stricter diet is recommended.- table No. 1 a. This diet is prescribed during periods of intense illness accompanied by acute pain. As a rule, the patient at this time is forced to stay in bed. The goal of the diet is a completely sensitive attitude to digestion and the maximum exclusion of any impact of food on the stomach.
What can and cannot be eaten during an exacerbation of a stomach ulcer? The acute stomach ulcer diet involves dividing 6-7 meals a day into 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 absolutely unacceptable. Salt consumption is significantly reduced. Boiled and steamed foods are served in liquid or puree form. Creamy soups, liquid and slimy porridges and soufflés are widely used.
In addition to the main list of prohibited foods in the dietNo. 1 aBread 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 transitions gently.diet number 1, purpose—It not only provides protection to the mucous membrane, but also accelerates its healing. While the essence of the diet as a whole is preserved, the list of acceptable foods is expanded 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. Dried white bread is also allowed, as well as mashed potatoes or soufflés made from potatoes, beets and carrots. Various mousses, jellies, milk jelly, sweet fruits and juices, honey and sugar are introduced. Steamed dishes made from yeast-free cottage cheese and egg whites, sour cream, soft cheese and butter are allowed.
Stomach ulcer - symptoms and treatment
What is a stomach ulcer? Surgeon with 17 years of experience, Dr. In the article by Nizhegorodtsev A. S. we will consider the causes, diagnosis and treatment methods.
Description of the disease. Causes of the disease
Stomach ulcer(Stomach ulcer) is a chronic, recurring disease in which disorders occur in the gastric mucosa. If left untreated or left untimely, it can cause disability or death.
Causes of stomach ulcer
The most common cause of stomach and duodenal ulcersHelicobacter pylori infection. It is detected in approximately 70% of patients with stomach ulcers and in up to 90% of patients with duodenal ulcers. The prevalence of H. pylori, the main cause of stomach and duodenal ulcers, has decreased in developed countries in recent years (for example, it is 11% in Sweden). Typically this is due to improvements in the quality of medical care, which allows timely diagnosis and treatment of infection, as well as improved sanitation conditions (for example, the quality of tap water). The incidence of infection in our country reaches about 70%, while most infected people do not suspect it and do not complain about anything.
Second leading cause of peptic ulcer diseasepainkillersespecially non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of NSAIDs relieved people from various pains, and on the other hand, due to long-term uncontrolled use of these drugs, "medical" ulcers of the stomach and duodenum began to appear more often.
It ranks third among the causes of stomach and duodenal ulcers.Diseases 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. takes place.
The likelihood of developing a peptic ulcer is greatly affected by:predisposing factors, which ones:
- neuro-emotional overstrain (stress);
- violation of the daily routine and nutrition, consumption of refined foods and fast food;
- complex inheritance (for example, the presence of peptic ulcers in parents).
If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous to your health!
Stomach ulcer symptoms
Pain- The most common symptom of stomach ulcer. It is localized in the upper abdomen and may decrease or intensify immediately or after a meal, depending on the location of the ulcer. If the ulcer is localized in the duodenum, pain may intensify (or decrease) 30-40 minutes after eating.
The intensity of the pain varies from pronounced and transient to weak and constant, which can even lead to reflex vomiting immediately after eating, intensifying in the morning and disappearing after eating. Sometimes the patient may wake up at night due to a sucking sensation in the "pit of the stomach" (the hollow area under the ribs) or pain in the upper abdomen.
Feeling of "early satiety" and heaviness in the stomachThey are also symptoms of peptic ulcer disease. Since even the absorption of small amounts of food, reaching the inflamed areas of the gastric mucosa and ulcers, can cause these unpleasant sensations, a person often begins to reduce food portions.
Bad breath, nausea, change in taste, coating on the tongue- Frequent concomitants of any inflammatory disease of the upper gastrointestinal tract, including gastritis (inflammation of the stomach), in which ulcers most often occur.
Painless form of peptic ulcerIt is the most dangerous due to its terrible complications, which sometimes develop at lightning speed in an apparently healthy person. Sometimes they lead to fatal consequences. For example, as soon as the ulcer of the stomach wall is pierced, the patient feels sharply expressed 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 driver or airplane pilot. The same misfortune can happen to a person vacationing far from civilization: his chances of survival are significantly reduced due to the lack of opportunity to receive emergency medical care.
Stomach ulcer complications
Bleeding from an ulcer- the most common complication. It is dangerous because if the vessel wall in the ulcer is damaged and bleeding begins, the person will not feel anything, especially if the ulcer is painless. Reflex vomiting occurs when the stomach fills with blood. This is how the disease manifests itself. Later, the patient develops symptoms of blood loss:
- blood pressure decreases;
- the pulse accelerates;
- the skin becomes pale and covered with sweat;
- weakness increases;
- Despite the decrease in physical activity, shortness of breath occurs.
When the ulcerative defect and the source of bleeding are located in the lower parts of the stomach or in the duodenal bulb, signs of blood loss first appear, and then liquid, tarry ("black") stool appears.
Perforation of the stomach wall- The formation of a gaping hole when the ulcer spreads to all layers of the stomach wall. Through this opening, stomach contents flow into the abdominal cavity andperitonitis- total inflammation of the abdominal tissues. The moment of perforation is accompanied by sharp, extremely intense pain up to painful shock, a decrease in blood pressure and a sharp pallor of the skin. Then intoxication (symptoms of "poisoning") and multiple organ failure increase. Without emergency medical care, the person dies with such a complication.
Ulcer penetrationIt can also complicate the course of the disease. If the ulcer is located in the stomach wall adjacent to another organ (pancreas or intestinal wall), it can spread to the adjacent organ. Then the first symptoms of a stomach ulcer may be symptoms of gradually increasing inflammation in the affected secondary organs.
malignant disease- the transformation of peptic ulcer into stomach cancer and all the resulting consequences. The risk of this type of degeneration occurs 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, making it difficult or impossible for solid and liquid foods to pass. In this case, the patient loses weight, gets tired quickly and gradually dies of dehydration and starvation.
Diagnosis of stomach ulcers
Diagnosis of a typical ulcerStomach surgery is quite simple; It is performed by a therapist or gastroenterologist. During the examination, the doctor determines the general condition of the patient, clarifies complaints, the nature and features of the course of the disease, and during palpation clarifies the boundaries and nature of painful areas. If necessary, the doctor conducts blood tests and instrumental examinations to create a clear picture of the patient's health condition and develop the most appropriate treatment plan.
It is more difficult to diagnose whenatypical or painless ulcerespecially when complications arise in the form of penetration - the spread of the ulcer to a neighboring organ.
The first symptom of an asymptomatic or "silent ulcer" is usually its complication in the form of bleeding, for which the patient is urgently admitted to a surgical hospital, where a medical examination is performed, the anamnesis is clarified, blood is taken. tests and, if necessary, EGD, ultrasound, x-ray.
The most convenient method (and the only and effective, if painless, way) to diagnose peptic ulcer diseaseroutine endoscopic examination— esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, takes a few minutes and is accompanied by unpleasant but completely tolerable sensations. As a result of the examination, comprehensive information is revealed 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.
During endoscopy, using special technologies, the acidity of gastric juice and the presence of H. Pylori infection are determined, and small pieces of gastric mucosa are taken from tumors for histological examination to determine the type of tumor.
When a patient develops symptoms 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, heal ulcers, and eliminate the cause of this disease through diet, lifestyle changes, and medication.
To get rid of ulcer-causing H. pylori infection, the doctor prescribes antibiotics and controls the acidity of gastric juice, acid-reducing drugs, etc. reduces. If the stomach ulcer is caused by taking painkillers (NSAIDs) or other drugs that can trigger the development of ulcers, the doctor will select other drugs that do not have an ulcer-forming effect for the patient, similar to the "culprits" of the disease.
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.
You also need to adhere to a certain diet during treatment - diet number 1. It includes a nutritious diet divided into 5-6 meals a day. Consumption of substances that strongly irritate gastric secretion (ketchup, hot spices), rough foods and dishes is limited. Dishes are mostly 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 table salt intake.
Once the balance between aggressive and protective factors is restored, ulcers heal spontaneously within 10-14 days.
In case of complications of peptic ulcer disease (perforation, stenosis, uncontrolled, recurrent bleeding) or if drug therapy is ineffective, treatment is performed surgically. However, surgery is always a big risk. It is applied as a last resort in peptic ulcers. It is better to take advantage of this opportunity if it can be prevented without allowing the disease to develop.
To guess. Prevention
The prognosis of peptic ulcer disease depends on the patient. With a healthy lifestyle, proper nutrition and a careful attitude towards your health, the likelihood of developing a stomach ulcer is extremely low. Violation of sleep and nutrition patterns, overwork, stress, neglect of routine medical examinations and ignoring the person's seemingly minor ailments often lead to the development of complex forms.
Preventing peptic ulcer disease is much easier, faster and cheaper than treating its advanced forms and complications. For this purpose, the World Health Organization (WHO) recommends that you undergo annual preventive examinations by a general practitioner or gastroenterologist starting from the age of 25. If relatives have a peptic ulcer, regardless of complaints, it is recommended to perform endoscopy with determination of the acidity of 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, preventive comprehensive endoscopy is indicated every two years after 35 years. Diseases detected in the early stages and promptly treated - gastritis, duodenitis, H. pylori infection - will prevent the development of not only ulcerative processes, but also cancer.
Variousthree stages of prevention:
- priority- when there is no disease but there is a risk of developing it;
- secondary- aimed at preventing 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 should eat often, in small portions. Eliminate "starvation" and "mono-diets". It is highly undesirable to consume alcohol, soda, fatty, fried, smoked foods, canned food, fast food. It is recommended to consume grain porridges, soups, boiled meat and fish, vegetables and fruits. Moderate consumption of bakery products and sweets is allowed.
- Adhere to 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 a doctor regularly as part of a medical examination and eliminate foci of chronic infection, including timely treatment of caries, as they reduce general immunity, which facilitates any infection, including H. Pylori.
- From the age of 25, every two years have a planned comprehensive endoscopic examination - endoscopy with the detection of H. Pylori.
Insidesecondary and tertiaryPrevention was added to all rules from the first stage:
- Definitely follow diet number 1. Avoid eating hard foods that are difficult to digest, meat, fish and mushroom broths, strong tea and coffee, baked goods, chocolate, fresh sour fruits, spicy vegetables - turnips, radishes, radishes, onions. Food should be steamed, boiled or baked (without crust) in puree form. It should be warm: neither cold nor hot. Portions should be small. It is recommended to drink mineral water, which reduces stomach acidity.
- Eliminate the causes of ulcer exacerbation, such as chronic gastritis.
- Follow medical instructions carefully.
It follows from all this that, in most cases, the development of peptic ulcer disease and its complications can be easily prevented if you are a medically literate person, listen to the advice of doctors, official authorized medical sources and do not neglect routine examinations.