Problems with the gastrointestinal tract force a person to radically change his eating habits. And this is understandable, because if you experience acute pain, burning, 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 to relieve the acute symptoms of the disease and to feel the joy of life again. Today we will take a detailed look at what diet you should follow if you have a stomach ulcer.
Diet for stomach ulcer is the most important direction of therapy
Nutrition certainly has a significant impact on our health. Properly formulated nutrition can accelerate the healing of ulcers and prevent the development of complications. Therefore, anyone who is faced with a similar disease must know how to eat properly if they have a stomach ulcer. Of course, diet does not replace treatment, but without a special diet, drug therapy will not be effective.
With an ulcer, the integrity of the mucous membrane is broken, so digestion, accompanied by the secretion of hydrochloric acid, causes severe pain. What stomach ulcer diet will help relieve symptoms and speed up healing? The main goal of the diet is to promote rapid ulcer closure. However, this process is long, and if the patient with the first signs of relief returns to the food that causes the development of the disease, then the ulcer will not wait long. In order for this not to happen, therapeutic nutrition should become a way of life for several months and even years.
How to eat if you have a stomach ulcer
What you don't need is to starve, because then the acid starts to erode the stomach walls even more, which only worsens the course of the disease. Therefore, it is necessary to follow the diet prescribed by the gastroenterologist, avoiding the feeling of hunger and discomfort. What should you eat if you have a stomach ulcer?
- Food must not cause irritation of the mucous membrane and increase the acidity of gastric juice.
- You should eat only easily digestible food in liquid, pureed, chopped form, chewing it slowly.
- Hot and cold food is forbidden, because such dishes interfere with the production of enzymes and slow down the regeneration of the mucous membrane. The optimal temperature is from 26 to 33 °C.
- You must eat in small portions with breaks of no longer 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 nutrition 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? Medical diet follows the pharmacological treatment of ulcers during the abatement of exacerbation and remission and lasts from six months to a year. Therapeutic nutrition includes minimizing the mechanical, chemical and thermal load on the painful stomach. Food should activate regeneration and healing of damage, reduce inflammation, improve secretion and motility of the stomach.
When following a therapeutic diet for stomach ulcers, 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 in order 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. Food should be enriched with fats in the form of unsalted butter, and vegetable oils should only be added to ready meals, and not used for thermal processing.
Carbohydrate foods are recommended to include some vegetables (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, 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, soft, sweet berry and fruit jellies, baked fruit, natural marshmallows, marshmallows 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 envelops the walls of the stomach and protects the mucous membrane. Fermented dairy products should be introduced into the diet with caution 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 fresh 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, compotes, jellies, 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 the 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 stomach ulcers, the better. It should be remembered that salt is also obtained from finished 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 patients with ulcers because they irritate the mucous membrane, take a long time to digest and cause bleeding. All fatty, hot, salty, sour, smoked, fried and canned foods, sausages, offal, spices, ketchups, sauces and marinades are excluded. You should give up white cabbage, radish, radish, turnip, sour greens (sorrel, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard and onions.
The list of prohibited foods also includes strong tea and coffee, citrus fruits, nuts, wholemeal bread, any baked goods, including homemade pastries, chocolate, ice cream, alcoholic and carbonated drinks.
In different stages of the disease, different subtypes of table no. 1. Which diet to follow for a stomach ulcer depends on the patient's well-being and the severity of the symptoms.
So, to alleviate a sharp 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, at this moment the patient is forced to stay in bed. The goal of the diet is a purely delicate attitude towards digestion and maximum exclusion of any influence of food on the stomach.
What can you eat during an exacerbation of a stomach ulcer, and what can't you? The diet for acute stomach ulcer implies divided 6-7 meals a day in 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. Cream soups, liquid and slimy porridges and soufflés are widely used.
In addition to the main list of prohibited foods 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 switches to gentlediet no. 1, whose purpose is—they not only protect the mucous membrane, 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, 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 allowed, as well as mashed potatoes or potato souffles, beets and carrots. Various foams, jellies, jelly with milk, sweet fruit and juices, honey and sugar are introduced. Steamed dishes made of 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 will discuss the causes, diagnosis and treatment methods in the article by dr. Nizhegorodtsev A. S. , a surgeon with 17 years of experience.
Definition of disease. Causes of disease
Stomach ulcer(Stomach ulcer) is a chronic, relapsing disease in which defects occur in the lining of the stomach. If not treated or not treated in time, it can cause disability or death.
Causes of stomach ulcers
The most common cause of gastric 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 (e. g. in Sweden it is 11%). This is usually due to improvements in the quality of medical care, which allows timely diagnosis and treatment of infection, as well as improved sanitation (for example, the quality of tap water). In our country, the prevalence of infection reaches about 70%, and the majority of those infected do not suspect it and do not complain about anything.
The second leading cause of peptic ulcer disease ispain pills, especially non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of the action of NSAIDs freed people from various pains, on the other hand, due to the long-term uncontrolled use of these drugs, "healing" ulcers on the stomach and duodenum began to appear more often.
They are in third place 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.
They greatly affect the likelihood of developing a peptic ulcerpredisposing factors, which are:
- 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 parents).
If you notice similar symptoms, contact your doctor. Do not self-medicate - it is dangerous for your health!
Stomach ulcer symptoms
Pain- the most common symptom of a stomach ulcer. It is localized in the upper part of the abdomen and can decrease or increase immediately or after a meal, 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 pronounced and transient, which can lead to reflex vomiting immediately after eating, to weak and constant, which increases in the morning and disappears after eating. Sometimes the patient may wake up at night due to a feeling of "sucking in the stomach" (in the cavity under the ribs) or pain in the upper abdomen.
Feeling of "early fullness" and heaviness in the stomachare also signs of peptic ulcer. A person often begins to reduce food portions, because the absorption of even a small amount of food that ends up on 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), accompanied by ulcers most often.
Painless form of peptic ulceris the 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 moment of perforation of an ulcer on the stomach wall, the patient experiences sharp, intense pain, which leads to shock and disorientation, sometimes even to loss of consciousness. It's scary to imagine what this will lead to if this person turns out to be a car, bus or plane pilot. The same misfortune can happen to a person who is on vacation far from civilization: due to the lack of emergency medical assistance, the chances of survival are significantly reduced.
Complications of gastric ulcer
Bleeding from ulcers- 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 decreases;
- pulse quickens;
- skin pales and becomes covered with sweat;
- weakness increases;
- shortness of breath occurs despite reduced physical activity.
When the ulcerative defect and the source of bleeding are located in the lower parts of the stomach or in the bulb of the duodenum, then symptoms of blood loss appear first, followed by liquid, tarry ("black") stools.
Perforation of the stomach wall- the formation of a passing hole when the ulcer spreads through all layers of the stomach wall. Through this opening, the contents of the stomach enter the abdominal cavity and causeperitonitis- total inflammation of the abdominal tissue. The moment of perforation is followed by a sharp, extremely intense pain, up to a painful shock, a drop in blood pressure and a sharp pallor of the skin. After that, intoxication (symptoms of "poisoning") and multiple organ failure increase. Without emergency medical help, a person dies from 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 near another organ - the pancreas or the intestinal wall, then it can spread to this neighboring organ. Then the first manifestations of stomach ulcers can be gradually increased symptoms of inflammation in the secondarily affected organs.
Malignancy- degeneration of peptic ulcer into stomach cancer with all the consequences. The risk of such 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 can 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 exhausted and gradually dies from dehydration and hunger.
Diagnosis of stomach ulcer
Diagnosis of a typical ulcerStomach surgery is quite simple, it is performed by a therapist or gastroenterologist. During the examination, the doctor determines the patient's general condition, clarifies complaints, the nature and characteristics of the course of the disease, and during palpation clarifies the boundaries of painful areas and their nature. If necessary, the doctor prescribes blood tests and instrumental examinations in order to create a clear picture of the patient's state of health and create the most optimal treatment plan.
It is more difficult to diagnose whenatypical or painless ulcer, especially when complications arise in the form of penetration - spread of the ulcer to the 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 performed, the history is clarified, and blood is drawn. tests, and if necessary, EGD, ultrasound, X-ray.
The optimal method for diagnosing peptic ulcer (and if it is painless, the only effective way) isroutine 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 appears on the condition of the upper gastrointestinal tract, the presence and nature of inflammatory and erosive-ulcerative processes, as well as the occurrence of neoplasms.
Special technologies during endoscopy determine the acidity of gastric juice and the presence of H. Pylori infection, and small fragments of the gastric mucosa are taken from the tumor for histological examination to determine the type of tumor.
When a patient has signs of gastric bleeding, EGD is used to identify sources of bleeding that can be immediately eliminated, allowing the patient to avoid major surgical interventions.
Treatment of stomach ulcers
Peptic ulcers are treated by a therapist or gastroenterologist. Its goal is to eliminate symptoms, treat ulcers and eliminate the cause of this disease through diet, lifestyle changes and medication.
In order to get rid of the H. pylori infection that causes the ulcer, the doctor prescribes antibiotics, and to reduce the acidity of the gastric juice, drugs to reduce acid, etc. If a stomach ulcer is caused by taking painkillers (NSAIDs) or other drugs that can cause ulcers, the doctor will choose other drugs for the patient similar to the "culprits" of the disease, which do not have an ulcer 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 treatment, you need to follow a specific diet - diet no. 1. It implies a nutritious diet, divided into 5-6 meals a day. The consumption of strong irritants of gastric secretion (ketchup, hot spices), coarse food and dishes is limited. Food is prepared mostly pureed, steamed or boiled in water, and 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 establishing a 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, uncontrolled, recurrent bleeding) or in case of inefficiency of drug therapy, treatment is carried out surgically. However, surgery is always a big risk. In case of 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 use this opportunity.
Forecast. Prevention
The prognosis for peptic ulcer depends on the patient. With a healthy lifestyle, proper nutrition and a careful attitude towards your health, the probability of developing a stomach ulcer is extremely low. Violation of sleeping and eating regimes, excessive work, stress, neglecting routine medical examinations and ignoring one's own seemingly minor ailments often lead to the development of complicated forms.
Prevention of peptic ulcer is much easier, faster and cheaper than treatment of its developed forms and complications. For this purpose, the World Health Organization (WHO) recommends that, starting at the age of 25, you undergo annual preventive examinations with a general practitioner or gastroenterologist. If the relatives had a peptic ulcer, then, regardless of the complaints, an endoscopy is recommended with the determination of the acidity of the gastric juice, clarification of biopsies for the determination of 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 the age of 35. Diseases identified and promptly treated 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;
- secondary- in order to prevent the progression of an already existing disease;
- tertiary- is carried out after the development 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 must eat often, in small portions. Eliminate "starvation" and "mono diet". It is highly undesirable to consume alcohol, carbonated drinks, fatty, fried, smoked food, canned food and fast food. It is recommended to eat cereals, soups, cooked meat and fish, vegetables and fruits. Moderate consumption of pastries 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 the foci of chronic infection, including timely treatment of tooth decay, because it reduces general immunity, which makes any infection easier, including H. Pylori.
- Starting at the age of 25, once every two years, undergo a planned comprehensive endoscopic examination - an endoscope with the determination of H. Pylori.
Usecondary and tertiaryprevention to all the rules from the first phase are added:
- Strictly follow diet no. 1. Avoid eating hard-to-digest coarse food, meat, fish and mushroom broths, strong tea and coffee, pastries, 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, which reduces stomach acidity.
- Eliminate all causes of ulcer exacerbation, for example, chronic gastritis.
- Follow medical instructions carefully.
It follows from everything that in most cases the development of peptic ulcer disease and its complications can easily be avoided if you are a medically literate person, listen to the recommendations of doctors, official authoritative medical sources and do not neglect routine examinations.