Problems with the gastrointestinal tract force a person to radically change their eating habits. And this is understandable, because experiencing 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 harm the patient even more. Therefore, a clear understanding of how to eat if you have stomach problems will help you relieve the acute symptoms of the disease and regain the joy of life. Today we will see in detail what diet you should follow if you have a stomach ulcer.
Diet for stomach ulcers is the most important therapeutic direction.
Nutrition 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, anyone facing 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.
With an ulcer, the integrity of the mucous membrane is compromised, 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 healing? The main objective of nutrition is to promote rapid closure of the ulcer. However, this process is long, and if at the first signs of relief the patient again consumes foods that cause the development of the disease, the ulcer will not take long to arrive. 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 is not necessary to do is starve, because then the acid begins to further corrode the walls of the stomach, which only aggravates the course of the disease. Therefore, it is imperative 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 should not cause irritation of the mucous membrane or increase the acidity of gastric juice.
- You should consume only easily digestible foods in liquid, pureed and crushed form, chewing them slowly.
- Hot and cold foods are prohibited because they interfere with the formation of enzymes and slow down the restoration of the mucous membrane. The optimal temperature is 26 to 33 °C.
- It is necessary to eat in small portions with breaks of no 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.
This is interesting
The first medical diet for patients with stomach ulcers was developed by Mikhail Pevzner, the founder of gastroenterology and clinical dietetics.
It has been proven that diet directly affects the course of the disease. Therefore, strict compliance with the nutritionist's recommendations is the key to recovery. The diet for people with a stomach ulcer is called "table number 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 drug 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 stomach pain. Food should activate regeneration and healing of damage, reduce inflammation and improve gastric secretion and motility.
When following a therapeutic diet for stomach ulcers, permitted foods can be boiled, baked or steamed. Meat and fish must be completely clean 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 meats of rabbit, turkey, chicken, veal, veal, 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-made dishes, without using them for heat treatments.
Among carbohydrate foods, some vegetables are recommended (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked cereals (oats, semolina, rice, buckwheat), as well as various pastas, dry white bread, crackers , cookies, yeast-free cookies.
Desserts included in the diet include purees, mousses, soft and sweet berry and fruit jellies, baked fruits, natural marshmallows, marshmallows and jams, jams and jams. Honey is recommended as it relieves pain and inflammation and helps neutralize acid.
It is useful to drink milk, which envelops the walls of the stomach and protects the mucous membranes. Fermented dairy products should be included in the diet with caution and ensure that they do not contain vegetable fats (for example, palm oil), which have a detrimental effect on digestion. Let's say low-fat cottage cheese in the form of stews, acidophilus, fresh kefir (! ), natural yogurt and sour cream, unleavened cheese.
Recommended drink: decoctions of chamomile, rose hips, mint, weak tea, compotes, jellies, fruit drinks, diluted sweet juices and water at room temperature. With the approval of a doctor, 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.
Special mention deserves the role of salt in diet No. 1. The maximum allowable amount of salt is 6 g per day. But the less that enters the body of a person suffering from a stomach ulcer, the better. It must be taken into account that we also obtain salt 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 ulcer patients because they cause irritation of 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, ketchup, sauces and marinades are excluded. It is necessary to give up white cabbage, radishes, radishes, turnips, sour vegetables (sorrel, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard and onions.
Also on the list of prohibited items are strong tea and coffee, citrus fruits, nuts, whole grain bread, any 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. The diet to be followed in case of a stomach ulcer depends on the patient's well-being and the severity of the symptoms.
So, to relieve an acute 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 time the patient is forced to stay in bed. The aim of the diet is a purely gentle attitude towards digestion and the maximum exclusion of any effect of food on the stomach.
What can you eat during a stomach ulcer exacerbation and what can't? The diet for acute stomach ulcers involves dividing 6-7 meals a day into very small portions and a low energy value (up to 2010 kcal). All foods that provoke the secretion of gastric juice and irritate the mucous membranes are absolutely unacceptable. Salt consumption is significantly reduced. Boiled and steamed foods are served in liquid or puree form. Creamy soups, liquid and viscous porridges, and soufflés are widely used.
In addition to the main list of foods prohibited from the diet.No. 1aBread in any form, fermented dairy products and all vegetables and fruits are completely excluded.
This diet is prescribed until the ulcer begins to heal. After this, the patient switches to gentlediet number 1, whose purpose—They not only provide protection to the mucosa, but also accelerate 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 and puree 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. Dry white bread is allowed, as well as mashed potatoes or soufflés made of potatoes, beets and carrots. Various mousses, jellies, jellies with milk, sweet fruits and 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? The causes, diagnosis and treatment methods will be discussed in the article by Dr. Nizhegorodtsev A. S. , a surgeon with 17 years of experience.
Definition of disease. Causes of the disease
Stomach ulcer(Stomach ulcers) is a chronic and recurring 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 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 recent years in developed countries (for example, in Sweden it is 11%). This is usually due to improvements in the quality of medical care, which allows for timely diagnosis and treatment of infection, as well as improved 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 even suspect it and do not complain about anything.
The second leading cause of peptic ulcer isanalgesics, particularly non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of action of NSAIDs relieved people of various pains; On the other hand, due to prolonged and uncontrolled use of these drugs, "medicinal" ulcers of the stomach and duodenum began to appear more frequently.
In third place among the causes of stomach and duodenal ulcers areDiseases 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 probability of developing a peptic ulcer is greatly influenced bypredisposing factors, What are they:
- neuroemotional overexertion (stress);
- violation of daily routine and nutrition, consumption of refined foods and fast food;
- complicated inheritance (for example, the presence of peptic ulcer in the parents).
If you notice similar symptoms, see your doctor. Do not self-medicate, it is dangerous for your health!
Symptoms of a stomach ulcer.
Pain- the most common symptom of gastric ulcer. It is located in the upper abdomen and may decrease or intensify immediately or after a meal, depending on the location of the ulcer. And if the ulcer is located in the duodenum, the pain may intensify (or decrease) 30 to 40 minutes after eating.
The intensity of the pain varies from pronounced and transient, which can even cause reflex vomiting immediately after eating, to weak and constant, which intensifies in the morning and disappears after eating. Sometimes the patient may wake up at night due to a "sucking" sensation in the pit of the stomach (in the hollow area under the ribs) or pain in the upper abdomen.
Feeling of "early fullness" and heaviness in the stomach.They are also signs of peptic ulcer disease. A person often begins to reduce food portions, since the absorption of even a small amount of food that ends up in inflamed areas of the gastric mucosa and ulcers can provoke these unpleasant sensations.
Bad breath, nausea, changes in taste, coating on the tongue.- frequent companions of any inflammatory disease of the upper gastrointestinal tract, including gastritis (inflammation of the stomach), against which ulcers appear more frequently.
Painless form of peptic ulcer.It is more dangerous because of its terrible complications, which sometimes develop at lightning speed in a seemingly healthy person. Sometimes they have fatal consequences. For example, at the time of perforation of an ulcer of the stomach wall, the patient experiences intense, sharp pain, which causes 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 driver. The same misfortune can happen to a person who is on vacation far from civilization: due to the lack of opportunities 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 ulcer vessel is damaged and bleeding begins, the person does not feel anything, especially if the ulcer was not painful. 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;
- the pulse quickens;
- the skin becomes pale and covered with sweat;
- weakness increases;
- Shortness of breath appears despite decreased 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, symptoms of blood loss first appear, and then liquid, tarry ("black") stools appear.
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 contents of the stomach flow into the abdominal cavity and causeperitonitis- total inflammation of the abdominal tissues. The moment of piercing is accompanied by sharp and extremely intense pain, up to painful shock, a decrease in blood pressure and a sharp pallor of the skin. Subsequently, intoxication ("intoxication" symptoms) and multiple organ failure increase. Without emergency medical care, a person dies with 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 adjacent to another organ, the pancreas or the intestinal wall, then it can spread to this neighboring organ. Then, the first manifestations of gastric ulcer may be symptoms of gradually increasing inflammation in the affected secondary organs.
Malignancy- degeneration of a peptic ulcer into stomach cancer with all the ensuing consequences. The risk of such degeneration appears 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, to the point that it is difficult or impossible for solid foods and liquids to pass through it. In this case, the patient loses weight, quickly becomes exhausted and gradually dies from dehydration and hunger.
Diagnosis of stomach ulcers.
Diagnosis of a typical ulcer.Stomach 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 the complaints, the nature and characteristics of the course of the disease, and during palpation, clarifies the boundaries of the painful areas and their nature. If necessary, the doctor prescribes blood tests and instrumental examinations to have a clear idea of the patient's health status and develop the most optimal treatment plan.
It is more difficult to establish a diagnosis whenatypical or painless ulcer, especially when complications arise in the form of penetration - the spread of the ulcer to a neighboring organ.
The first sign of a "silent ulcer" or asymptomatic is often its complication 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. for tests and, if necessary, EGD, ultrasound, X-ray.
The optimal method to diagnose peptic ulcer (and if it is painless, the only and effective one) isroutine endoscopic examination— esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, lasts several minutes and is accompanied by unpleasant but completely tolerable sensations. As a result of the examination, complete information appears about the state of the upper gastrointestinal tract, the presence and nature of inflammatory and erosive-ulcer 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 and determination of the type of tumor.
When a patient presents with signs 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. Its goal is to eliminate symptoms, heal ulcers and eliminate the cause of this disease through diet, lifestyle changes and medication.
To get rid of H. pylori infection causing an ulcer, the doctor prescribes antibiotics and to reduce the acidity of gastric juice, acid-reducing drugs, etc. If the stomach ulcer is caused by taking painkillers (NSAIDs) or other drugs that can trigger the development of an ulcer, the doctor will select for the patient other drugs similar to the "culprits" of the disease, which do not have any ulcer-forming effect. ulcers.
If you have a peptic ulcer, it is very important that you give up bad habits, mainly smoking and excessive alcohol consumption. This will eliminate the risk of complications.
In addition, during treatment, it is necessary to follow a certain diet - diet number 1. This is a nutritious diet, divided into 5-6 meals a day. The consumption of strong irritants of gastric secretion (ketchup, hot spices), ordinary foods and dishes is limited. Food is mainly prepared pureed, steamed or boiled in water; fish and lean meats are served in pieces. Very cold and hot dishes are excluded from the diet. Limit your consumption of table salt.
After restoring the balance between aggressive and protective factors, ulcers heal on their own within 10 to 14 days.
In case of complications of peptic ulcer (perforation, stenosis, uncontrolled recurrent bleeding) or in case of ineffectiveness of drug therapy, treatment is carried out surgically. However, surgery always carries a great risk. For peptic ulcers, it is done as a last resort. If it can be avoided without allowing the disease to develop, then it is better to take advantage of this opportunity.
Forecast. Prevention
The prognosis of peptic ulcer depends on the patient himself. With a healthy lifestyle, proper nutrition and a careful attitude to 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 one's own seemingly minor discomforts often lead to the development of complicated forms.
Preventing peptic ulcer is much easier, faster and cheaper than treating its developed forms and complications. To this end, the World Health Organization (WHO) recommends that, starting at the age of 25, annual preventive examinations be carried out with a family doctor or gastroenterologist. If relatives had a peptic ulcer, regardless of the complaints, endoscopy with determination of the acidity of gastric juice, clarifying biopsies to determine H. pylori infection, and histological examination of suspicious areas are recommended. It is carried out every two years. In the absence of complaints, comprehensive preventive endoscopy is indicated every two years starting at age 35. Diseases identified and treated quickly in the early stages (gastritis, duodenitis, H. pylori infection) will prevent 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 developing it;
- secondary- intended to prevent the progression of an already existing disease;
- tertiary- performed 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. It is necessary to eat frequently, in small portions. Eliminate "hunger" and "mono-diets. "It is very undesirable to consume alcohol, soda, fatty, fried, smoked foods, canned foods 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 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.
- Regularly visit a doctor as part of a medical examination and eliminate foci of chronic infection, including timely treatment of cavities, as this reduces overall immunity, making it easier to fight any infection, including H. Pylori.
- Starting from the age of 25, once every two years, you undergo a planned comprehensive endoscopic examination - endoscopy with determination of H. Pylori.
Insecondary and tertiaryPrevention is added to all the rules of the first stage:
- Strictly follow diet number 1. Avoid eating hard and difficult to digest foods, 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 a puree form. It should be warm: neither cold nor hot. Portions should be small. It is advisable to drink mineral water, which reduces stomach acidity.
- Eliminate any causes of ulcer exacerbation, for example, chronic gastritis.
- Carefully follow medical instructions.
From all this it follows that, in most cases, the development of peptic ulcer and its complications can be easily avoided if you are a person with medical knowledge, listen to the recommendations of doctors, authoritative official medical sources and do not neglect routine exams.