Problems with the gastrointestinal tract force a person to radically change their eating habits. And it is understandable, because you experience 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 alleviate acute symptoms of the disease and once again feel the joy of life. Today we will take a closer look at what diet you should follow if you have a stomach ulcer.
Diet for stomach ulcers is the most important treatment direction
Nutrition certainly has a significant impact on our health. A properly formulated diet can speed up the healing of wounds and prevent the development of complications. Therefore, everyone who is facing a similar disease must 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 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 goal of nutrition is to promote rapid wound closure. However, this process is long, and if the patient, with the first signs of relief, returns to foods that provoke the development of the disease, the ulcer will not be long in coming. 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 don't need to do is starve yourself, because then the acid will start to eat away at the stomach walls even more, which only worsens the course of the disease. Therefore, it is imperative to adhere to 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 cause irritation of the mucous membrane and increase the acidity of gastric juice.
- You should only consume easily digestible food in liquid, pureed, crushed form, chew it slowly.
- Hot and cold food is prohibited, because such dishes interfere with enzyme formation and slow down the recovery of the mucous membrane. The optimum temperature is from 26 to 33 °C.
- You must eat in small portions with breaks of no more than three hours. The frequency of meals is determined by the severity of the condition and varies from five to eight times a day.
- Drinking regime - from 1. 5 to two liters per day.
It is interesting
The first medical diet for patients with peptic 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, 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 peptic ulcer
So the most important question: what can you eat if you have a stomach ulcer? A medical diet accompanies pharmacological treatment of ulcers during decreasing exacerbation and remission and lasts from six months to a year. Therapeutic nutrition involves minimizing the mechanical, chemical and thermal stress on the tender stomach. Food should activate regeneration and healing of injuries, reduce inflammation and improve gastric secretion and motility.
When following a therapeutic diet for peptic ulcers, permitted foods can be boiled, baked or steamed. Meat and fish must be completely cleaned of skin, bones, cartilage, veins, tendons and fat. When cooking meat, drain the cooking water twice to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: lean meat from rabbit, turkey, chicken, veal, beef, lean sea fish, soft-boiled eggs or omelette. It is necessary to enrich the diet with fats in the form of unsalted butter and only add vegetable oils to finished dishes, do not use them for heat treatment.
Among carbohydrate foods, some vegetables (potatoes, beetroot, carrots, cauliflower, broccoli, pumpkin, zucchini), well-prepared grains (oatmeal, semolina, rice, buckwheat) as well as various pastas, dried white bread, crackers, crackers, unleavened crackers are recommended.
Desserts included in the diet include purees, mousse, jelly from soft, sweet berries and fruits, baked fruits, natural marshmallows, marshmallows and jam, jam and marmalade. 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 membrane. Acidified milk products should be included in the diet with caution and ensure that they do not contain vegetable fat (e. g. palm oil), which has a harmful effect on digestion. Let's say low-fat cottage cheese in the form of casseroles, acidophilus, fresh (! ) kefir, natural yogurt and creme fraiche, unleavened cheese.
Recommended drink: decoction of chamomile, rose hip, mint, weak tea, compotes, jelly, fruit drinks, diluted sweet juices and water at room temperature. With a 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 diet No. 1 deserves special mention. The maximum permitted amount of salt is 6 g perday. But the less of it that enters the body of a person suffering from a stomach ulcer, the better. It must be remembered that we also get salt from finished products, for example it is present in large quantities in cheeses, even processed ones.
It is important to understand that many foods are completely unacceptable for patients with ulcers, 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 food, sausages, giblets, spices, ketchups, sauces and marinades are excluded. You must give up white cabbage, radishes, radishes, turnips, sour vegetables (sour, spinach), cucumbers, legumes, mushrooms, garlic, horseradish, mustard and onions.
Also on the list of prohibited items are strong tea and coffee, citrus fruits, nuts, wholemeal bread, all baked goods, including homemade baked goods, chocolate, ice cream, alcoholic and carbonated beverages.
At different stages of the disease, different subtypes of table No. 1 are used. Which diet to follow for a stomach ulcer depends on the patient's well-being and the severity of the symptoms.
So, to relieve a sharp aggravation, 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 remain in bed. The goal of the diet is a purely delicate attitude to digestion and the 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 peptic ulcers involves dividing 6-7 meals a day into 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 puréed state. Cream soups, liquid and slimy porridge and souffles 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 wound begins to heal. After this, the patient switches to gentleDiet No. 1, whose goal—not only provides protection to the mucous membrane, but also accelerates its recovery. The essence of the diet as a whole remains the same, while the list of acceptable foods expands and the nature of the preparation changes: from completely liquid, pureed food to a 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 well as mashed potatoes or soufflés of potatoes, beets and carrots. Various mousses, jellies, jelly with milk, sweet fruits and juices, honey and sugar are introduced. Steamed dishes made from unleavened cottage cheese and egg whites, sour cream, mild cheese and butter are allowed.
Stomach ulcers - symptoms and treatment
What is a stomach ulcer? We will discuss causes, diagnosis and treatment methods in the article by Dr. Nizhegordtsev A. S. , a surgeon with 17 years of experience.
Definition of disease. Causes of the disease
Ulcer(Ulcer) is a chronic, relapsing disease in which defects occur in the stomach lining. If left untreated or untimely, it can cause disability or death.
Causes of stomach ulcers
The most common cause of peptic ulcer and duodenal ulcer isHelicobacter pylori infection. It is detected in approximately 70% of patients with peptic ulcers and up to 90% of patients with duodenal ulcers. The incidence 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%). Typically, this is due to improvements in the quality of medical care, which allows for 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%, while most infected people do not even suspect it and do not complain about anything.
The second leading cause of peptic ulcers ispainkiller, especially non-steroidal 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, "medical" ulcers of the stomach and duodenum began to occur more often due to long-term uncontrolled use of these drugs.
In third place among the causes of peptic ulcer and duodenal ulcer isdiseases 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 is:
- neuro-emotional overload (stress);
- violation of daily routine and nutrition, consumption of refined foods and fast food;
- complicated heredity (for example, the presence of peptic ulcers in parents).
If you notice similar symptoms, contact your doctor. Do not self-medicate - it is dangerous for your health!
Symptoms of peptic ulcer
Pain- the most common symptom of stomach ulcers. It is located in the upper part of the stomach and can decrease or intensify immediately or after a meal, depending on the location of the wound. And if the ulcer is located in the duodenum, the pain may intensify (or decrease) 30-40 minutes after eating.
The intensity of 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 goes away after eating. Sometimes the patient may wake up at night due to a feeling of "sucking in the abdominal cavity" (in the hollow area below the ribs) or pain in the upper part of the abdomen.
Feeling of "early satiety" and heaviness in the stomachare also signs of stomach ulcers. A person often begins to reduce portions of food, since the absorption of even a small amount of food that ends up on the inflamed areas of the gastric mucosa and ulcers can cause 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 most often occur.
Painless form of peptic ulceris most dangerous for its terrible complications, which sometimes develop with the rapidity of lightning in an apparently healthy person. Sometimes they lead to fatal consequences. For example, at the moment when a wound in the abdominal wall is perforated, the patient experiences a sharply expressed intense pain, which leads to a shock and disorientation, sometimes with loss of consciousness. It is 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 befall a person vacationing far from civilization: due to the lack of opportunity to receive emergency medical care, the chances of survival are significantly reduced.
Complications of peptic ulcer
Bleeding from a wound- the most common complication. It is dangerous because if the wall of the vessel in the wound is damaged and bleeding begins, the person does not feel anything, especially if the wound was painless. When the stomach becomes full of blood, reflex vomiting occurs. This is how the disease manifests itself. Then the patient develops symptoms of blood loss:
- blood pressure drops;
- pulse faster;
- the skin becomes pale and covered with sweat;
- weakness increases;
- shortness of breath appears 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 duodenum, symptoms of blood loss first appear, and then liquid, tarry ("black") stools appear.
Perforation of the abdominal wall- the formation of a continuous hole when the wound spreads through all layers of the abdominal wall. Through this opening the contents of the stomach flow into the abdominal cavity and causeperitonitis- total inflammation of the stomach tissue. The moment of perforation is accompanied by sharp, extremely intense pain, up to painful shock, a drop in blood pressure and sharp pallor of the skin. Subsequently, intoxication (symptoms of "poisoning") and multiple organ failure increase. Without emergency medical help, a person with such a complication dies.
Sore penetrationcan also complicate the course of the disease. If the wound 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 peptic ulcer may be gradually increasing symptoms of inflammation in secondary affected organs.
Malignancy- degeneration of a stomach ulcer into stomach cancer with all the consequent consequences. The risk of such degeneration appears if the wound exists for a long time.
Scar stenosis- a dangerous consequence of wound 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 it. In this case, the patient loses weight, quickly becomes exhausted and gradually dies of dehydration and starvation.
Diagnosis of peptic ulcer
Diagnosis of a typical woundStomach surgery is quite simple, 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 to form a clear picture of the patient's state of health and develop the most optimal treatment plan.
It is more difficult to make a diagnosis whenatypical or painless ulcer, especially when complications arise in the form of penetration - the spread of the wound to a neighboring organ.
The first sign of an asymptomatic or "silent wound" is often its complication in the form of bleeding, due to which the patient is urgently admitted to a surgical hospital, where a medical examination is carried out, anamnesis is clarified, blood is taken for tests, and if necessaryEGD, ultrasound, x-ray.
The optimal method to diagnose peptic ulcer (and if it is painless, the only and effective way) 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, extensive information is shown 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 taken from tumors for histological examination to determine the type of tumor.
When a patient shows signs of gastrointestinal bleeding, EGD is used to identify sources of bleeding that can be eliminated immediately, allowing the patient to avoid major surgical procedures.
Treatment of stomach ulcers
Ulcers are treated by a therapist or gastroenterologist. It aims to eliminate symptoms, heal wounds 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 gastric juice, acid-reducing drugs, etc. If a stomach ulcer is caused by taking pain-relieving drugs (NSAIDs) or other drugs. that can trigger the development of an ulcer, the doctor will select other medicines for the patient, medicines corresponding to the "culprit" 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, you must adhere to a certain diet - diet No. 1. It involves a nutritious diet, divided into 5-6 meals a day. The consumption of strongly irritating substances of gastric secretion (ketchup, hot spices), coarse foods and dishes is limited. The food is prepared mainly pureed, steamed or boiled in water; 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 restoring the balance between aggressive and protective factors, wounds heal by themselves within 10-14 days.
In case of complications of peptic ulcer (perforation, stenosis, uncontrolled, recurrent bleeding) or in case of ineffectiveness of drug treatment, the treatment is carried out surgically. However, surgery is always a big risk. For 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 take advantage of this opportunity.
Forecast. Prevention
The prognosis for stomach ulcers depends on the patient himself. With a healthy lifestyle, proper nutrition and careful attitude to your health, the probability 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 ailments often lead to the development of complicated forms.
Prevention of stomach ulcers is much easier, faster and cheaper than treating its developed forms and complications. For this purpose, the World Health Organization (WHO) recommends that from the age of 25 you undergo annual preventive examinations with a general practitioner or gastroenterologist. If relatives had a peptic ulcer, regardless of complaints, endoscopy with determination of the acidity of gastric juice, clarification of biopsies to determine H. pylori infection and histological examination of suspicious areas is recommended. It is held every other year. In the absence of complaints, preventive comprehensive endoscopy is indicated every two years after age 35. Diseases identified and immediately 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 developing it;
- secondary- aimed at preventing the development of an already existing disease;
- tertiary- is performed after the development of complications.
Rules for primary prevention:
- 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 must eat often, in small portions. Eliminate "hungry" and "mono-diets". It is extremely undesirable to consume alcohol, soft 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 baked goods and sweets is allowed.
- Maintain 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 caries, as it reduces general immunity, making it easier for any infection, including H. Pylori.
- From the age of 25, a planned comprehensive endoscopic examination is carried out once every two years - endoscopy with determination of H. Pylori.
INsecondary and tertiaryprevention to all rules from the first phase is added:
- Follow strict diet No. 1. Avoid eating hard-to-digest raw materials, meat, fish and mushroom broth, strong tea and coffee, baked goods, chocolate, fresh sour fruits, spicy vegetables - turnips, radishes, radishes, onions. The food must 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 advisable to drink mineral water, which reduces the stomach acid content.
- Eliminate any cause of exacerbation of the ulcer, 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 medically literate person, listen to the recommendations of doctors, official authoritative medical sources and do not neglect routine examinations.