Problems with the digestive 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 food, but also completely lose your appetite. However, food boycotts can be more detrimental to patients. Therefore, a clear understanding of how to eat if you have stomach problems will help relieve the acute symptoms of the disease and return to feeling the joy of life. Today we will see in detail what diet you should follow if you suffer from stomach ulcers.
Diet for stomach ulcers is the most important direction of therapy
Nutrition certainly has a significant impact on our health. A well-formulated diet can speed up ulcer healing and prevent the development of complications. Therefore, everyone who faces a similar disease needs to know how to eat properly if they suffer from stomach ulcers. Of course, diet does not replace medication, but without special nutrition, drug therapy will be ineffective.
With an ulcer, the integrity of the mucous membrane is disturbed, so digestion, accompanied by the secretion of hydrochloric acid, causes a lot of pain. What stomach ulcer diet can help relieve symptoms and speed healing? The main goal of nutrition is to accelerate ulcer closure. However, this process takes a long time, and if, at the first signs of healing, the patient returns to consuming foods that provoke the development of the disease, then the ulcer will not be long in coming. To prevent this from happening, nutritional therapy should become a lifestyle for several months, or even years.
How to eat if you suffer from stomach ulcers
What you don't need to do is starve, because the acid begins to damage the walls of the stomach even more, which only worsens the course of the disease. Therefore, it is very important to adhere to the diet prescribed by the gastroenterologist, avoiding feelings of hunger and discomfort. What should you eat if you suffer from stomach ulcers?
- Food should not cause irritation of the mucous membranes and increase the acidity of gastric juice.
- You should only consume foods that are easily digested in liquid form, mashed, crushed, chewed slowly.
- Hot and cold foods are prohibited, as such dishes disrupt the formation of enzymes and slow down the recovery of the mucous membrane. Optimum temperature is 26 to 33 °C.
- You need 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 regime - from 1. 5 to two liters per day.
This is interesting
The first medical diet for stomach ulcer patients 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 of stomach ulcer sufferers is called "table no. 1". Let's take a 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 suffer from stomach ulcers? A medical diet accompanies pharmacological treatment of ulcers during which exacerbations and remissions subside and last from six months to a year. Therapeutic nutrition involves minimizing the mechanical, chemical and thermal load on colic. Food should activate regeneration and healing of damage, reduce inflammation, and increase 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 thoroughly cleaned of skin, bones, cartilage, tendons, tendons and fat. When cooking meat, you need to drain the cooking water twice to reduce the concentration of animal fat as much as possible.
Healthy protein foods: lean rabbit meat, turkey, chicken, veal, beef, lean sea fish, boiled eggs or omelettes. It is necessary to enrich food with fats in the form of unsalted butter, and add vegetable oils only to ready-made dishes, not using them for heat treatment.
Among carbohydrate foods, some vegetables are recommended (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked grains (oatmeal, semolina, rice, buckwheat), as well as various pasta, dry white bread, crackers, biscuits, unleavened biscuits.
Desserts included in this diet include purees, mousses, soft and sweet fruit and fruit jellies, baked fruits, natural marshmallows, marshmallows and marmalade, jams and marmalades. Honey is recommended because 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. Fermented milk products should be introduced into the diet carefully and ensure that they do not contain vegetable fats (for example palm oil), which have a bad effect on digestion. Let's say low-fat cottage cheese in the form of casseroles, acidophilus, fresh kefir (! ), natural yogurt and sour cream, unleavened cheese.
Recommended drinks: decoctions of chamomile, rosehip, mint, weak tea, compote, jelly, fruit drinks, diluted sweet juices, as well as 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 accelerates the healing of damaged stomach walls.
The role of salt in diet No. 1 deserves special attention. The maximum allowable amount of salt is 6 g per day. However, the less that enters the body of stomach ulcer sufferers, the better. It should be remembered that we also get salt from finished products, for example salt is found in large quantities in cheese, including processed cheese.
It is important to understand that many foods are completely unacceptable for ulcer sufferers because they irritate the mucous membranes, take a long time to digest, and provoke bleeding. All fatty, spicy, salty, sour, smoked, fried and canned foods, sausages, offal, spices, ketchup, sauces and marinades are excluded. You should abandon white cabbage, radishes, radishes, radishes, sour vegetables (sorrel, spinach), cucumbers, peas, 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, subtypes table No. 1 different is used. What diet to follow for stomach ulcers depends on the patient's well-being and the severity of the symptoms.
So, to relieve sharp exacerbations, a stricter diet is recommended— table No. 1a. This diet is prescribed during periods of intense illness, accompanied by acute pain. Usually, at this time the patient is forced to remain in bed. The goal of this diet is a very gentle attitude towards digestion and maximum exclusion of any impact of food on the stomach.
What can you eat during an exacerbation of stomach ulcers and what should not be eaten? The diet for acute stomach ulcers 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 release of gastric juice and irritate the mucous membrane are completely unacceptable. Salt consumption is significantly reduced. Food, boiled and steamed, is served liquid or mashed. Cream soups, liquid and slimy porridges, and soufflés are widely used.
In addition to the main list of foods prohibited 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 this, the patient switches to gentlediet number 1, which is the goal—not only provides protection to the mucous membrane, but also accelerates its recovery. The essence of the diet as a whole is maintained, while the list of acceptable foods is expanded and the nature of their preparation changes: from completely liquid and pureed foods to "small piece" foods.
The energy value increases to 2500 kcal per day, the frequency of meals is reduced to six times a day. Dry white bread is allowed, as well as mashed potatoes or souffles from potatoes, beets and carrots. Various mousses, jellies, jellies with milk, fruit and sweet juices, honey and sugar are introduced. Steamed dishes made from unleavened cottage cheese and egg white, sour cream, soft cheese and butter are allowed.
Stomach ulcers - symptoms and treatment
What is stomach ulcers? 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. Cause of this disease
Gastric pains(Stomach ulcers) is a chronic disease that recurs in which damage occurs to the gastric mucosa. If left untreated or not treated in time, this disease can cause disability or death.
Causes of stomach ulcers
The most common causes of gastric and duodenal ulcers areHelicobacter 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, the main cause of gastric and duodenal ulcers, has decreased in recent years in developed countries (e. g. in Sweden by 11%). As a rule, this is due to improving the quality of medical services, which allows timely diagnosis and treatment of infections, as well as improving sanitary conditions (for example, the quality of tap water). In our country, the prevalence of infection reaches about 70%, while the majority of infected people are not even aware of it and do not complain about anything.
The second cause of gastric ulcers ispainkillers, especially nonsteroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of action of NSAIDs relieves various pains, on the other hand, due to long-term uncontrolled use of these drugs, "medicinal" stomach and duodenal ulcers began to occur more often.
In third place is the cause 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 possibility of developing stomach ulcers is greatly influenced bypredisposing factors, Which one:
- neuro-emotional tension (stress);
- violation of daily routine and nutrition, consumption of processed foods and fast food;
- complicated hereditary factors (for example, the presence of peptic ulcer disease in parents).
If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!
Symptoms of stomach ulcers
Painful- the most common symptom of gastric ulcer. It is localized in the upper abdomen and may decrease or increase immediately or after eating, 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 severe and transient, which may even cause a gag reflex 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 pit of the stomach" (in the hollow area under the ribs) or pain in the upper abdomen.
Feeling of "premature fullness" and heaviness in the stomachis also a sign of peptic ulcer disease. A person often begins to reduce food portions, because the absorption of even small amounts of food, which ends up in inflamed areas of the gastric mucosa and ulcers, can cause such unpleasant sensations.
Bad breath, nausea, change in taste, coating on the tongue- often accompanies inflammatory diseases of the upper digestive tract, including gastritis (inflammation of the stomach), which most often causes ulcers.
A painless form of gastric ulcermost dangerous because of its terrible complications, which sometimes develop at lightning speed in seemingly healthy people. Sometimes it leads to fatal consequences. For example, when a gastric ulcer perforates, the patient experiences very severe pain, which causes shock and disorientation, sometimes accompanied by loss of consciousness. It's scary to imagine what would happen if that person turned out to be a car driver, bus driver, or airplane pilot. The same misfortune can happen to a person on vacation far from civilization: due to the lack of opportunity to receive emergency medical care, the chances of survival are significantly reduced.
Complications of stomach ulcers
Bleeding due to ulcers- the most common complication. This is dangerous because if the walls of the blood vessels in the ulcer are damaged and bleeding occurs, the person will not feel anything, especially if the ulcer does not cause pain. When the stomach is full of blood, a vomiting reflex occurs. This is how the disease manifests itself. Then the patient experiences symptoms of blood loss:
- decreased blood pressure;
- the pulse becomes faster;
- the skin becomes pale and sweaty;
- increasing weakness;
- shortness of breath appears even though physical activity is reduced.
When the ulcerative disorder and the source of bleeding are located in the lower part of the stomach or in the duodenum, then symptoms of blood loss first appear, and then liquid ("black") stools appear.
Perforation of the stomach wall- the formation of a through hole when the ulcer spreads to all layers of the stomach wall. Through this opening, the contents of the stomach flow into the abdominal cavity and give rise toperitonitis- total inflammation of the stomach tissue. The moment of perforation is accompanied by sharp, very intense pain, up to painful shock, a drop in blood pressure and a sharp pallor of the skin. Subsequently, intoxication ("poisoning" symptoms) and multiple organ failure increase. Without emergency medical care, a person dies with such complications.
Ulcer penetrationIt can also complicate the course of the disease. If the ulcer is located on the stomach wall, which is adjacent to another organ - the pancreas or intestinal wall, then the ulcer can spread to these neighboring organs. Then the first manifestations of gastric ulcer may gradually increase the symptoms of inflammation in the secondarily affected organs.
Malignancy- degeneration of gastric ulcers into gastric cancer with all the consequences it causes. The risk of degeneration arises if the ulcer has been present for a long time.
Scar stenosis- dangerous consequences of ulcer healing. As a result of scar tissue, the lumen of the stomach or duodenum can narrow significantly, making it difficult or impossible for solid and liquid foods to pass through. In this case, the patient loses weight, quickly becomes exhausted and gradually dies from dehydration and starvation.
Diagnosis of stomach ulcers
Typical ulcer diagnosisGastric surgery is quite simple, 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 on palpation clarifies the boundaries of the pain area and its nature. If necessary, the doctor will prescribe blood tests and instrumental examinations to get a clear picture of the patient's health condition and draw up the most optimal treatment plan.
It is more difficult to establish a diagnosis whenatypical or painless ulcers, especially if complications arise in the form of penetration - spread of the ulcer to neighboring organs.
The first sign of an asymptomatic disease or "silent ulcer" is often its complication in the form of bleeding, so the patient is immediately admitted to a surgical hospital, where a medical examination is carried out, the anamnesis is clarified, blood is taken for collection. tests, and, if necessary, EGD, ultrasound, X-ray.
The optimal method for diagnosing peptic ulcer disease (and if it is painless, the only effective way) isroutine endoscopic examination— esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, lasts a few minutes, and is accompanied by unpleasant but quite tolerable sensations. As a result of the examination, complete information appears regarding 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 technology 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 the tumor for histological examination to determine the type of tumor.
When a patient shows signs of gastric bleeding, EGD is used to identify the source of bleeding that can be promptly removed, so that the patient can avoid serious surgical intervention.
Stomach ulcer treatment
Gastric ulcers are treated by a therapist or gastroenterologist. It aims to eliminate symptoms, cure ulcers and eliminate the causes of this disease through diet, lifestyle changes and medication.
To eliminate the H. pylori infection that causes ulcers, the doctor will prescribe antibiotics, and to reduce stomach acidity, acid reducing drugs, etc. If the ulcer is caused by the use of pain relievers (NSAIDs) or other drugs that can trigger the development of ulcers, the doctor will select another drug for the patient with a drug similar to the "cause" of the disease, which does not have an ulcer-forming effect.
If you suffer from gastric ulcers, it is very important to give up bad habits, especially smoking and excessive alcohol consumption. This will eliminate the risk of complications.
In addition, during treatment, you must follow a certain diet - diet No. 1. It involves a nutritious diet, divided into 5-6 meals a day. The consumption of foods that strongly irritate gastric secretion (tomato sauce, hot spices), rough foods and dishes is limited. Food is prepared mainly by mashing, steaming or boiling in water, fish and lean meat are served in pieces. Very cold and hot dishes are not included in the diet. Limit your table salt intake.
Once the balance between aggressive and protective factors is restored, the boil heals on its own within 10-14 days.
If complications of peptic ulcer disease occur (perforation, stenosis, recurrent uncontrolled bleeding) or if drug therapy is ineffective, treatment is carried out surgically. However, surgery always has big risks. For gastric ulcers, this action is performed as a last resort. If it can be avoided without allowing the disease to progress, it's a good idea 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 maintaining good health, the chances of developing stomach ulcers are very low. Violation of sleep and nutritional patterns, overwork, stress, neglect of routine medical examinations, and ignoring seemingly minor discomforts often lead to the development of complicated forms.
Preventing peptic ulcer disease is much easier, faster and cheaper than treating advanced forms and complications. For this reason, 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 a relative suffers from gastric ulcer, then, regardless of complaints, endoscopy is recommended with determination of the acidity of gastric juice, clarification of the biopsy to determine H. pylori infection and histological examination of suspicious areas. It is held every two years. If there are no complaints, preventive comprehensive endoscopy is indicated every two years after 35 years. Timely identified and treated diseases in the early stages - gastritis, duodenitis, H. pylori infection - will avoid the development of not only ulcerative processes, but also cancer.
Variesthree stages of prevention:
- main- when there is no disease, but there is a risk of contracting it;
- secondary- aims to prevent the development of existing diseases;
- tertiary- carried out after the development of complications.
Primary prevention rules:
- Adhere 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 need to eat often, in small portions. Eliminate "hunger" and "mono-diet". It is highly undesirable to consume alcohol, soda, fatty foods, fried foods, 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.
- Adhere to a healthy lifestyle: give up bad habits, be physically active, sleep at least 7 hours at night. Avoid stressful situations, learn to understand them correctly.
- Visit a doctor regularly as part of a medical examination and exclude foci of chronic infection, including timely treatment of caries, as this reduces general immunity, thereby facilitating any infection, including H. Pylori.
- Starting from the age of 25, once every two years, undergo a planned comprehensive endoscopic examination - endoscopy with the determination of H. Pylori.
In thesecondary and tertiaryprevention to all the rules of the first stage is added:
- Strictly follow diet No. 1. Avoid eating rough foods that are difficult to digest, meat, fish and mushroom broths, strong tea and coffee, baked goods, chocolate, fresh sour fruits, spicy vegetables - radishes, turnips, 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 that reduces stomach acidity.
- Eliminate all causes of ulcer exacerbation, for example chronic ulcers.
- Follow medical instructions carefully.
From this it follows that in most cases the development of peptic ulcer disease and its complications can be easily avoided if you are a medically literate person, listen to the recommendations of doctors, authoritative official medical sources and do not neglect regular examinations.