Gastrointestinal problems force a person to completely change his eating habits. And this is understandable, because experiencing acute pain, tingling, burning, heaviness, stomach cramps or constant heartburn, you can not only give up your favorite dishes, but alsoComplete loss of appetite. However, boycotting food can harm patients even more. Therefore, understanding how to eat if you have stomach problems will help reduce the acute symptoms of the disease and once again feel the joy of life. Today we will look in detail at the 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 proper diet can speed up the healing process of ulcers and prevent the development of complications. Therefore, those who are facing a similar disease need to 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 damaged, so the digestive process, accompanied by the secretion of hydrochloric acid, causes a lot of pain. What diet for stomach ulcers will help reduce symptoms and speed healing? The main goal of nutrition is to promote ulcer healing. However, this process is long and if, at the first signs of relief, the patient returns to eating foods that stimulate the development of the disease, the ulcer will not last long. To prevent this from happening, therapeutic nutrition must become a way of life for several months, even years.
How to eat if you have a stomach ulcer
What you do not need to do is starve yourself, because then the acid begins to erode the stomach wall even more, which only aggravates the course of the disease. Therefore, it is necessary to adhere to the diet prescribed by the gastroenterologist to avoid feelings of hunger and discomfort. What should you eat if you have a stomach ulcer?
- Food should not irritate the mucous membrane and increase the acidity of gastric juice.
- You should only consume easily digestible foods in liquid form, puree, mash, and chew slowly.
- Hot and cold foods are prohibited because such dishes interfere with the formation of enzymes and slow down the recovery process of mucous membranes. The optimal temperature is from 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 regimen - from 1. 5 to two liters per day.
That's good
The first medical diet for patients with gastric ulcers was developed by Mikhail Pevzner, founder of clinical gastroenterology and dietetics.
It has been proven that diet directly affects the course of the disease. Therefore, strict adherence to the recommendations of a nutritionist is the key to recovery. The diet for people with stomach ulcers is called "table number 1". Let's look at the basics of this diet.
Table number 1 - diet for exacerbation of gastric ulcer
So, the most important question: what can you eat if you have a stomach ulcer? A medical diet accompanies drug treatment of ulcers during exacerbation and remission and lasts from six months to a year. Therapeutic nutrition involves minimizing mechanical, chemical and thermal loads on the stomach pain area. Food should activate the process of regeneration and healing of damage, reduce inflammation, improve secretion and motility of the stomach.
When following a gastric ulcer treatment diet, allowed foods can be boiled, grilled or steamed. Meat and fish must be completely cleaned of skin, bones, cartilage, tendons, 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.
Foods rich in healthy protein: lean meat of rabbit, turkey, chicken, veal, beef, lean ocean fish, soft-boiled eggs or omelets. It is necessary to enrich the diet with fat in the form of unsalted butter, add vegetable oil only to prepared dishes, do not use for heat treatment.
Among carbohydrate foods, certain vegetables are recommended (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), cooked cereals (oatmeal, floursemolina, rice, buckwheat), as well as various types of pasta, dry white bread, crackers, biscuits, unleavened biscuits.
Desserts on the diet include purees, mousses, jellies from berries and soft, sweet fruits, baked fruits, natural marshmallows, marshmallows and marmalades, jams and marmalades. Honey is recommended because it soothes pain, inflammation and helps neutralize acids.
It will be useful to drink milk, milk envelops the walls of the stomach and protects the mucous membrane. Fermented milk products should be introduced into the diet with caution and make sure that they do not contain vegetable fats (eg palm oil), which have a negative effect on the digestive process. 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, wild rose, mint, weak tea, fruit juices, jelly, juices, diluted sweet juices, as well as water at room temperature. With your 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 number 1 deserves special mention. The maximum allowable amount of salt is 6 g per day. But the less of this substance that enters the body of a person with a stomach ulcer, the better. It should be noted that we also get salt from finished products, for example, it is present in large quantities in cheese, including processed cheese.
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, spicy, salty, sour, smoked, fried and canned foods, sausages, offal, spices, ketchup, sauces and marinades are excluded. You need to give up white cabbage, radishes, radishes, radishes, 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, chocolatemules, ice cream, alcoholic and carbonated drinks.
At different stages of the disease, different subgroups of Table No. 1 are used. Which diet to follow when suffering from a stomach ulcer depends on the patient's health condition and the severity of the symptoms.
Therefore, to reduce the severity of the condition, a stricter diet should be applied.— table number 1a. This diet is prescribed during periods of severe illness, accompanied by acute pain. According to regulations, at this time the patient is forced to lie in bed. The goal of the diet is a completely delicate attitude towards the digestive process and the maximum exclusion of all effects of food on the stomach.
What can you eat when your stomach ulcer is worse and you can't eat anything? Diet for acute gastric ulcer disease includes dividing 6-7 meals per day into very small portions and reducing energy value (up to 2010 kcal). All foods that cause gastric secretions and irritate mucous membranes are completely unacceptable. Salt consumption is significantly reduced. Boiled and steamed foods are served in liquid or pureed form. Cream soups, loose and mucous porridges, and soups are widely used.
In addition to the main list of prohibited foods in the dietnumber 1aBread in any form, fermented milk products, all vegetables and fruits are completely excluded.
This diet is prescribed until the ulcer begins to heal. Then the patient switches to a gentle modediet number 1, the purpose of that—not only protects the mucous membrane, but also accelerates its recovery. The nature of the diet generally remained the same, while the list of acceptable foods expanded and the nature of preparation changed: from purely liquid, pureed foods to pureed foods. cut into "small pieces".
The energy value increases to 2500 kcal per day, the frequency of eating is reduced to six times a day. Dry white bread is allowed, as well as mashed potatoes or soufflé from potatoes, beets and carrots. Various mousses, jellies, jellies with milk, fruit and sweet juices, honey and sugar are presented. Steamed dishes made from 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, diagnostic methods and treatment in the article by Dr. Nizhegorodtsev A. S. , a surgeon with 17 years of experience.
Definition of disease. Cause of the disease
Stomach ulcers(Gastric ulcer) is a chronic, relapsing disease in which defects occur in the stomach lining. If not treated or not promptly, 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 ulcers and up to 90% of patients with duodenal ulcers. The incidence of H. pylori infection, the main cause of gastric and duodenal ulcers, has decreased in recent years in developed countries (e. g. in Sweden by 11%). Usually, this is due to improvements in the quality of medical care, allowing timely diagnosis and treatment of infections, as well as improved sanitary conditions (for example, the quality of tap water). In our country, the infection rate reaches about 70%, while most infected people do not even suspect anything and do not complain about anything.
The second cause of peptic ulcer disease isanalgesic, especially nonsteroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of the action of NSAIDs help people relieve various pains, on the other hand, due to long-term uncontrolled use of these drugs, gastric and duodenal ulcers develop. "Medication-induced" colitis begins to occur more frequently.
Ranked third among the causes of gastric and duodenal ulcers isThe disease increases 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. v.
The likelihood of developing peptic ulcer disease is greatly influenced byFactors affecting, that is:
- neuro-emotional tension (stress);
- violation of daily habits and nutrition, consumption of refined foods and fast food;
- Complex genetics (eg, 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
Pain- The most common symptom of stomach ulcers. It is localized in the upper abdomen and may subside or intensify immediately or after meals, 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 sharp and transient, which can even lead to a vomiting reflex immediately after eating, to weak and constant, intensifying in the morning and disappearing 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 "early fullness" and heaviness in the stomachIt is also a sign of duodenal ulcer disease. A person often begins to reduce food portions, since the absorption of even a small amount of food acts on inflamed areas of the gastric mucosa, and ulcers can cause these unpleasant sensations.
Bad breath, nausea, change in taste, film on tongue- a frequent companion of any inflammatory disease of the upper digestive tract, including gastritis (gastritis), in which ulcers most often appear.
Painless form of duodenal ulcerThe most dangerous because of the terrible complications, which sometimes develop at lightning speed in a seemingly healthy person. Sometimes they lead to fatal consequences. For example, at the moment of perforation of an ulcer in the stomach wall, the patient feels severe pain, leading to shock and disorientation, sometimes loss of consciousness. It's scary to imagine what this would lead to if this person turned out to be a car, 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 from ulcers- most common complications. This is dangerous because if the vessel wall in the ulcer is damaged and begins to bleed, the person will not feel anything, especially if the ulcer is painless. When the stomach fills with blood, the vomiting reflex occurs. This is how the disease manifests itself. The patient then shows symptoms of blood loss:
- decreased blood pressure;
- faster pulse;
- skin becomes pale and sweaty;
- increased weakness;
- Shortness of breath occurs despite reduced 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, the first symptoms of blood loss appear, followed by loose, tarry ("black") stools.
Perforation of the stomach wall- hole formation when the ulcer spreads through all layers of the stomach wall. Through this hole, the food in the stomach flows into the abdominal cavity and causesperitonitis- inflammation of all abdominal tissues. The moment of perforation is accompanied by sharp, extremely intense pain, up to the point of painful shock, decreased blood pressure and pale skin. Subsequently, intoxication ("poisoning" symptoms) and multiple organ failure increase. Without emergency medical care, a person will die from such complications.
Penetrating ulcerscan also complicate the progression of the disease. If the ulcer is located on the wall of the stomach, adjacent to another organ - the pancreas or intestinal wall, then it can spread to this neighboring organ. At that time, the first manifestations of stomach ulcers may be symptoms of gradually increasing inflammation in secondary affected organs.
malignant disease- degeneration of gastric ulcer into gastric cancer with all the subsequent consequences. The risk of such degeneration appears if the ulcer persists for a long time.
Scar narrowing- a dangerous consequence of ulcer healing. Due to scarring, the lumen of the stomach or duodenum may be significantly narrowed, to the point where it becomes difficult or impossible for solid and liquid foods to pass through it. In this case, the patient loses weight, quickly becomes exhausted and gradually dies from dehydration and starvation.
Diagnosis of gastric ulcer
Diagnosis of typical ulcersGastric surgery is quite simple, performed by a gastroenterologist or gastroenterologist. During the examination, the doctor determines the general condition of the patient, clarifies complaints, nature and features of the course of the disease, and during palpation clarifies the boundaries of painful areas and the nature of the disease. they. If necessary, the doctor orders blood tests and instrumental examinations to get a clear picture of the patient's health condition and come up with the most optimal treatment plan.
Determining the diagnosis will be more difficult whenAtypical or painless ulcers, especially when complications arise in the form of infiltration - the spread of the ulcer to neighboring organs.
The first sign of a silent or asymptomatic ulcer is often its complication in the form of bleeding, so the patient is urgently taken to a surgical hospital, where a medical examination is carried out, Clear history, take blood for testing. tests, and if necessary, EGD, ultrasound, X-ray.
The optimal method for diagnosing peptic ulcer disease (and if it is painless it is the only and effective way) isregular endoscopic examination- Esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, lasts a few minutes and is accompanied by unpleasant but completely tolerable sensations. As a result of the examination, comprehensive information appears about the condition of the upper digestive tract, the presence and nature of inflammatory and ulcerative-erosive processes, as well as the appearance of tumors.
Using special technologies during endoscopy, the acidity of gastric fluid and the presence of H. Pylori infection are determined and small pieces of 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 the bleeding which can be immediately removed, 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 the disease through diet, lifestyle changes and medication.
To eliminate the H. pylori bacteria that cause ulcers, doctors prescribe antibiotics, reducing the acidity of gastric juice, antacids, etc. v. If your stomach ulcer is caused by taking pain relievers (NSAIDs) or other medications. can cause ulcers to develop, the doctor will choose for the patient other drugs that are similar to the "culprit" of the disease, and do not have the effect of causing ulcers.
If you have a stomach ulcer, it is important to give up bad habits, mainly smoking and drinking too much alcohol. This will eliminate the risk of complications.
In addition, during treatment, you need to adhere to a certain diet - diet number 1. It includes a nutritious diet, divided into 5-6 meals a day. Limit consumption of strong stimulants of gastric secretion (tomato sauce, hot spices), rough foods and dishes. Food is prepared mainly in pureed form, 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 salt intake.
After restoring the balance between aggressive and protective factors, the ulcer heals spontaneously within 10-14 days.
In case of complications of duodenal ulcer (perforation, stricture, uncontrolled bleeding, recurrence) or in case of ineffective medical treatment, treatment is performed surgically. However, surgery always carries many risks. For stomach ulcers, it is done as a last resort. If you can avoid it without letting the disease develop, it is better to take advantage of this opportunity.
Forecast. Prevent
The prognosis of duodenal ulcer disease depends on the patient himself. With a healthy lifestyle, proper nutrition and careful attitude towards health, the chance of getting a stomach ulcer is extremely low. Disturbances in sleep and eating habits, overwork, stress, neglect of regular medical examinations and ignoring seemingly small personal discomforts often lead to the development of various forms ofcomplicated.
Preventing peptic ulcer disease is much easier, faster and cheaper than treating its developing forms and complications. For this purpose, the World Health Organization (WHO) recommends that, starting at age 25, you have an annual preventive examination with a general practitioner or gastroenterologist. If a relative has a stomach ulcer, then regardless of complaints, an endoscopy is recommended to determine the acidity of the gastric juice, a clarifying biopsy to confirm 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 that are identified and treated promptly in the early stages - gastritis, duodenitis, H. pylori infection - will avoid the development of not only ulcerative processes, but also cancer.
Changethree stages of prevention:
- elementary- when there is no disease but there is a risk of developing the disease;
- middle school- aimed at stopping the progression of an already existing disease;
- high shool- performed 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 regularly, divided into small portions. Eliminate "hunger" and "mono diet". The consumption of alcohol, soda, fatty, fried, smoked foods, canned foods and fast foods is undesirable. You should eat cereal porridge, soup, boiled meat and fish, vegetables and fruits. Allow moderate consumption of baked goods and sweets.
- Follow a healthy lifestyle: give up bad habits, be physically active, sleep at least 7 hours at night. Avoid stressful situations, learn to perceive them correctly.
- Regularly visit a doctor as part of a medical examination and the elimination of foci of chronic infection, including the timely treatment of dental caries, as it reduces general immunity, facilitatingeasier for all infections, including H. Pylori.
- Starting from the age of 25, every two years, it is necessary to undergo a planned comprehensive endoscopic examination - colonoscopy to identify H. Pylori.
INmiddle and high schoolPrecautions for all rules from the first phase are added:
- Strictly adhere to diet number 1. Avoid eating rough foods that are difficult to digest, meat, fish and mushroom broths, strong tea and coffee, baked goods, chocolate, sour fresh fruits, spicy vegetables - tubersradishes, radishes, radishes, onions. Food should be steamed, boiled or grilled (without the skin) in pureed form. It should be warm: not cold and not hot. Portions should be small. You should drink mineral water, which reduces acidity in the stomach.
- Eliminate any causes that aggravate the ulcer, for example chronic gastritis.
- Carefully follow medical instructions.
From all this, in most cases, the development of stomach ulcers and its complications can be easily avoided if you are medically knowledgeable, listen to your doctor's recommendationsdoctors, competent official medical sources and do not neglect regular medical examinations.