Problems with the gastrointestinal tract force a person to fundamentally change his eating habits. And this is understandable, because you experience severe pain, itching, burning, heaviness, stomach irritation or constant heartburn, not only you, but also your favorite foods to refuse, as well as a complete loss of appetite. However, a food boycott can cause even more harm to the patient. Therefore, if you have problems with your stomach, understanding exactly how to eat will help you to eliminate the acute symptoms of the disease and feel the joy of life again. Today we will take a detailed look at what diet you should follow if you have a peptic ulcer.
Diet is the most important aspect of therapy for peptic ulcer
Nutrition, of course, has a significant impact on our health. A properly formed diet accelerates the healing of wounds and prevents the development of complications. Therefore, anyone suffering from a similar disease should know how to eat properly if they have a stomach ulcer. Of course, diet does not replace treatment, but drug therapy without special nutrition will not be effective.
The integrity of the mucous membrane is disturbed by the ulcer, so indigestion accompanied by the secretion of hydrochloric acid causes a lot of pain. What diet for peptic ulcers can help relieve symptoms and speed healing? The main purpose of nutrition is to promote rapid wound healing. But this process takes a long time, and with the first signs of relief, if the patient returns to the food that provoked the development of the disease, then the ulcer will not last long. To prevent this, therapeutic nutrition should become a way of life for several months or even years.
How to eat if you have a stomach ulcer
What should not be done is hunger, because then the acid starts to corrode the walls of the stomach, which worsens the course of the disease. Therefore, it is necessary to avoid feelings of hunger and discomfort and follow a diet prescribed by a gastroenterologist. What to eat if you have a stomach ulcer?
- Food should not irritate the mucous membrane and increase the acidity of gastric juice.
- Liquid, pureed, ground, easily digestible food should be chewed slowly.
- Hot and cold foods are prohibited, because such dishes prevent the formation of enzymes and slow down the recovery of the mucous membrane. The optimum temperature is from 26 to 33°C.
- Eat in small portions with breaks of no more than three hours. The frequency of feeding is determined according to the severity of the condition and is from five to eight times a day.
- Drinking mode - from 1. 5 to two liters per day.
It's fun
The first medical diet for patients with gastric ulcers was developed by Mikhail Pevzner, the founder of clinical gastroenterology and dietetics.
Diet has been proven to directly affect the course of the disease. Therefore, strict adherence to the nutritionist's recommendations is the key to recovery. The diet of people with stomach ulcers is called "Table No. 1". Let's take a look at the basics of this diet.
Table No. 1 - diet for exacerbation of gastric ulcer
So, the most important question is: what can you eat if you have a stomach ulcer? A medical diet is accompanied by pharmacological treatment of ulcers in exacerbations and remissions and lasts from six months to a year. Therapeutic nutrition involves minimizing the mechanical, chemical and thermal load on the stomach. Food should activate regeneration and damage healing, reduce inflammation, and improve gastric secretion and motility.
When following a therapeutic diet for peptic ulcer, 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, the boiling water should be drained twice to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: rabbit, turkey, chicken, veal, beef, lean seafood, soft-boiled eggs or omelets. The diet should be enriched with fats in the form of unsalted butter, and vegetable oil should not be used for thermal processing, but should be added only to ready meals.
Carbohydrates include some vegetables (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked grains (oats, semolina, rice, buckwheat), as well as various types of pasta, dry white bread, crackers, cookies. , unleavened cookies.
Desserts included in the diet include puree, mousse, soft, sweet fruit jelly, baked fruit, natural marshmallows, marshmallows and marmalade, jam and marmalade. Honey is recommended because it helps to reduce pain and inflammation and neutralize acid.
It is useful to drink milk, which wraps the stomach wall and protects the mucous membrane. Fermented milk products should be carefully included in the diet, and should not contain vegetable oils (for example, palm oil) that have a negative effect on digestion. Casserole, acidophilus, fresh (! ) kefir, natural yogurt and cream, low-fat cheese in the form of unleavened cheese.
Recommended drink: decoctions of chamomile, hips, mint, weak tea, compotes, jelly, fruit drinks, diluted sweet juices, as well as water at room temperature. With the doctor's permission, you can drink fresh cabbage juice, it has an antibacterial effect, normalizes the enzymatic processing of food and promotes the healing of damaged stomach walls.
The role of salt in the No. 1 diet should be specially noted. The maximum permissible amount of salt is 6 g per day. But the less it enters the body of a person with a stomach ulcer, the better. It is important to remember that we also get salt from finished products, for example cheese, which is present in large quantities even when it is processed.
It is important to understand that many foods are completely unacceptable for ulcer patients 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, ketchups, sauces and marinades are excluded. White cabbage, radishes, radishes, turnips, sour greens (sorrel, spinach), cucumbers, beans, mushrooms, garlic, horseradish, mustard, and onions should be avoided.
The list of prohibited products also includes strong tea and coffee, citrus fruits, nuts, bread, various baked goods, including home-baked products, chocolate, ice cream, alcoholic and carbonated drinks.
Different subtypes of table No. 1 are used in different stages of the disease. What kind of diet to follow for a peptic ulcer depends on the patient's condition and the severity of the symptoms.
So, to alleviate acute exacerbations, a more strict diet is recommended— table No. 1a. This diet is prescribed during periods of intensive illness accompanied by severe pain. As a rule, in this case, the patient is forced to stay in bed. The goal of the diet is a clean gentle approach to maximize digestion and any effects on the stomach.
What can you eat and what can't you eat when a stomach ulcer worsens? Diet for acute gastric ulcer divides meals 6-7 times a day into very small portions and reduces the energy value (up to 2010 kcal). All foods that irritate the secretion of gastric juice and mucous membranes are absolutely unacceptable. Salt consumption is significantly reduced. Boiled and steamed food is served in liquid or pureed form. Creamy soup, liquid and slimy porridge, souffle are widely used.
In addition to the main list of foods prohibited from the dietNo. 1aBread of any kind, sour milk products, all vegetables and fruits are completely excluded.
This diet is prescribed until the wound heals. After that, the patient goes to a gentleDiet #1, the goal—not only protects the mucous membrane, but also accelerates its recovery. The essence of the diet remains intact, the list of acceptable foods expands, and the nature of preparation changes: from completely liquid, pureed food to "small pieces".
The energy value increases by 2500 kcal per day, the frequency of food intake is reduced to six times per day. Dried white bread is allowed, as well as potato, beet and carrot puree or souffle. Various mousses, jellies, jellies with milk, sweet fruits and juices, honey and sugar are included. Unfermented cottage cheese and egg whites, cream, soft cheese, steamed foods made of oil are allowed.
Stomach ulcer - symptoms and treatment
What is a stomach ulcer? Nizhegorodtsev A. , a surgeon with 17 years of experience in causes, diagnosis and treatment methods. S. will be discussed in the article.
Definition of disease. Causes of disease
Stomach ulcer(Gastric ulcer) is a chronic, recurring disease caused by defects in the gastric mucosa. If not treated or not treated in time, it can lead to disability or death.
Causes of stomach ulcers
It is the most common cause of gastric and duodenal ulcersHelicobacter pylori infection. It is detected in approximately 70% of gastric ulcer patients and up to 90% of duodenal ulcer patients. The prevalence of H. pylori as a major cause of gastric and duodenal ulcers has decreased in developed countries in recent years (for example, it is 11% in Sweden). As a rule, this is due to the improvement of the quality of medical care, which allows timely diagnosis and treatment of infection, as well as improvement of sanitary conditions (for example, the quality of tap water). The prevalence of infection in our country reaches about 70%, and most of the infected do not suspect it and do not complain about anything.
It is the second leading cause of peptic ulcer diseasepain reliever, in particular, non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed and versatility of the action of NSAIDs relieves people of various diseases, on the other hand, "medicinal" ulcers in the stomach and duodenum began to appear more and more due to the long-term uncontrolled use of these drugs.
Among the causes of gastric and duodenal ulcers, it is in third placeDiseases of increased production of gastrin- a hormone that increases the production of hydrochloric acid and increases the aggressiveness of gastric juice. They include B12 deficiency anemia, gastrinoma (tumor of the pancreas), etc. b.
The likelihood of stomach ulcers is greatly affectedpredisposing factors, are they:
- excessive neuro-emotional stress (stress);
- Violation of daily routine and diet, use of refined foods and fast food;
- complex heredity (for example, the presence of gastric ulcers in parents).
If you experience similar symptoms, see your doctor. Do not self-medicate - it is dangerous for your health!
Stomach ulcer symptoms
Pain- the most common symptom of peptic ulcer. It is localized in the upper part of the abdomen, and depending on the location of the lesion, it may decrease or increase immediately or after a meal. 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, even to reflex vomiting immediately after eating, to weak and persistent, which worsens in the morning and goes away after eating. Sometimes the patient may wake up during the night with "sucking in the pit of the stomach" (in the hollow area under the ribs) or pain in the upper abdomen.
Feeling of "early satiety" and heaviness in the stomachare also symptoms of stomach ulcers. A person often begins to reduce portions of food, because absorption of small amounts of food in inflamed areas of the gastric mucosa and ulcers can cause these unpleasant sensations.
Bad breath, nausea, taste changes, tongue coating- various inflammatory diseases of the upper gastrointestinal tract, including gastritis (inflammation of the stomach), against which ulcers are common.
Painless type of stomach ulcermost dangerous because of the dangerous complications that sometimes develop with lightning speed in an apparently healthy person. Sometimes they are fatal. For example, in the case of a perforation of the stomach wall, the patient experiences a sharp, intense pain that leads to shock and disorientation, and sometimes loss of consciousness. It's scary to imagine what would happen if this person turned out to be a car driver, a bus driver, or an airplane pilot. The same misfortune can happen to a person vacationing far from civilization: the lack of access to emergency medical care greatly reduces the chance of survival.
Complications of gastric ulcer
Bleeding from the 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 will not feel anything, especially if the wound is not painful. Reflex vomiting occurs when the stomach is full of blood. This disease manifests itself. Then the patient has symptoms of blood loss:
- blood pressure decreases;
- the pulse accelerates;
- the skin becomes pale and sweaty;
- weakness increases;
- shortness of breath occurs despite a decrease in physical activity.
When the source of ulcer disease and bleeding is in the lower part of the stomach or duodenum, symptoms of blood loss first appear, followed by liquid, tarry ("black") stools.
Perforation of the stomach wall- formation of a 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 formperitonitis- general inflammation of abdominal tissues. The moment of perforation is accompanied by acute, very strong pain, from shock to shock, a drop in blood pressure, a sharp pallor of the skin. Later, intoxication (symptoms of "poisoning") and failure of many organs increase. Without immediate medical attention, a person can die from this complication.
Entering the woundcan also complicate the course of the disease. If the ulcer is located on the wall of the stomach adjacent to another organ - the pancreas or the intestinal wall, then it can spread to this neighboring organ. After the first manifestation of gastric ulcer, the inflammatory symptoms of the affected organs may gradually increase.
Damage- transformation of gastric ulcer into gastric cancer and all its consequences. The risk of such damage occurs if the wound has been present for a long time.
Scar stenosis- wound healing is a dangerous outcome. As a result of the scar, the lumen of the stomach or duodenum is significantly narrowed, making it difficult or impossible for solid and liquid food to pass through it. In this case, the patient loses weight, gets tired quickly, and slowly dies from dehydration and hunger.
Diagnosis of gastric ulcer
typical wound diagnosisStomach surgery is very 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 during palpation, clarifies the boundaries of the painful areas and their nature. If necessary, the doctor prescribes blood and instrumental studies to create a clear picture of the patient's health and develop an optimal treatment plan.
When is more difficult to diagnosean atypical or painless lesion, especially when complications occur, penetration - the spread of the wound to the neighboring organ.
The first sign of an asymptomatic or "silent wound" is often its complication in the form of bleeding, in connection with which the patient is urgently admitted to a surgical hospital, where a medical examination is performed, an anamnesis is clarified, blood tests, and if necessary, EGD, ultrasound, X-ray.
The optimal way to diagnose peptic ulcer disease (if it is painless, the only and effective way)routine endoscopic examination— esophagogastroduodenoscopy (EGDS). The EGDS procedure is safe, takes only a few minutes, and is accompanied by unpleasant, but completely tolerable sensations. As a result of the examination, there will be detailed information about the condition of the upper intestine, the presence and nature of inflammatory and erosive-ulcerative processes, as well as the formation of tumors.
During endoscopy, with the help of special technologies, the acidity of gastric juice and the presence of H. Pylori infection are determined, and small fragments of gastric mucosa are taken from tumors for histological examination to determine the type of tumor.
When a patient develops symptoms of gastrointestinal bleeding, EGD is used to identify sources of bleeding that can be eliminated immediately, which allows the patient to avoid serious surgical intervention.
Treatment of gastric ulcer
Gastric ulcers are treated by a therapist or gastroenterologist. It focuses on eliminating symptoms, healing wounds, and addressing the cause of the disease through diet, lifestyle changes, and medication.
To get rid of the H. pylori infection that causes the ulcer, the doctor may prescribe antibiotics, antacids, etc. to reduce the acidity of the gastric juice. can trigger the formation of ulcers, the doctor chooses other drugs for the patient, the "culprits" of the disease are similar, and do not have an ulcer-causing effect.
If you have a stomach ulcer, it is very important to give up bad habits, especially smoking and excessive alcohol consumption. This eliminates the risk of complications.
Also, during treatment, it is necessary to follow a certain diet - diet No. 1. It includes a nutritious diet divided into 5-6 meals a day. The use of substances that strongly irritate gastric secretions (ketchups, hot spices), coarse foods and utensils is limited. The dish is mainly pureed, steamed or boiled, and fish and lean meat are cut into portions. Very cold and hot foods are excluded from the diet. Limit the use of table salt.
After restoring the balance between aggressive and protective factors, the lesions heal on their own within 10-14 days.
When gastric ulcer disease (perforation, stenosis, uncontrolled, recurrent bleeding) becomes complicated or drug therapy is ineffective, surgical treatment is performed. However, surgery is always a big risk. It is used as a last resort for stomach ulcers. If it is possible to prevent the development of the disease, then it is better to use this opportunity.
Approx. Prevention
Prognosis of gastric ulcer depends on the patient. By living a healthy lifestyle, eating right, and taking care of your health, the chances of developing a stomach ulcer are very low. Violation of sleep and eating habits, overwork, stress, failure to undergo daily medical examination, and neglecting one's minor discomforts often lead to the development of complex forms.
Prevention of gastric ulcer is much easier, faster and cheaper than treatment of its advanced forms and complications. For this purpose, the World Health Organization (WHO) recommends an annual preventive examination by a general practitioner or gastroenterologist from the age of 25. If relatives have peptic ulcer, regardless of complaints, it is recommended to determine the acidity of gastric juice, confirm biopsies to detect H. pylori infection, and endoscopy with 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. Diseases detected in the initial stage and promptly treated - gastritis, duodenitis, H. pylori infection - prevent the development of not only ulcerative processes, but also cancer.
VaryThree stages of prevention:
- initial- when there is no disease, but there is a risk of developing it;
- medium- aimed at preventing the development of an already existing disease;
- third- performed after complications.
Primary prevention rules:
- 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. Eat in small portions, often. Eliminate "starvation" and "mono-diet". It is very undesirable to use alcoholic beverages, carbonated water, fatty, fried, smoked foods, canned foods, and fast food. It is recommended to eat cereals, soups, boiled meat and fish, fruits and vegetables. 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 accept them correctly.
- As part of medical care, regular visits to the doctor and elimination of foci of chronic infection, including timely treatment of caries, as this lowers the general immunity, which facilitates any infection, including H. Pylori.
- Starting from the age of 25, every two years they undergo a planned comprehensive endoscopic examination - endoscopy with detection of H. Pylori.
Insecondary and tertiaryPrevention is added to all rules from the first stage:
- Strictly follow the No. 1 diet. The diet is difficult to digest, avoid meat, fish and mushroom broth, strong tea and coffee, baked goods, chocolate, fresh sour fruits, spicy vegetables - turnip, radish, radish, onion. Food should be steamed, boiled or baked (without skin) in a puree form. It should be warm: not cold and not hot. Portions should be small. It is advisable to drink mineral water that reduces the acidity of the stomach.
- Eliminate various causes of ulcer exacerbation, for example, chronic gastritis.
- Follow medical instructions carefully.
All of this shows that if you are a medically literate person, listen to the recommendations of doctors, official authorized medical sources, and do not ignore scheduled examinations, in most cases, you can easily avoid the development of peptic ulcer disease and its complications.