Problems with the gastrointestinal tract force a person to radically change his eating habits. And this is understandable, because experiencing intense pain, tingling, burning, heaviness, tightness in the stomach or constant heartburn, youNot only can you give up your favorite dishes, but you can also lose your appetite completely. However, exclusion of food can cause even more harm to the patient. Therefore, be clear about how to eat if you have stomach problems. Understanding will provide relief from the acute symptoms of the disease and once again feel the joy of life. Today we will see in detail what diet you should take if you have a stomach ulcer.
Diet is the most important direction of therapy for stomach ulcers.
Nutrition certainly has an important impact on our health. Properly formulated diet can accelerate the healing of ulcers and prevent the development of complications. Therefore, every person facing a similar disease should knowEssential is how to eat properly when there is a stomach ulcer. Of course, diet does not replace treatment, but without special nutrition, drug therapy will not be effective.
With ulcers, the integrity of the mucous membrane is compromised, so digestion, accompanied by the secretion of hydrochloric acid, causes a lot of pain. Which diet for stomach ulcers will help relieve symptoms and accelerate healing? The main goal of nutrition is to promote the rapid closure of the ulcer. However, this process is long, and if, with the first signs of relief, the patient returns to the foods that provoked the development of the disease, the ulcer mayIt won't take long. To prevent this from happening, therapeutic nutrition should become a way of life for several months or years.
How to eat if you have stomach ulcer?
You do not need to starve, because then the acid begins to corrode the stomach walls even more, which only aggravates the disease. Therefore, to avoid feelings of hunger and discomfort, adhere to the diet prescribed by the gastroenterologist. It is mandatory to do this. What should you eat when you have stomach ulcer?
- Food should not irritate the mucous membrane and increase the acidity of gastric juice.
- You should eat only easily digestible food in liquid, mashed, crushed form, chewing it slowly.
- Hot and cold foods are prohibited, as such dishes hinder enzyme formation and slow down the restoration of the mucous membrane. The optimum temperature is from 26 to 33 degrees Celsius.
- 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 patients with stomach 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 number 1". Let's look at the basics of this diet.
Table number 1 - Diet for exacerbation of stomach ulcers
So, the most important question: what can you eat with a stomach ulcer? A medical diet accompanies the medicinal treatment of ulcers during periods of low intensity and remission and lasts from six months to a year. Therapeutic nutrition involves reducing the mechanical, chemical and thermal load on the painful stomach. Food is used for regeneration andHealing of the damage should activate healing, 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 should be thoroughly cleaned of skin, bones, cartilage, veins, tendons and fat. Must go. When cooking meat, you need to drain the boiling water twice to reduce the concentration of animal fat as much as possible.
Protein foods are healthy: lean meat of rabbit, turkey, chicken, veal, beef, lean sea fish, soft-boiled eggs or omelettes. It is necessary to enrich the diet with fats in the form of unsalted butter, and vegetable oils onlyAdd to prepared dishes, do not use them for heat treatment.
Among carbohydrate foods, some vegetables (potatoes, beets, carrots, cauliflower, broccoli, pumpkin, zucchini), well-cooked cereals (oatmeal, semolina, rice, buckwheat), as well as various pasta, dried white bread. , Crackers are recommended. Biscuits, unleavened biscuits.
Sweets included in the diet include purees, mousses, jellies made from soft, sweet berries and fruits, baked fruits, natural marshmallows, marshmallows and marmalades, jams and marmalades. Honey is recommended as it soothes pain and inflammation. And helps in neutralizing the acid.
It is useful to drink milk, which envelops the walls of the stomach and protects the mucous membrane. Fermented milk products should be included in the diet with caution and make sure that they do not contain vegetable fats (for example, palm oil). Do not be, which have a harmful effect on digestion. Let's say pilaf, acidophilus, fresh (! ) kefir, natural yogurt and sour cream, low-fat cottage cheese in the form of unleavened cottage cheese.
Recommended drinks: decoction of chamomile, rose hips, mint, weak tea, compotes, jellies, fruit drinks, diluted sweet juices, as well as water at room temperature. With the permission of the doctor, you can drink fresh cabbage juice, in whichHas 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 grams per day. But the less its entry into the body of a person suffering from stomach ulcer, the better. It should be borne in mind thatWe also get salt from finished products; For example, it is present in large quantities in cheeses, including processed cheeses.
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 provoke bleeding. All fatty, spicy, salty, sour, smoked, fried and canned foods, sausages, offal, spices, ketchups, sauces and marinades are excluded. You should also eat white cabbage, radishes, radishes, turnips, sour greens (sorrel, spinach), cucumbers, legumes, mushrooms, garlicYou will have to give up horseradish, mustard and onion.
Also on the list of prohibited items include strong tea and coffee, citrus fruits, nuts, wholemeal bread, any baked goods, including homemade baked goods, chocolate, ice cream, alcohol and carbonated drinks.
At different stages of the disease, different subtypes of table number 1 are used. Which diet should be adopted for stomach ulcers depends on the patient's well-being and the severity of symptoms.
Therefore, to reduce acute exacerbations, a more strict diet is recommended.— Table No. 1A, This diet is prescribed during the period of acute illness with severe 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 towards digestion andThere is maximum exclusion of any effect of food on the stomach.
What can you eat and what not when stomach ulcer increases? The diet for acute stomach ulcer consists of dividing 6-7 meals per day into very small portions and reducing the energy value (up to 2010 kcal). All foods that cause the secretion of gastric juice and the mucous membraneare absolutely unacceptable. Salt consumption is significantly reduced. Food, boiled and steamed, served in liquid or pure state. Cream soups, liquid and viscous porridges and soufflés are widely consumed. is used to.
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 starts healing. After this the patient goes to gentlediet number 1, whose purpose,not only provide protection to the mucous membrane, 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 the preparation changes: completeFrom liquid, pureed food 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, as well as mashed potatoes or soufflé made from potatoes, beets and carrots are allowed. Various mousses, jellies, jellies with milk, sweet fruits and juices, honey and sugar are introduced. Unleavened cottage cheese and egg whites, sour cream, boiled dishes made from mild cheese and butter are allowed.
Stomach Ulcer - Symptoms and Treatment
What is stomach ulcer? We are Dr. Nizhegorodtsev A. , a surgeon with 17 years of experience. S. In the article we will discuss the causes, diagnosis and treatment methods.
Definition of disease. due to disease
stomach ulcer(Stomach ulcer) is a chronic, recurrent disease in which defects develop in the gastric mucosa. If left untreated or untimely treated, it can lead to disability or death.
causes of stomach ulcers
The most common cause of stomach and duodenal ulcers isHelicobacter pylori infection, It is found in approximately 70% of patients with gastric ulcers and 90% of patients with duodenal ulcers. The prevalence of H. pylori as the main cause of gastric and duodenal ulcers has declined in recent years in developed countries (e. g. For example, in Sweden it is 11%. Generally, this is due to improvements in the quality of medical care, which leads to timely diagnosis and treatment of infections, as well as improvements in sanitary conditions (for example, improved access to tap water). quality). The prevalence of infection in our country reaches about 70%, while most of the infected people do not even suspect it and do not complain about anything.
The second leading cause of peptic ulcer disease isPainkillers, especially non-steroidal anti-inflammatory drugs (NSAIDs). On the one hand, the speed of action and versatility of NSAIDs brought people relief from various pain, on the other hand, due to the long-term uncontrolled use of these drugs, stomach and"Medicinal" ulcers of the duodenum began to occur more frequently.
ranks third among the causes 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 anemia caused by B12 deficiency, gastrinoma (tumor of the pancreas), etc.
The likelihood of developing peptic ulcer is significantly influenced bypredisposing factors, which are:
- Neuro-emotional overstrain (stress);
- Violation of daily routine and nutrition, consumption of refined foods and fast food;
- Complex heredity (for example, the presence of peptic ulcer in parents).
If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous to your health!
symptoms of stomach ulcer
Pain- The most common symptom of gastric ulcer. It is localized in the upper stomach and, depending on the location of the ulcer, can subside or intensify immediately after or after a meal. And if the ulcer is localized in the duodenum, 30-The pain may become stronger (or less) after 40 minutes.
The intensity of pain varies from pronounced and transient, which can cause reflex vomiting immediately after eating, to weak and constant, which intensifies in the morning and goes away after eating. Sometimes the patient experiences "stomachOne may wake up at night due to a feeling of pain in the "pit of ribs" (in the hollow area below the ribs) or in the upper abdomen.
Feeling of "early fullness" and heaviness in the stomachPeptic ulcer disease also has symptoms. A person often begins to reduce portions of food, since the absorption of even small amounts of food ends up on inflamed areas of the gastric mucosa and ulcers, causing these unpleasant sensations. Can.
bad breath, nausea, change in taste, coating on the tongue- Frequent companion of any inflammatory diseases of the upper gastrointestinal tract, including gastritis (inflammation of the stomach), against which ulcers often appear.
Painless form of peptic ulcerIt is most dangerous for its terrible complications, which sometimes develop with lightning speed in a seemingly healthy person. Sometimes they even result in fatal consequences. For example, perforation of the ulcer of the stomach wall. time, the patient experiences severe intense pain, leading to shock and disorientation, sometimes even loss of consciousness. It is scary to imagine what would happen if this person became a car, bus driver or airplane pilot. What will be the outcome? The same misfortune can befall a person vacationing away from civilization: due to the lack of opportunity to receive emergency medical care, the chances of survival are significantly reduced.
Complications of stomach ulcer
bleeding from ulcers- The most common complication. This is dangerous because if the wall of the vessel in the ulcer is damaged and bleeding begins, the person does not feel anything, especially if the ulcer is painless. Reflex vomiting occurs when the stomach fills with blood. . This is how the disease manifests itself. Then the patient develops symptoms of anemia:
- Blood pressure decreases;
- The pulse becomes faster;
- The skin turns pale and becomes covered with sweat;
- Weakness increases;
- Shortness of breath appears despite reduced physical activity.
When the ulcerative defect and the source of bleeding is located in the lower parts of the stomach or the duodenal bulb, first symptoms of blood loss appear, and then liquid, tarry ("black") stools.
abdominal wall perforation- Formation of a through hole when the ulcer spreads through all layers of the stomach wall. Through this hole, the contents of the stomach flow into the abdominal cavity and causeperitonitis- Total swelling of the abdominal tissues. The moment of perforation is accompanied by sharp, extremely intense pain, up to traumatic shock, a decrease in blood pressure and a sharp pallor of the skin. Subsequently, intoxication (symptoms of "poisoning") and multiple organ failure increases. Without emergency medical care, a person dies with such a complication.
ulcer penetrationCan 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, it can spread to this neighboring organ. Then the first manifestation of gastric ulcerThere may be a gradual increase in symptoms of inflammation in secondary affected organs.
treachery- Transformation of peptic ulcer into stomach cancer with all the ensuing consequences. The danger of such degeneration appears if the ulcer exists for a long time.
scar stenosis- A dangerous consequence of healing ulcers. As a result of the lesion, the lumen of the stomach or duodenum can become quite narrow, to such an extent that it becomes difficult or impossible for solid and liquid food to pass through it. In this case, the patient may lose weight. becomes exhausted, he quickly gets tired and slowly dies of dehydration and hunger.
Diagnosis of stomach ulcers
Diagnosis of a specific ulcerStomach 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 features of the course of the disease, and identifies painful areas during palpation. Clarifies the limitations and their nature. If necessary, the doctor prescribes blood tests and instrumental tests to create a clear picture of the patient's health status and develop the most optimal treatment plan.
When the diagnosis is more difficult to establishunusual or painless ulcers, especially when complications arise in the form of penetration - spread of the ulcer to a neighboring organ.
The first sign of an asymptomatic or "silent ulcer" 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, the history is clarified, blood is taken. Tests, and, if necessary, EGD, ultrasound, X-ray.
The optimal method for diagnosing peptic ulcer disease (and if it is painless, the only and effective method)routine 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, the condition of the upper gastrointestinal tract, the presence of inflammatory and erosive-ulcerative processes andComprehensive information on the nature, as well as the appearance of the neoplasm appears.
Using special techniques during endoscopy, the acidity of the gastric juice 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 symptoms of gastric bleeding, EGD is used to identify sources of bleeding that can be immediately eliminated, allowing the patient to avoid serious surgical intervention.
stomach ulcer treatment
Peptic ulcers are treated by a physician or gastroenterologist. The aim is to eliminate the symptoms, heal the ulcer, and eliminate the cause of the disease through diet, lifestyle changes, and medication.
To get rid of H. pylori infection that causes ulcers, doctors prescribe antibiotics, and acid-reducing medications to reduce the acidity of gastric juice. If a stomach ulcer is caused by taking painkillers (NSAIDs) or other drugs that can trigger the development of ulcers, the doctor will select for the patient other drugs similar to the "culprits" of the disease, which have an ulcer-forming effect. Does not happen.
If you have peptic ulcer, it is very important to give up bad habits, primarily smoking and excessive alcohol consumption. This will eliminate the risk of complications.
In addition, during treatment, you need to adhere to a certain diet - diet number 1. It involves a nutritious diet, divided into 5-6 meals a day. The intake of strong stimulants of gastric secretion (ketchup, hot spices), coarse foods and dishes is limited. Food is mainly pureed, Prepared by steaming or boiling in water; Fish and low-fat meat are served in pieces. Very cold and hot dishes are excluded from the diet. Limit the intake of table salt.
After restoring the balance between aggressive and protective factors, ulcers heal on their own within 10–14 days.
In case of complications of peptic ulcer disease (perforation, stenosis, uncontrolled, recurrent bleeding) or ineffectiveness of drug therapy, treatment is performed surgically. However, surgery always carries a great risk. For peptic ulcer, it is considered a last resort. If the disease can be avoided by not allowing it to progress, then it is better 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 a careful attitude towards one's health, the probability of developing a stomach ulcer is extremely low. Violation of sleep and nutrition patterns, overwork, stress, regularNeglect of medical examinations, and ignoring one's own minor discomforts often lead to the development of complicated forms.
Preventing peptic ulcer disease is much easier, faster and cheaper than treating its advanced forms and complications. For this purpose, the World Health Organization (WHO) recommends that, starting at the age of 25, youHave annual preventive checkups with a therapist or gastroenterologist. If relatives had peptic ulcer, then, regardless of complaints, endoscopy with determination of the acidity of gastric juice, biopsy to determine H. pylori infection is recommended. are clarified and suspicious areas are examined histologically. This is conducted every two years. In the absence of complaints, preventive comprehensive endoscopy is indicated every two years after 35 years. In the early stagesIdentified and promptly treated diseases – gastritis, duodenitis, H. pylori infection – will avoid not only ulcerative processes, but also the development of cancer.
varyThree steps of prevention,
- primary- when there is no disease, but there is a risk of developing it;
- secondary- with the aim of preventing the progression of a pre-existing disease;
- tertiary- Performed after the development of complications.
rules of 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 need to eat frequently, in small portions. Need to "eliminate hunger" and "mono-diets". It is extremely undesirable to consume alcohol, soda, fatty, fried, smoked foods, canned food and fast food. Cereal porridge, soups, boiled meatAnd it is recommended to eat fish, vegetables and fruits. Moderate consumption of baked goods and sweets is allowed.
- Adopt 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.
- Visit the doctor regularly 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. Is.
- Starting from the age of 25, once every two years, undergo a planned comprehensive endoscopic examination - endoscopy with the determination of H. pylori.
Insecondary and tertiaryAll prevention rules from the first step have been added:
- Strictly follow diet number 1. Avoid eating hard-to-digest coarse foods, meat, fish and mushroom broths, strong tea and coffee, baked goods, chocolate, fresh citrus fruits, pickled vegetables - turnips, radishes, radishes, onions. Steaming food, boilingOr cooked (without layers). It should be warm: neither cold nor hot. Portions should be small. It is advisable to drink mineral water, which reduces the acidity of the stomach.
- Eliminate any causes of ulcer aggravation, for example, chronic gastritis.
- Follow medical instructions carefully.
All this suggests 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 authoritative medical sources and undergo regular examinations. Don't ignore.