Peptic Ulcer Disease, Diet Chart For Stomach Ulcer, And Nutrition!
Understanding Peptic Ulcer, Causes, Symptoms, Nutrition, And Diet Chart:
What Is Peptic Ulcer?
Peptic Ulcer, (also known as ulcus peptic), is a raw and painful area that occurs in the gastrointestinal tract as a result of mucosal erosion by acidic gastric juices. It may occur in the esophagus, stomach, or duodenum. Mostly the duodenum (after the stomach; the first part of the small intestine) is most likely to be afflicted by the peptic ulcer. Peptic Ulcers could occur as single or multiple ulcers and they normally measure from 10mm to 25mm across and around 0.25mm in depth. Diet Chart
An “ulcer” is an open sore.
The word “peptic” means that the cause of the problem is due to acid. Most of the time when a gastroenterologist is referring to an “ulcer” the doctor means a peptic ulcer.
The two most common types of peptic ulcers are called “gastric ulcers” and “duodenal ulcers”. These names refer to the location where the ulcer is found. Gastric ulcers are located in the stomach Duodenal ulcers are found at the beginning of the small intestine (also called the small bowel) known as the duodenum. A person may have both gastric and duodenal ulcers at the same time. Di
Signs and Symptoms of a Peptic Ulcer:
The most typical symptom is that of a gnawing persistent pain in the abdomen especially when the stomach is empty. Some people suffering from a peptic ulcer show no symptoms, but most people complain of burning pain in the abdomen which also wakes them up at the night at times. Eating relieves the pain of a duodenal ulcer, only for the pain to recur after a couple of hours.
Other symptoms which are common for both ulcers, that of duodenal and gastric ulcers, are:
- Loss of appetite (although in the case of duodenal ulcers, it sometimes increases appetite).
- Belching.
- Weight loss.
- A bloated feeling.
- Nausea.
- Vomiting (which is sometimes even blood).
- Waterbrash (rush of saliva to dilute the stomach acids after the reflux).
- And melena (unusual and bad-smelling feces).
Causes:
The lining of the duodenum is at continuous risk of erosion by the acidic juices produced by the stomach walls. The lower part of the esophagus is at risk only if and when the reflux of the acidic juices from the stomach takes place. Reflux is when there is a backward flow of the acids, that is when the acidic juices from the stomach backflow into the esophagus (throat or food pipe).
Peptic Ulcers arise in the jejunum, only when there is a massive secretion of the gastric juices. The jejunum is a part of the small intestine, which is about 8 to 10 feet in length, between the duodenum and ileum. It helps in the absorption process of the bile salts and nutrients indigestion.
Some of the main causes of the occurrence of peptic ulcers mostly could be by the consumption of a lot of :
- Alcohol or excessive coffee drinking induces high caffeine intake.
- Or even by regular ingestion of aspirin.
- Other irritants could also be bile and bacteria among others.
- They are also caused by an increase in acid secretion and a reduction in mucus production.
- For some people, peptic ulcers occur due to genetics, as they are predisposed to developing these ulcers hereditarily.
If the occurrences are frequent in the family’s medical history, it is important to take preventive measures. Psychological stress also plays a major part in aggravating an existing ulcer, thus making it even worse.
Even smoking worsens ulcers, as the nicotine in tobacco increases the amount and concentration of acids in the stomach and thus intensifying the existing ulcer or it could also lead to the creation of more ulcers. Smoking may also slow down the treatment and healing process of ulcers.
Both men and women are equally prone to the incidence of gastric ulcers, but when it comes to duodenal ulcers, more men are likely to suffer from them than women. Diet Chart Diet Chart
How Is An Ulcer Diagnosed and Treated?
Diagnosis of an ulcer is typically performed either by endoscopy (a viewing tube passed down the throat into the stomach) and tissue sample (biopsy) or by giving the patient a barium meal and then an X-ray examination. Helicobacter pylori bacteria can be diagnosed by endoscopy, or a relatively simple “urea breath test”, or by a blood test. Diet chart diet chart diet chart
Where the ulcer is related to H.pylori infection,
a permanent cure can be achieved through medication alone. A stomach-acid-reducing drug combined with antibiotics usually eradicates the bacteria and either cures the ulcer in a matter of weeks or leads to long-term remission.
Where the ulcer is unrelated to bacteria, stomach acid-reducing medication may be prescribed on an ongoing basis to protect the stomach lining. Although the majority of peptic ulcers respond well to such treatment, many patients suffer a relapse within 12 months. Thus the search for a permanent cure continues.
Eating, Diet, And Nutrition for Peptic Ulcers (Stomach Ulcers)
How can your diet help prevent or relieve a peptic ulcer?
Researchers have not found that diet and nutrition play an important role in causing or preventing peptic ulcers. Before acid-blocking drugs became available, milk was used to treat ulcers. However, milk is not an effective way to prevent or relieve a peptic ulcer. Alcohol and smoking do contribute to ulcers and should be avoided.
Here are foods to avoid for those with peptic ulcers:
One of the important things about the treatment of ulcers is that there should always be some food in the stomach to absorb the acid. Small, easily digested meals are best and anything which would scratch or sting the sore place should be avoided.
- Lemon juice.
- Vinegar.
- Vinaigrette.
- Pickles.
- Spices.
- Chutneys.
- Cereals.
- Very hot food.
- And very cold food.
- Very hot or cold drinks.
- Strong alcohol.
- Curries.
- Rich pastries.
- Wholemeal bread.
- Doughnuts or doughy buns.
- Biscuits or cakes made with wholemeal flour or oatmeal rolled oats, nuts dried fruit, or spices.
- Fired food (hot fat contains an acid that irritates the stomach).
- Baked or grilled cheese.
- Soused or highly seasonal fish, also fried fish.
- Jam containing seeds (unless sieved).
- Coarse vegetables.
- Fried potatoes.
- Whole vegetables or coarse vegetables such as cabbage or celery. Vegetables must be pureed first.
Diet And Ulcers:
In general, if you want to ease the symptoms of an ulcer, or reduce your risk of developing one in the first place, you should avoid eating large meals, as they encourage the production of excessive amounts of stomach acid to digest the food.
In addition, diets that are high in fat and sugar, but low in fiber are known to cause a variety of adverse effects in the gut. Here are some specific dietary tips which may help to reduce the symptoms and formation of peptic ulcers.
Reduce your intake of:
1. Spicy Foods:
Although there is no clear evidence to suggest these foods cause ulcers, they have been shown to aggravate symptoms. So avoid foods like:
- Chili peppers.
- Black pepper.
- Mustard.
- Curry.
- And other strong spices.
2. Alcohol, And Caffeine Intake:
Both alcohol and caffeine can be problem foods for anyone with an ulcer, or at risk from an ulcer, and should be avoided or consumed sparingly. These items typically increase the acidity of the stomach and therefore can contribute to ulcer development or aggravate symptoms of existing ulcers.
3. Sodium:
An American study has linked high intakes of salt and soy sauce to a higher risk of stomach ulcers. So avoid adding salt to your the food on your plate and use food labels to check for low-sodium varieties. Foods commonly high in sodium include:
- Canned soup.
- Tortilla chips.
- Potato/corn chips.
- Salted nuts.
- Salted meats (eg. bacon), blue cheese, cornflakes. Switching to a diet containing fewer packaged or processed foods will definitely reduce your sodium intake.
4. Add Oily Fish To Your Diet:
Some studies suggest that omega-3 fatty acids – found in oily fish, like salmon, mackerel, sardines, and herring – may help reduce the risk of ulcers. It seems that these omega-3 fats increase our production of prostaglandins, compounds that help to protect the lining of the alimentary canal, that is, the entire digestive passage, including the lining of the stomach and intestines.
5. General Advice About Dietary Vitamins And Minerals:
The protective antioxidant effects of certain micronutrients should help to lower the risk of ulcers and ease symptoms when an ulcer has already formed.
For instance,
Some nutritionists recommend eating more vegetables and fruit, such as:
- Carrots.
- Kale.
- Red-green peppers.
- Cabbage juice.
- Apricots.
- And kiwi fruit, for their beta-carotene and vitamin C content, in order to help protect the lining of the stomach and intestine.
- Vitamin E from foods like wheat germ, hazelnuts, cold-pressed sunflower seed oil, soybean oil, should also help, as should zinc from seafood and whole grains.
Other nutritionists are strong advocates of the healing properties of amino acids, the basic building blocks of proteins, and recommend L-Glutamine for peptic ulcers.
Good food sources include:
- Wheatgerm.
- Cheddar cheese.
- Almonds.
- Sunflower seeds, and sesame seeds.
6. Possible Herbal Remedies For Ulcers:
In some tests, a tablet form of licorice root – which has been treated to remove an acid that may raise blood pressure – has been shown to protect against ulcers caused by the adverse effects of aspirin on the stomach lining. Camomile tea may also ease the symptoms of ulcers. Diet Chart Diet Chart
Table 1 – Diet Chart For Stomach Ulcer For A Week:
| Sunday | |
| Breakfast (8:00-8:30 AM) | Brown bread Egg sandwich (1) + 1 apple |
| Mid-Meal (11:00-11:30AM) | Coconut water (1 glass) + 2 biscuits |
| Lunch (2:00-2:30 PM) | Roti (2) + Soybean Curry (1 cup) + 1/2 cup curd |
| Evening (4:00-4:30 PM) | Tea (1 cup) + 1 Roasted Papad/ murmured/ bhuna chana/ roasted namkeen |
| Dinner (8:00-8:30 PM) | Roti (2) + Bottle Gourd Curry (1 cup) |
| Monday | |
| Breakfast (8:00-8:30 AM) | Brown bread Potato sandwich (1) + 1 cup low-fat curd |
| Mid-Meal (11:00-11:30AM) | 1 cup chhach |
| Lunch (2:00-2:30 PM) | rice (1 cup) + Fish/ chicken Curry (1 cup) + cucumber salad |
| Evening (4:00-4:30 PM) | Tea (1 cup) + 1 Roasted Papad/ murmured/ bhuna chana/ roasted namkeen |
| Dinner (8:00-8:30 PM) | Roti (2) + Pointed Gourd Curry (1 cup) |
Tuesday |
|
| Breakfast (8:00-8:30 AM) | Brown bread vegetable sandwich (1) + 1 pear |
| Mid-Meal (11:00-11:30AM) | 1 cup chana sattu |
| Lunch (2:00-2:30 PM) | Roti (2) + Mushroom n Green pea Curry (1 cup) + 1/2 cup curd |
| Evening (4:00-4:30 PM) | Tea (1 cup) + 1 Roasted Papad/ murmured/ bhuna chana/ roasted namkeen |
| Dinner (8:00-8:30 PM) | Roti (2) + Beetroot Curry (1 cup) |
| Wednesday | |
| Breakfast (8:00-8:30 AM) | vegetable Poha (1 cup) + Pomegranate juice (1 glass) |
| Mid-Meal (11:00-11:30AM) | 1 cup chhach |
| Lunch (2:00-2:30 PM) | Roti (2) + Chana Dal (1 cup) + 1 cup karela vegetable + green chutney |
| Evening (4:00-4:30 PM) | Tea (1 cup) + 1 Roasted Papad/ murmured/ bhuna chana/ roasted namkeen |
| Dinner (8:00-8:30 PM) | Roti (2) + Potato n Beans Curry (1 cup) |
| Thursday | |
| Breakfast (8:00-8:30 AM) | Scrambled Egg (2) +brown bread Toasted (1) + 1 apple |
| Mid-Meal (11:00-11:30AM) | Coconut water (1 glass) + 2 biscuits |
| Lunch (2:00-2:30 PM) | Rice (1 cup) + kidney beans Curry (1 cup) + green chutney |
| Evening (4:00-4:30 PM) | Tea (1 cup) + 1 Roasted Papad/ murmured/ bhuna chana/ roasted namkeen |
| Dinner (8:00-8:30 PM) | Roti (2) + lotus stem (1 cup) + green chutney |
| Friday | |
| Breakfast (8:00-8:30 AM) | Mashed Potato n Carrot Sandwich (1) + 1 cup curd |
| Mid-Meal (11:00-11:30AM) | 1 cup chhach |
| Lunch (2:00-2:30 PM) | Roti (2) + Moong Dal (1 cup) + 1 cup ladyfinger + green chutney |
| Evening (4:00-4:30 PM) | Tea (1 cup) + 1 Roasted Papad/ murmured/ bhuna chana/ roasted namkeen |
| Dinner (8:00-8:30 PM) | Roti (2) + Potato n Drumstick Curry (1 cup) |
| Saturday | |
| Breakfast (8:00-8:30 AM) | Besan Cheela with paneer stuffing (2) + Pomegranate Juice (1 glass) |
| Mid-Meal (11:00-11:30AM) | 1 cup chana sattu |
| Lunch (2:00-2:30 PM) | Roti (2) + Chicken Curry (1 cup) + onion salad |
| Evening (4:00-4:30 PM) | Tea (1 cup) + 1 Roasted Papad/ murmured/ bhuna chana/ roasted namkeen |
| Dinner (8:00-8:30 PM) | Roti (2) + Broad Beans Curry (1 cup) |
Lifestyle And Risk Of Ulcers:
Damage caused by smoking increases the risk of ulcer formation and slows ulcer healing. Another reason to quit! The effects of stress on ulcer development are less easy to assess, although a stressful lifestyle clearly impacts eating habits, alcohol consumption, and smoking.
So if you want to lower your risk of an ulcer,
taking steps to alleviate the stress in your life is almost certain to be beneficial. caused by smoking increases the risk of ulcer formation and slows ulcer healing. Another reason to quit! The effects of stress on ulcer development are less easy to quantify, although a stressful lifestyle is known to affect eating habits, alcohol consumption, and smoking.
So if you want to lower your risk of an ulcer, taking steps to alleviate the stress in your life is almost certain to be beneficial.
Table 1- Nutritional recommendations for patients with PU to accelerate the healing process.
|
Characteristics |
Recommendation |
|
|
Daily energy needs (DEN) |
Sufficient to maintain or recover the nutritional status 30-35 kcal/kg: weight gain31 |
|
|
Acute phase |
Recovery phase |
|
|
Carbohydrate (%)35 |
50-60 |
50-60 |
|
Proteins ( g/kg/weight)35 |
1.2 |
1.5 |
|
Lipids (%)89,35 |
25-30 |
25-30 |
|
Zinc (mg)90 |
11 |
40 |
|
Selenium (μg)91 |
55 |
400 |
|
Vitamin A (μg)90 |
900 |
3000 |
|
Vitamin C (mg)90 |
75 |
500 |
|
Vitamin B12 (μg)90 |
2.4 |
2.4 |
|
Folic acid (μg)90 |
400 |
400 |
|
Iron (mg)90 |
45 |
45 |
|
Fiber (g)90 |
20 to 30 |
20 to 30 |
|
Probiotics (UFC/day)89 |
109 – 1011 lactic acid bacteria |
109 – 1011 lactic acid bacteria |
Source: 89Marrota; Flock (1993); 35Reis (2003); 90DRI’S (UL); 90DRI’S (RDA)
Table: 2- Allowed foods, foods that should be consumed with caution and foods prohibited for dyspeptic patients.
|
Food groups |
Allowed |
Use with caution |
Prohibited |
|
Dairy |
Milk, low-fat cheese, yogurt, fermented milk |
Fatty cheeses (mascarpone, cream cheese, gorgonzola) |
– |
|
Oilseeds |
Flaxseed, Brazilian nut, walnuts |
– |
– |
|
Oils and olive oils |
Vegetable oils, olive oil |
– |
Fried foods |
|
Fruits |
Apples, papaya, melon, banana |
Orange, pineapple, acerola, passion fruit |
Lemon |
|
Vegetables |
Leafy dark green vegetables, carrot, beet, green bean, spinach, kale, radish, zucchini, leek |
Broccoli, cauliflower, cabbage, cucumber, onion, red pepper |
Spicy pepper (black pepper, chilies) |
|
Legumes |
Bean soup, lentils, chickpeas, soybean |
Beans |
– |
|
Meats |
Lean meat( beef, pork, chicken, fish) |
Fatty meat, organ meats, sausages |
– |
|
Sweets |
– |
Concentrated sweets |
Chocolates |
|
Beverages |
Natural juices |
Citrus/acidic fruit juices |
Coffee, black tea, cola drinks, fizzy |
|
Other foods |
– |
Industrialized seasonings, spices, and condiments |
Source: ABCD Arq Bras Cir Dig 2014; 27(4): 298-302
Summing Up:
Dietary factors are increasingly recognized to have an important role in both triggering and alleviating symptoms in a large proportion of patients with PUD (either GU or DU) and functional dyspepsia. Evidence suggests that Fatty foods seem to be the main trigger, but other foods such as:
- Unfermented milk and dairy products, citrus fruits, spicy foods, coffee, alcohol, high intake of salt, and soy sauce have also been concerned.
- On the other hand diets rich in fiber, fermented milk, polyunsaturated fatty acids (especially n-6 family) and vitamins A and C appear to be a positive role in improving the symptoms.
However,
blind trial tests do not provide consistent results. Moreover, although patients identify specific foods as triggers of their PU symptoms, these patients often do not seem to make behavioral adjustments in an attempt to improve those symptoms; that is, any differences in dietary intake and lifestyle between patients and healthy individuals are small.
A diet rich in fiber should receive emphasis, as is true on general principles.
If DU is related not only to the presence of a factor such as H pylori but also to impaired gastrointestinal function, then additional intake of dietary fiber could contribute to reduced recurrence of DU.
- Fermented milk and several of its component whey proteins have emerged as potential candidates for complementary therapy for H. pylori-induced PUD.
- The potential efficacy of individual whey proteins in H. pylori eradication has also been a subject of interest in recent research.
However,
The role of fermented milk or whey proteins in clinical practice is not yet universally accepted precisely defined or widely discussed. On the basis of the available evidence, no strong argument can be made for significant adjustment of dietary pattern; it needs more work on this, including alterations in intake of alcohol or caffeine, specifically to address symptoms of dyspepsia.
Despite the lack of compelling evidence in the literature, interventions supported by judgment and physiologic mechanisms, such as restriction in alcohol or caffeine intake, are reasonable on a trial basis in individual patients. Avoidance of large meals in close proximity to bedtime is a standard and sensible practice in the treatment of GERD, as are positional adjustments that may diminish reflux.
A balanced diet is vital in the treatment of PUD,
once food can prevent, treat, or even alleviate the symptoms involving this pathology. However, additional studies are required to address more specifically the diet therapy for the treatment of PUD and non-ulcer functional dyspepsia that affects a large part of the population is necessary. Diet Chart
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Disclaimer: “Nothing in this article makes any claim to offer cures or treatment of any disease or illness. If you are sick please consult with your doctor.”
References:
Brito, G.A.C.; Ribeiro, R.A.; Cunha, F.Q.; Souza, M.H.L.P. Hydrogen sulfide prevents ethanol-induced gastric damage in mice: Role of ATP-sensitive potassium channels and capsaicin-sensitive primary afferents neurons. J. Pharmacol. Exp. Ther. 2009, 330, 764–770.
Konturek, S.J.; Pawlik, W. W. Interaction of nonsteroidal anti-inflammatory drugs (NSAID) with Helicobacter pylori in the stomach of humans and experimental animals. J. Physiol. Pharmacol. 2006, 57, 67–79.Excellent nutrition is the basis of a healthy lifestyle!
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