Food can be a cure for many diseases. And you can't argue with that. It is not for nothing that in Soviet times, health care gave priority to diet for stomach ulcers. Compliance with the principles of therapeutic nutrition was strictly mandatory.
The secret is that peptic ulcers of the digestive tract often heal even without treatment, but with proper nutrition.
Briefly about the ulcer
An ulcer is a single or multiple defect in the gastric mucosa or duodenum, which leaves a scar after healing. When performing FGDS, it can be barely noticeable (1-2 mm) or huge (more than 1 centimeter).
Even today it is a pathology from which people die. An invisible enemy, bleeding claims thousands of lives every year. Gastric ulcer loves large cities and goes off scale where high level economic development. Among the population, he prefers carriers of the first blood group.
There are so many causes of ulcers that almost every person is at risk. You can start the list of factors for its appearance with the stomach - this is a disruption of the secretory, motor and protective functions. Add the state of neuropsychic activity, hormonal levels and end with heredity with the presence of pathogenic bacteria. But this is also an incomplete list.
One of the important points in the appearance of ulcers is poor nutrition, when a person prefers spicy, rough foods, eats hastily, often drinks alcohol and smokes a lot.
Features of nutrition for stomach ulcers, general principles
How should you eat to live without stomach pain?
The first thing to do is evaluate your diet. Gastritis and peptic ulcers in themselves signal the need to change habits and eating habits. Food should become medicine, water that wears away the stone.
Diet therapy will help with this. It solves a number of problems: normalizes gastric motility, increases the protective properties of mucus, neutralizes acid, and stimulates the healing process. In fact, therapeutic nutrition should be based on products that weakly stimulate secretion, quickly leave the stomach and have little irritation to its mucous membrane.
Principle one - reduce the aggressive effect of hydrochloric acid.
It is the leading damaging factor. It is necessary to remove foods that stimulate the secretion of gastric juice. This includes everything that makes food spicier, piquant, and stimulates the appetite: spices, herbs.
All drinks containing alcohol, strong tea, coffee, Coca-Cola, soda. Rich meat broths. Food prepared by frying: meat, fish, potatoes and other vegetables.
Principle two - do not injure the mucous membrane. Eliminate rough foods: raw vegetables with solid fiber (radish, turnip), coarsely chopped cucumbers. Dried, dried fish, tough meat, sour berries with small seeds (gooseberries, currants). Extremely cold or hot food.
Ideal food is cooked in a slow cooker or steamer.
Principle three - don't overeat. It should become habitual fractional meals(5-6 times a day). The daily calorie intake should be 2800-3000 kcal
How to control the secretion of gastric juice? By consuming certain foods you can increase or decrease the secretion of hydrochloric acid. Compliance simple recommendations will allow you to forget about the disease.
Prohibited foods for ulcers:
- Flour products: brown bread, especially fresh, fried pies, pastries with cream.
- From the meat set: fatty fried meat, meat broths, cabbage soup, rich borscht, canned food.
- Fruits and vegetables: sour with coarse fiber when chopped raw. It is better to bake or boil.
- Drinks: carbonated, coffee, soda, Coca-Cola.
- Spices: red and black pepper, hot sauces, mustard, horseradish.
You also need to pay attention to individual intolerance to foods that cause heartburn and indigestion. Avoid food processing such as frying.
Allowed dishes and products:
- From flour products: white stale bread, crackers, dry cookies.
- From meat dishes: boiled and lean meat, fish, white poultry. Boiled lamb, beef, pork, poultry. Steamed cutlets, meatballs, and zrazy are also allowed.
- Dairy products: cream, milk, low-fat sour cream. Everything is not sour and low-fat.
- First courses: various slimy soups with the addition of milk and cereals.
- Vegetables and fruits: not sour without rough skin and fiber when boiled.
- Drinks: still water, jelly, compotes, weak black tea, herbal tea. Juices from vegetables (potatoes, cabbage), decoctions of flax seeds, rose hips, oats.
From the list of these products you can create an approximate diet.
Diet for stomach ulcers - weekly menu
- Monday
Prepare any slimy porridge with milk and tea with butter. Some kind of baked fruit with rosehip infusion. You can have chicken noodle soup and mashed potatoes. Dry cookies, jelly. Pumpkin casserole for dinner and an hour before bed a glass of flax seeds.
- Tuesday
Milk with black tea, dry biscuits and an omelette. Any vegetable puree soup with boiled meat, compote, curd mass with pumpkin and fruit jelly. Semolina porridge with jam and still mineral water an hour before bedtime.
- Wednesday
Herbal tea (linden), raw egg, white bread with butter, low-fat cottage cheese, baked fruits and pureed vegetables. Steamed fish and slimy porridge. Boiled beets with the addition of prunes. A glass of milk before bed.
- Thursday
Lazy dumplings, milk and tea. Baked vegetables and porridge in the form of a “spread” with meat pate. Vegetable puree soup and beef with pumpkin, oatmeal jelly. Semolina porridge with tea and butter. At night, a rosehip drink.
- Friday
Omelet with steamed vegetables, jelly. Boiled white poultry and pureed porridge, bananas, baked apples and curd with vermicelli. Yogurt.
- Saturday
Burak with vermicelli baked in the oven, milk, peach, cereal soup with carrots and steamed cutlets with porridge (buckwheat, rice).
- Sunday
Meat pate, jelly and puree. Vegetable stew baked in the oven or slow cooker. Barley soup with poultry, semolina porridge with jam and tea with milk. Before bed: chamomile tea.
What diet is prescribed for stomach ulcers?
Depending on the stage of the peptic ulcer (open ulcer, scarring stage or remission period), different types diets Some types of tables are also divided into “a” and “b”, intended for a more strict diet.
For diseases of the stomach and duodenum, diets No. 1, No. 1 “a” and No. 1 “b” are indicated. As a person recovers, he moves from one diet to another, thus expanding his diet. This is reasonable; compliance with the rehabilitation period will help avoid relapse.
Diet No. 1 for stomach ulcers
This diet takes place during the formation of a fresh scar, when the exacerbation of peptic ulcer disease and the phenomenon of acute gastritis subsides.
Moderately mechanically and chemically gentle food is provided, with a decrease in irritants. In fact, it is a physiologically complete diet, but in pureed form, cooked in steam or water. Baking without crust is acceptable.
Table salt is moderately limited. Very cold and hot dishes are excluded. The frequency of meals is at least 6 times a day. Milk before bed is good.
For gastritis with high acidity. To table 1 “a” you are allowed to add stale white bread, low-fat cottage cheese, dry cookies, non-sour dairy products, porridge with added butter, steamed cutlets, white poultry, boiled meat, fish (pike perch). Finely chopped greens and vegetables or chopped in a blender are allowed, berries are allowed, but sweet ones.
Diet 1 "a" for stomach ulcers
It is also called pureed food. The most strict diet. This is a diet for exacerbation of stomach ulcers, gastritis, and burns of the esophagus.
Prescribed for 8-10 days. Its goal is maximum sparing and peace of the inflamed gastric mucosa. Basic principle: eat frequently (at least 6 times a day), in small portions in liquid form. The emphasis is on milk, slimy soups (barley, oatmeal, rice), eggs, both raw and soft-boiled, various types of jellies, and jelly from sweet fruits. “Muddy” porridge with milk and rice is allowed. Good for the gastric mucosa semolina.
Boiled meat in the form of a soufflé. Bread and crackers are prohibited. Vegetable side dishes are not recommended. When cooking, limit salt (it increases secretion). During an exacerbation, it is good to include rosehip drinks in the diet for stomach ulcers, raw potatoes, cabbage, wheat bran on an “empty” stomach.
Diet No. 1 “b” for stomach ulcers
This table is less strict, shown after table No. 1 “a”.
Such a diet for stomach and duodenal ulcers can be considered a stress diet. Here you can add 50 grams of crackers, mashed porridge with butter, mashed potatoes, meat and fish dumplings, and meatballs. Cereal, milk, pureed soups. Pureed milk porridges are shown.
The frequency of meals is maintained up to 6 times.
For stomach ulcers during the period of exacerbation of peptic ulcer disease, it is not prescribed. It is indicated for hepatitis and cholecystitis in remission. Its goal is nutritious nutrition, which should be provided by a healthy stomach.
A suitable diet for stomach ulcers is table No. 5 “a” and No. 5 “p”. They recommend gentle food, which does not contradict stomach diseases.
Diet for stomach ulcers during exacerbation, menu
During this period, for 10-14 days, table No. 1 “a” is shown, then table No. 1 “b” and only then we move to table No. 1.
In the first days you need a strict diet.
- Cabbage juice (half a glass);
- Milk steam omelette, glass of milk;
- Then milk jelly (glass);
- Slimy rice soup, meat in the form of pate;
- Potato juice (half a glass);
- Pike perch pate, oatmeal, jelly;
- At night: milk (half a glass).
During this period, the meat is carefully processed, tendons and fat are removed. After boiling, it is passed through a meat grinder (several times). If fish, then boiled and low-fat varieties.
On the third day, you can add white bread croutons to the soups, which should be soaked. Vegetables and fruits only in pureed form.
After a week, we can introduce curd mass, slimy porridge with the addition of butter into the diet, and replace the meat soufflé with boiled finely chopped poultry.
After 3 weeks, the diet expands as much as possible. The ulcer is already in the stage of a fresh scar. Therefore, baked vegetables and fruits, in the form of jellies, compotes and jelly, are acceptable. Boiled meat and fish are served in whole pieces.
With appropriate treatment and gentle nutrition, the ulcer heals quite quickly, but inflammation persists for a long time. Therefore, the diet for ulcers and gastritis must be followed for another 2-3 months.
In addition, the threat of exacerbation of peptic ulcer disease remains in the future. Therefore, the principles of therapeutic nutrition must be adhered to throughout life.
For diseases of the gastrointestinal tract, a special place in treatment is occupied by proper nutrition, which reduces the excessive load on the digestive system. A diet correctly selected for the treatment of gastric ulcers promotes recovery no worse than drug support. It should be understood that the elimination of any symptoms of an ulcer is not an indication for stopping the chosen type of diet - now you should adhere to the adjusted menu throughout your life. So that giving up your usual food, which led to erosive damage to the stomach, does not seem like a punishment, you need to choose a diet that can satisfy the taste needs of any person without harming his health.
Gastric ulceration is a very serious and dangerous disease that can lead to internal bleeding and the degeneration of damaged cells into malignant ones. The main predisposing factor is poor nutrition, which is dominated by heavy, low-quality, hot, spicy foods. If an additional factor arises, such as taking ulcerogenic drugs, stress, endocrine pathologies, then the secretion of gastric juice is disrupted and the gastric mucosa begins to be damaged.
An ulcer can be suspected based on the following group of signs:
- severe pain and discomfort in the epigastric region, mainly after meals or at night;
- belching, heartburn;
- nausea, heaviness in the stomach.
After clarifying the diagnosis, the patient is prescribed a course of antibiotics and drugs that inhibit the secretion of hydrochloric acid. Nutrition must be adjusted, because drug treatment ineffective.
The treatment regimen can be adjusted if the patient has concomitant diseases or a complication of a peptic ulcer, such as bleeding or perforation.
Prohibited foods and dishes
When choosing a menu, it is necessary to exclude any food that can increase the production of gastric juice, increase its acidity, or put unnecessary strain on the digestive organs. All products are selected with a minimum percentage of fat content and are not fried, smoked or salted. It is also necessary to completely exclude from the diet:
- hot spices and spices;
- strong tea and coffee;
- alcohol, carbonated drinks;
- nuts, seeds;
- citrus fruits in any form;
- dry snacks.
At the same time, the list of acceptable products is very diverse. Any vegetables that do not cause increased gas formation, cooked in a slow cooker or stewed, will do. Potatoes can be used to make mashed potatoes, baked casseroles, and vegetable soups. Dietary fish such as pangasius, pike perch, pollock, cod, as well as beef and chicken can be baked in the oven, steamed in small portions of fillets, or served in the form of steamed meatballs and cutlets.
Drinks can include not only weak black or green tea, with a small amount of sugar or milk, but also a decoction of rose hips or chamomile, kefir, jelly, compote, and even ordinary boiled water. warm water no gases.
Any drink should be warmer room temperature. Food that is too hot can also irritate your stomach.
To pamper yourself, you should not resort to fresh baked goods, especially those made from butter or puff pastry. As an alternative, cottage cheese casseroles with any variety of dried fruits, fruits and berries are suitable. Sweet cottage cheese with honey is not forbidden. Pastille, marshmallows, a little real chocolate or jam, jam, marmalade, jelly - all this is also acceptable for ulcers in remission.
Features of the diet in the acute phase
For a period of severe pain and the acute phase of the disease, including in the presence of complications, frequent split meals are necessary with the complete exclusion of any food that, even slightly, will irritate the digestive tract. There should not be a long period of fasting during an ulcer - the feeling of hunger in combination with the natural production of hydrochloric acid negatively affects the walls of the stomach.
- eating 6-7 times a day;
- portions are small;
- complete exclusion of any fried, smoked, pickled, sweet, fatty foods;
- food is served in crushed (puree) or liquid form, at moderate temperature.
If the patient does not eat enough of the portion, its volume should not be increased. It is considered acceptable to increase the number of meals up to 7-8 times.
| Eating | Dishes |
|---|---|
| Breakfast | A couple of soft-boiled eggs / omelet / any milk porridge (semolina, pearl barley, rice, vermicelli). Lightly brewed green leaf tea. 1 teaspoon honey |
| Lunch | Fruit puree with a little milk (banana, peach, apricot) |
| Dinner | Vegetable or potato puree soup with croutons. Boiled chicken or fish fillet / steam cutlets. Garnish with rice or mashed potatoes. Salad of boiled vegetables (carrots and beets). Compote |
| Afternoon snack | Cottage cheese casserole with raisins, strawberries / Baked apple or pear with honey. Chamomile or rosehip decoction |
| Dinner | Boneless chicken fillet or dietary fish / soup / cottage cheese casserole |
| Snack before bed | A glass of warm milk with honey or kefir |
Following this kind of diet after 7-8 days leads to a significant improvement in a person’s well-being - pain in the epigastric region is eliminated, heartburn and nausea are less bothersome, and appetite improves. At this time, it is necessary to adjust the dosage and combination of medications and update the menu.
Menu for a week with a history of ulcers
After one or two weeks of exacerbation, a diet for the following months is determined. It is less harsh, allowing lean pork and beef, weak black tea, and some cereals. Restrictions on the intake of alcohol, coffee, fatty meats and fish, marinades, smoked meats, pickles, baked goods, and carbonated drinks are still relevant.
| Day of the week | Breakfast | Lunch | Dinner | Afternoon snack | Dinner | Second dinner |
|---|---|---|---|---|---|---|
| Monday | Milk rice porridge. A couple of soft-boiled eggs. Weak black tea with milk and sugar | Low-fat cottage cheese with sour cream, peach and apricot | Beetroot soup. Boiled vegetables (carrots, potatoes, beets) with cod in white sauce. Compote | Kissel. Cracker | Chicken meatballs. Baked potato. Tea with cracker | Milk. |
| Tuesday | Vermicelli milk soup. Rose hip decoction | Carrot salad | Puree soup with vegetables. Baked chicken with mashed potatoes on the side. Compote | Fruit or berry puree with a glass of water | Pollock baked in foil. Vegetable stew. Green tea | Crackers. Yogurt |
| Wednesday | Semolina. Milk/green tea | Apple casserole. Green tea or glass of water | Meatball soup. Baked pike perch with a side dish of buckwheat porridge. Kissel | Rusks or crackers with milk | Casserole with vegetables and chicken. Compote | Milk |
| Thursday | Lazy cottage cheese dumplings or low-fat cottage cheese with sour cream, honey or sugar. Herbal decoction | Baked apple/pear with honey. | Cream soup. Boiled fish with vermicelli in sauce. Kissel | A soft-boiled egg and a glass of milk or carrot juice | Baked cod. Vegetable puree (zucchini, pumpkin). Compote | Kefir |
| Friday | Cottage cheese with sour cream, sugar and honey. Chamomile decoction | Sweet curd casserole. Green tea | Vegetable soup Steamed beef meatballs with pasta and sauce. Kissel | Banana. Kefir | Boiled lean beef with mashed potatoes. Green tea | Milk. |
| Saturday | Scrambled eggs. Crackers with butter. Green or black tea with milk | Fruit puree with cottage cheese and sour cream. Rose hip decoction | Pearl barley soup. Steamed chicken cutlets with cauliflower on the side. Compote | Curd berry casserole. Rosehip or chamomile decoction | Beet salad. Fish meatballs with buckwheat porridge. Kissel | A glass of milk with a spoon of honey |
| Sunday | Omelette. Weak tea with sugar and milk | Strawberry/strawberry/banana milk mousse or smoothie | Soup with dumplings. Beef Stroganoff. Vermicelli with white sauce. Compote | Jelly from berries or fruits. Rice or fruit pudding. Herbal decoction or jelly | Boiled beef in sauce with mashed potatoes. Weak black tea | Ryazhenka |
From the dishes proposed above, you can take any ingredients and cook something new at your own discretion, but taking into account the list of prohibited foods and cooking methods.
Video - Stomach ulcer
Prevention of exacerbation of gastric ulcer
It is impossible to completely get rid of stressful situations that weaken the body’s protective properties and damage the gastric mucosa. However, it is quite possible to adjust your diet in such a way that once again inner surface the organ was not injured by aggressive food. Special attention This point should be given even after the symptoms have been relieved and it has been confirmed according to diagnostic criteria that the erosive cavities have healed. The stomach lining will never be completely healthy again due to scarring of areas that were once riddled with ulcers. At this long stage, it is extremely important to avoid those mistakes in nutrition that led to such a pathology, and to be more picky in choosing your diet for the day.
To prevent relapse, you should undergo preventive treatment with vitamins and certain drugs that control the production of hydrochloric acid every few months - usually in spring and autumn. Compliance with the rules for taking other - especially ulcerogenic - medications also helps to avoid injury to the mucous membrane, not only of the stomach, but also of the esophagus and intestinal tract.
Regular and balanced nutrition guarantees quick relief from unpleasant symptoms of the disease, reduction of ulcers and improved well-being. If you follow generally accepted recommendations for healthy image life and follow the prescribed diet, the risk of relapse is significantly reduced. A small amount of imagination will help you make your diet more varied and tastier within the limits of what is permitted, thereby improving your quality of life and without spoiling your health.
Nutrition for stomach ulcers is a very important point in treating the disease and preventing exacerbations. No drug therapy will give the desired effect without an accompanying diet. For patients with peptic ulcers, the standard is table No. 1 according to Pevzner. Below we will take a closer look at what to eat if you have a stomach ulcer.
The Pevzner diet No. 1 involves reducing the load on the stomach through mechanical, thermal and chemical sparing. It is divided into several successive stages, which are prescribed at different periods of the disease.
Table 1a
Diet 1a is prescribed for exacerbation of stomach ulcers and gastritis. During the acute period (10-12 days), patients are allowed only pureed and mushy dishes, which weakly stimulate gastric secretion. The calorie content of the food is about 2000 kcal.
The basis of the diet is slimy decoctions of cereals, semi-liquid soufflés of lean meat and fish, pureed porridge with water. Eggs can only be eaten soft-boiled or as a steam omelet. The preferred drinks are jelly, milk, and low-fat cream. It is allowed to add butter and vegetable oil (especially olive) to food. Other foods, including bread, are excluded.
The daily diet for exacerbation of a stomach ulcer contains 80-90 grams of fats and proteins, about 200 grams of carbohydrates and a sufficient amount of vitamins. Salt is limited to 5-6g/day. There should be at least 6 small meals per day. All food and drinks are served warm; cold or hot drinks are not allowed.
For diet 1 and for stomach ulcers, the daily menu looks something like this:
- breakfast – steam omelette, weak tea;
- 2nd breakfast – semolina porridge on water with butter, jelly;
- lunch – slimy oatmeal soup, meat soufflé, milk;
- afternoon snack – pureed rice porridge, fruit jelly;
- dinner – mashed potato soup;
- second dinner - soft-boiled eggs and a decoction of dried fruits.
Table 1b
When the exacerbation of the disease subsides, the next stage of the diet begins, which also lasts 10-12 days. The diet is gradually expanded to include white bread in the form of crackers (up to 70-100 g per day). The calorie content of daily food is 2500-2600 kcal. In addition to dishes from diet 1a for stomach ulcers, the menu includes vegetable purees, steamed fish or meat cutlets, mashed milk porridges, syrups, and jellies. The frequency of meals is 5 times a day.Sample diet menu 1b:
- breakfast – mashed non-sour cottage cheese and a glass of natural yogurt;
- 2nd breakfast – pureed rice porridge with milk, jelly, white bread crackers;
- lunch - boiled oatmeal with steamed beef cutlet, pureed vegetable soup, rosehip compote;
- afternoon snack – weak sweet tea and crackers, baked apple;
- dinner - fish soufflé with semi-liquid mashed potatoes, bran decoction.
Nutrition for stomach ulcers at the next (third) stage is close to normal in calorie content (about 3000 kcal). Stale white bread, boiled porridge with water and milk, boiled meat (beef, rabbit, chicken), boiled or steamed fish, pasta, cocoa, weak coffee with milk or cream are added to the diet. During the healing stage, fruits for stomach ulcers can only be eaten sour and ripe, in the form of puree or baked. The same applies to berries.
The third stage of therapeutic nutrition lasts as long as the previous ones, but it is not final. For 5-6 months, they adhere to some rules and restrictions, very gradually expanding the diet and bringing it to normal. And even with complete remission of the disease, you should limit the consumption of certain foods:
- fatty meat, fish, poultry;
- spices and herbs;
- sweet confectionery products;
- marinades, smoked meats, pickles;
- sausages;
- salted fish;
- "fast food";
- mushrooms;
- strong coffee.
The same principles should be followed to prevent stomach ulcers.
It is better to give up alcohol completely so as not to provoke a new exacerbation. It is also not recommended to eat fried foods. Food should be prepared by boiling, stewing, baking or steaming.
Nutrition after surgical treatment of ulcers
Diet after surgery to remove a stomach ulcer requires a special approach. Typically, this procedure usually removes two-thirds of the organ, so the volume of the stomach is significantly reduced. In the first days, a zero surgical diet is prescribed, which involves consuming only mucous decoctions and very weak broths and jelly. That is, all food is mainly given in the form of drinks. Gradually switch to diet 1, described above.
Bananas and stomach ulcers
Bananas are delicious and healthy fruits. They also contain a lot of starch, which envelops the mucous membranes of the gastrointestinal tract and protects them from the action of acid. Therefore, bananas for stomach ulcers help quickly relieve pain and alleviate the condition. If the patient tolerates this product well, it can be taken even during an exacerbation in the form of a puree. Of course, you shouldn’t overdo it; it’s enough to eat one fruit a day.
Bananas are a valuable source of vitamins, minerals and energy, which are needed in increased quantities for peptic ulcers.
Can I drink milk?
You can drink milk if you have a stomach ulcer, and it is very beneficial. During an exacerbation, the body especially needs vitamins and nutrients, which are contained in sufficient quantities in dairy products. But you should know that in the acute period you should not drink fermented milk drinks, they can irritate the inflamed mucous membrane and negatively affect the healing process of the ulcer.
It is allowed to drink skim or low-fat milk warm (boiled or pasteurized). You can drink not only cow's milk, but also goat's milk, but it must be diluted with boiled water. When the ulcer heals, you can gradually consume fermented milk products.
Ulcer and quail eggs
This product is considered dietary and is used to treat many diseases, including peptic ulcers.
Quail eggs are used for the prevention and treatment of ulcerative lesions of the gastrointestinal tract
Quail eggs for stomach ulcers contribute to faster healing of the defect and also help prevent exacerbation. They can be eaten as a steamed omelette or soft-boiled. Outside of an exacerbation, it is useful to take this product raw half an hour before meals with diluted juice or water. Eggs are also added to cereals, purees, and soups. Adults can eat up to 5-6 pieces per day.
Of course, in many cases, proper nutrition alone cannot overcome a stomach ulcer, although it is a necessary condition for treatment. We talked about all modern methods of combating the disease in the article, which we recommend that everyone who suffers from this disease read.
You can learn more about how to eat if you have a stomach ulcer by clicking on the link:
Peptic ulcer is chronic illness the whole body with ulcerative lesions of the stomach or duodenum. Exacerbation of the disease may occur due to disturbances in normal activities nervous systems s (excessive nervous tension, severe mental shocks, prolonged or frequently recurring difficult experiences). Non-compliance plays a major role in the occurrence of peptic ulcers. correct mode nutrition (irregular meals, dry food). The main signs of peptic ulcer disease are periodic, mainly on an empty stomach and at night, pain in the upper abdomen, heartburn, belching, vomiting.
The presence of an ulcer in the stomach or duodenum during peptic ulcer disease is a local manifestation of a disease of the whole organism, in which nervous, humoral and metabolic processes are disrupted.
Treatment of peptic ulcer disease should be comprehensive, including a number of methods, among which the leading place belongs to therapeutic nutrition.
The basic principles of therapeutic nutrition during exacerbation of peptic ulcer disease are as follows:
Creating the greatest peace for the mucous membrane of the stomach and duodenum;
Exclusion of products that have a strong juice effect;
Exclusion of products that mechanically irritate the gastric mucosa (i.e. food is given mainly in pureed form);
Frequent and small meals. Eating every 3-4 hours. Large amounts of food in one meal is contraindicated;
Avoiding too cold or very hot food;
High nutritional value of the diet, containing a sufficient amount of proteins, fats, carbohydrates, mineral salts, vitamins, mainly C, group B, A.
Products that increase the secretion of gastric juice are excluded from the diet: meat, fish and mushroom broths, meat and fish fried and stewed in their own juices, smoked and salted foods, herbs and spices (mustard, pepper, etc.), alcoholic drinks, sparkling water, strong tea and coffee. You should not include products containing coarse fiber (turnips, rutabaga, radishes), which mechanically irritate the gastric mucosa.
A gentle diet includes foods and dishes that weakly stimulate gastric secretion: milk, cream, cottage cheese, porridge, pureed boiled vegetables, pureed cereal and vegetarian (except cabbage) soups, soft-boiled eggs or omelet, boiled meat and fish, weak tea, alkaline minerals waters that do not contain carbon dioxide.
Let us remind you that milk and cottage cheese, cheese and eggs, meat and fish are rich in proteins. Fats are found in butter and vegetable oil, milk and cream. There are a lot of carbohydrates in bread and crackers, pasta and cereals (rice, semolina, oatmeal, barley, etc.), as well as in potatoes. An important source of vitamin C is rosehip decoction.
It should be borne in mind that milk can increase the acidity of gastric juice and cause heartburn in some people.
Depending on the characteristics of the course of peptic ulcer disease, several diets are used. Thus, in case of a sharp exacerbation, diets No. 1a and 16 are indicated, prescribed for short term, with a less severe exacerbation - diet No. 1 (it is also effective for a sluggish, asymptomatic course of the disease, without severe pain and heartburn).
The course of treatment usually begins with the most gentle diet, moving on to more stressful ones.
Diet No. 1a provides maximum mechanical and chemical sparing of the stomach. All dishes are prepared pureed, with a liquid or mushy consistency. They are boiled in water or steamed.
Soups - slimy ones made from rice, oatmeal or pearl barley; semolina soup (prepared with the addition of an egg-milk mixture, cream or butter). Decoctions can also be prepared (to speed up the cooking process) from flour for baby and dietary nutrition or from ground cereals.
Meat and fish dishes - steam soufflés made from lean meat (beef, veal, pork or rabbit), poultry (chicken, turkey), fish (cod, pike, hake, ice cod, navaga, etc.). Soufflé is included in the diet once a day.
Cereal dishes and side dishes - liquid porridge pureed from rice, oatmeal or buckwheat; porridge made from semolina, rice and buckwheat flour (with the addition of milk or cream).
Egg dishes - soft-boiled eggs, steam omelet, beaten egg whites (meringues).
Milk and dairy products - whole milk, condensed milk, natural and whipped cream, freshly prepared unleavened cottage cheese, steamed curd soufflé.
Fruit and berry dishes - jelly and jelly from sweet varieties.
Drinks - weak tea with milk or fresh cream, rosehip infusion, sweet fruit and berry juices, wheat bran infusion.
Fats - butter (added to prepared dishes).
Bread and bakery products are excluded from the diet.
Sample diet menu No. 1a
1st breakfast. Steam omelet, butter, milk (1 cup).
2nd breakfast. Milk (1 glass).
Dinner. Rice slimy soup, steamed meat soufflé with vegetable oil, fruit jelly.
Afternoon snack. Soft-boiled egg, milk (1 glass).
Dinner. Milk semolina porridge, lemon jelly.
Before bedtime. Milk (1 glass).
Diet No. 16 (less gentle) contains more steamed dishes from pureed meat and fish (cutlets and meatballs, quenelles and rolls, soufflé). Allowed sauce is milk or sour cream (from fresh sour cream), crackers from white bread (75 g), from fats - butter or refined olive, sunflower, corn (oil in in kind added to prepared dishes). More often they prepare pureed milk porridges and soups from various pureed cereals (rice, oatmeal, pearl barley, buckwheat, barley or millet). Liquid or mushy food is cooked in water or steamed.
Sample diet menu No. 16
1st breakfast. Steamed meat cutlets with milk sauce, pureed rice porridge, tea with milk.
2nd breakfast. Fruit jelly, cracker.
Dinner. Milk soup made from pureed barley, steamed meatballs, fruit jelly.
Afternoon snack. Soft-boiled egg, rosehip decoction (1 glass).
Dinner. Fish soufflé, pureed buckwheat porridge, fruit jelly.
For the night. Milk (1 glass).
Diet No. 1 is characterized by less strict adherence to the principles of mechanical and chemical sparing. White bread, boiled meat (chopped) and fish, boiled and pureed vegetables (potatoes, carrots, beets, zucchini, pumpkin) and fruits are allowed.
The diet includes milk, cream, fresh non-acidic sour cream, cottage cheese, soft biscuits, butter, soft-boiled eggs or steamed omelet, pureed milk cereal soups, milk pureed vegetable soups, milk soups with noodles, mashed milk porridge, pasta and boiled noodles. , baked dishes and weak tea with milk are allowed.
Broths and cabbage broths are excluded from the diet. All dishes are prepared pureed, boiled in water or steamed.
This diet is the main one in the course of therapeutic nutrition for peptic ulcer disease. There are 2 variants of this diet: in one case, the food is prepared pureed, in the other - not pureed.
Soups - pureed milk cereals (oatmeal, rice, buckwheat, barley, semolina); dairy with pureed vegetables, vermicelli or homemade noodles; pureed vegetables (potatoes, carrots, beets) with an egg-milk mixture, seasoned with butter or vegetable oil.
Meat and fish dishes - from low-fat varieties, cutlets, dumplings, meatballs, mashed potatoes, soufflés, rolls, etc., boiled in water or steamed.
Dishes from cereals and pasta - pureed milk porridge (rice, oatmeal, pearl barley, barley, millet, buckwheat); semolina porridge and oatmeal“Hercules”, souffle, puddings from pureed cereals; dishes from vermicelli, pasta, homemade noodles.
Vegetable dishes - from potatoes, carrots, beets, cauliflower, pumpkin, zucchini, green peas: boiled, pureed, steamed souffles and puddings (without crust).
Egg dishes - soft-boiled eggs, steam omelettes, beaten egg whites (meringues).
Milk and dairy products - whole milk, condensed milk, fresh cream, freshly prepared unleavened cottage cheese, cottage cheese soufflés and casseroles, dumplings with cottage cheese, sour cream, mild cheeses.
Fruit and berry dishes: natural fruits and ripe sweet berries, boiled, mashed or baked; sweet berry juices - strawberry or raspberry; jellies, jellies and mousses; baked apples.
Sweets - honey, jams, preserves from sweet berries and fruits, marshmallows, marshmallows.
Sauces - milk, sour cream or fruit.
Spicy vegetables - parsley, dill (a little).
Fats - butter and vegetable oil (added to ready-made dishes).
Drinks - weak tea with milk or cream, rosehip or wheat bran decoction, carrot juice.
Bread - wheat, slightly dried, savory cookies.
Sample diet menu No. 1
1st breakfast. Soft-boiled egg, pureed oat milk porridge, tea with milk.
2nd breakfast. Baked apple, rosehip infusion.
Dinner. Mashed pearl barley soup, steamed meat cutlets with milk sauce, mashed potatoes with vegetable oil, fruit jelly.
Afternoon snack. Milk jelly, dry cookies.
Dinner. Steamed fish balls with vermicelli, tea.
For the night. Milk (1 glass), biscuits.
If a peptic ulcer occurs without severe pain and heartburn (when we're talking about about peptic ulcer disease in remission), diet No. 1 without mechanical sparing is often the most effective. This diet is especially indicated if the disease is accompanied by a decrease in intestinal motor function, which is manifested by constipation. Food is prepared boiled, but not pureed (meat and fish are given in pieces, vegetables are not pureed, porridge is crumbly, etc.).
Sample diet menu No. 1 without mechanical stomach sparing
1st breakfast. Boiled meat with boiled noodles, crumbly millet porridge, cheese, tea with milk.
2nd breakfast. Baked apple, rosehip infusion, savory cookies.
Dinner. Vegetarian potato soup, boiled meat stew with boiled rice, boiled beets with vegetable oil, tea.
Afternoon snack. Soft-boiled egg, milk (1 glass) with cookies.
Dinner. Boiled fish with boiled potatoes, dried fruit compote, cheesecake with cottage cheese.
For the night. Milk (1 glass) or tea with milk.
Medical nutrition for peptic ulcers, despite many restrictions both in the range of products and in the methods of their culinary processing, it should still be as varied as possible.
In cases where patients do not tolerate milk well (heartburn, flatulence), it is replaced with milk jelly, milk diluted 1/3 with tea, or mineral water.
The content of the article
Dietary treatment for gastric and duodenal ulcers is based on the principle of influencing:a) clinical manifestations of the disease;
b) impaired metabolism;
c) other regulatory systems.
Medical nutrition should be based not only on clinical symptoms, but also on the characteristics of metabolic processes in the patient’s body, for which it is necessary to provide the body with essential nutritional factors, in particular amino acids, essential fatty acids, and vitamins.
Great importance has the correct feeding rhythm. It is recommended to eat food every 3-4 hours in small portions. Avoid too hot and cold foods. To relieve the inflammatory process in the gastroduodenal system, limit table salt to 10-12 g per day.
When creating diets, the influence of food on the secretory and motor functions of the stomach is taken into account.
All food substances can be divided into weak and strong stimulants of gastric secretion. Weak stimulants of gastric secretion: milk, cereal or vegetable soups (from potatoes, carrots and beets); liquid milk porridges; well-cooked meat and fresh boiled fish; milk and dairy products; soft-boiled eggs or in the form of an omelet; day-old white bread; alkaline waters, do not contain carbon dioxide; weak tea. Strong secretion stimulants include: spices (mustard, cinnamon, horseradish, etc.); all dishes of plant and animal origin prepared by frying; canned food; all dishes containing extractive substances (for example, meat, fish, mushroom broths; strong broths from vegetables); black bread; strong tea, coffee; drinks containing alcohol and carbon dioxide.
However, the same product, prepared in different ways, presents a completely different load on the stomach; piece fried meat is a strong stimulant of gastric secretion, and boiled meat causes a slight stimulation of the secretory process. Fat, for example, has
biphasic action, it suppresses secretion, and then the products of saponification of fat in the intestine stimulate it.
The secretion of gastric juice is also influenced by the consistency of the food. So, meat in a piece stays in the stomach for a longer time than meat soufflé. Liquid and mushy food leaves the stomach faster than solid food. The chemical composition of food is also important. Carbohydrates leave the stomach quickly, proteins leave the stomach more slowly, and fats remain in it the longest.
The longer the food is in the stomach, the more it irritates the mucous membrane and increases its secretory function.
The diet should not include products that mechanically irritate the gastric mucosa and contain rough cell membranes (turnips, radishes, radishes, asparagus, beans, peas); unripe and rough-skinned fruits and berries (gooseberries, currants, grapes, dates); bread made from wholemeal flour; products containing coarse connective tissue (cartilage, poultry and fish skin, stringy meat). When constructing gentle diets, food substances are prescribed that weakly stimulate secretion, quickly leave the stomach and little irritate its mucous membrane.
Under the influence of gentle diets, as a rule, all clinical manifestations of the disease disappear. By changing the chemical composition of the diet, it is possible to influence the disturbed metabolism, stimulate the healing processes of the ulcer, and influence the regulatory function of the nervous system. The anti-ulcer diet should be complete, balanced in terms of the content of proteins, fats, carbohydrates, mineral salts and vitamins (mainly C, D1 and A). Proteins included in the diet must contain all the necessary amino acids in optimal proportions. This is done by introducing a variety of foods of both animal and plant origin into the diet. Anti-ulcer diets are enriched with vegetable oils by reducing animal fat. Vegetable fats are introduced in an amount of 1/3 of the total fat content in the diet. Vegetable oils are added to porridges, soups and fish products. This normalizes impaired metabolic processes in patients with peptic ulcers and promotes ulcer healing. The diet includes homogenized vegetables (puree of beets, carrots, pumpkin). They are added to slimy soups, pureed porridges and other dishes. The use of homogenized vegetable purees can significantly improve the appearance of food, increase the taste and nutritional value of dishes.
Adequate content of mineral salts and vitamins in diets is of considerable importance. Vitamin C is most abundant; contained in rosehips, so it is advisable that the patient receive rosehip decoction daily. Vitamin C enhances redox and regenerative processes, has a desensitizing property and inhibits gastric secretion and motility in patients with peptic ulcer disease. Liquid porridges made from buckwheat, oatmeal, barley, as well as mucous soups made from wheat bran contain a large amount of vitamin B, which has a beneficial effect on the nervous system and reduces the acidity of gastric juice. Carrots contain a significant amount of carotene (provitamin L); Milk and dairy products are rich sources of vitamin L. All anti-ulcer diets must include milk.
Qualitatively different nutrition can influence not only metabolic processes, but also, if possible, normalize the nervous and humoral regulation of the body, stimulate recovery and compensation processes, reduce inflammatory and allergic reactions.
Under the influence of a diet rich in carbohydrates, the excitability of the autonomic nervous system increases, and the clinical symptoms of “irritable stomach” intensify. A diet restricting carbohydrates has the opposite effect.
In order for the recovery processes to proceed actively, the nutrition of patients with peptic ulcer must be complete and varied with an increased amount of animal proteins compared to the physiological norm.
Methods of diet therapy and characteristics of diets
The course of therapeutic nutrition for patients with peptic ulcer disease begins with the most gentle diet No. 1a. As a rule, in patients taking this diet, pain and dyspeptic symptoms (heartburn, belching, nausea, vomiting) disappear or decrease. Since this diet is low-calorie (2000-2200 kcal), it is prescribed for no more than 10-12 days.Diet No. 1a (maximally gentle)
General characteristics. A diet with a physiological ratio of basic nutrients, a sharp limitation of chemical and mechanical irritants of the mucous membrane and receptor apparatus, with a slight reduction in calorie content, containing qualitatively different fat.Culinary processing. All products are boiled, pureed or steamed. Dishes have a liquid or mushy consistency.
Calorie content and composition. Protein 80 g, fat 80-90 g (of which 15-20 g are vegetable), carbohydrates 200 g. Calorie content 2000-2200 kcal. The amount of free liquid is 1.5 l, table salt is 8 g. The weight of the daily ration is 2-2.5 kg.
Food temperature: hot dishes - from 57 to 65 °C, cold dishes - not lower than 15 °C.
An approximate menu for diet No. 1a is given in table.
Soups. Mucous cereals (oatmeal, semolina, rice) with the addition of mixed eggs and milk, cream, butter.
Bread and bakery products are excluded.
Meat and fish dishes. Steam souffle (once a day) from lean meats, poultry, fish without tendons, fascia and skin.
Vegetable dishes and side dishes are excluded.
Dishes and side dishes from cereals. Liquid pureed porridge (from any cereal except millet) once a day with the addition of milk or cream.
Approximate one-day diet menu No. 1a (2008 kcal)
Name of dishes | Output, g | Proteins, g | Fats, g | Carbohydrates, g |
| First breakfast | ||||
| Soft-boiled eggs (2 pcs.) | 96 | 10,2 | 10,9 | 0,5 |
| Milk (1 glass) | 200 | 5,6 | 7,0 | 9,0 |
| Lunch | ||||
| Fruit jelly | 180 | 0,18 | - | 36,3 |
| Milk (1 glass) | 200 | 5,6 | 7,0 | 9,0 |
| Dinner | ||||
| The soup is slimy ricemilk | 400 | 7,4 | 14,6 | 23,3 |
| Steamed meat soufflé | 110 | 22,8 | 11,5 | 5.9 |
| Lemon jelly | 125 | 2,5 | - | 15,7 |
| Afternoon snack | ||||
| Rose hip decoction (1 glass) | 180- | - | - | |
| Milk (1 glass) | 200 | 5,6 | 7,0 | 9,0 |
| Dinner | ||||
| Soft-boiled egg (1 pc.) | 48 | 5,1 | 5,4 | 0,2 |
| Semolina milk porridge | 300 | 8,9 | 9,5 | 46,6 |
| For the night | ||||
| Milk (1 glass) | 200 | 5,6 | 7,0 | 9,0 |
| All day | ||||
| Sugar 50 g | - | - | - | 49,9 |
| Total... | 80 | 80 | 214,2 |
Egg dishes. Soft-boiled eggs, steam omelettes (no more than 3 eggs per day).
Fats. Add butter to prepared dishes.
Fruits, berries, sweets. Kissels and jellies from sweet varieties of berries and fruits, sugar, honey, sweet berry and fruit juices mixed with water and sugar.
Sauces and spices are excluded.
Snacks are excluded.
Beverages. A decoction of rose hips and wheat bran.
Diet No. 16 (more intense)
General characteristics. A diet with a physiological ratio of basic nutrients contains qualitatively different fat. Chemical and mechanical irritants of the mucous membrane and receptor apparatus of the gastrointestinal tract are significantly limited.Culinary processing. All dishes are prepared pureed, boiled in water or steamed. The food is liquid and mushy.
Calorie content and composition. Proteins 90 g, fats 90 g (from 25 vegetable fats), carbohydrates 300-350 g. Calories 2500-2800 kcal. The amount of free liquid is 1.5 l, table salt is 10 g. The weight of the daily ration is 2.5-3 kg.
The diet is split (5-6 times a day).
Food temperature: hot dishes - from 57 to 65°C, cold dishes - not lower than 15°C.
List of recommended products and dishes. In addition to those products and dishes that are included in the most gentle diet No. 1a, add 75-100 g of white bread crackers premium, meat and fish in the form of cutlets, quenelles, meatballs. More often they give pureed milk porridges. Soups are not slimy, but cereal, milk, pureed.
This diet option is also prescribed for 10-12 days. An approximate menu for diet No. 16 is given in table. After diet No. 16, the patient should be transferred to diet No. 1.
Diet No. 1 (mashed)
General characteristics. A diet with a physiological content of proteins, fats and carbohydrates. Foods that stimulate gastric secretion and chemically irritate the mucous membrane are excluded from the diet. Limit dishes containing cell membranes.Culinary processing. All dishes are prepared boiled, pureed and steamed.
Calorie content and composition. Protein 100 g, fat 100 g (of which 1/3 is vegetable), carbohydrates 400-450 g. Calorie content 3000-3200 kcal. The amount of free liquid is 1.5 l, table salt is 12 g. The weight of the daily ration is 3 kg.
The diet is split (5-6 times a day).
An approximate diet menu No. 1 is given in table.
List of recommended products and dishes.
Bread and bakery products. Yesterday's wheat bread, dry biscuit, dry biscuits, 1-2 times a week a limited amount of shortbread buns or baked pies with apples, jam, boiled meat and eggs.
Soups. Dairy, cereal, pureed; dairy with the addition of pureed vegetables (cabbage excluded); dairy with chopped vermicelli or homemade noodles; pureed vegetables (from carrots, potatoes, beets), seasoned with butter or refined sunflower oil.
Meat and fish dishes. Lean varieties of meat and fish without tendons, fascia and skin (beef, chicken, rabbit, pike perch, perch, cod), mostly minced, steamed or boiled in water; non-coarse meats, poultry and fish can be cut into pieces.
Dishes and side dishes from cereals, pasta. Pureed milk porridges (except millet), pureed steam puddings, boiled vermicelli, finely chopped pasta.
Vegetable dishes and side dishes. Potatoes, carrots, beets, zucchini, pumpkin in the form of shores, steam puddings without crust.
Sample menu for day No. 16 (2500 kcal)
| Name of dishes | Output, g | Proteins, g | Fats, g | Carbohydrates, g |
| First breakfast | ||||
| Steamed meat cutlets milk sauce | 110 | 17,1 | 15,0 | 16,3 |
| Buckwheat porridge milk pureed | 200 | 7,1 | 8,3 | 30,29,0 |
| Milk (1 glass) | 200 | 5,6 | 7,0 | 9,0 |
| Lunch | ||||
| Fruit jelly (1 glass) | 180 | 0,18 | - | 36,3 |
| Dinner | ||||
| Rice soup pureed milk | 400 | 7,7 | 14,8 | 32 |
| Steamed meatballs | 110 | 15,3 | 13,2 | 10,5 |
| Fruit jelly | 125 | 2,6 | - | 23,4 |
| Afternoon snack | ||||
| Rosehip decoction (1 glass) | 180 | - | - | - |
| Crackers (from the daily bread allowance) | - | - | - | - |
| Dinner | ||||
| Fish cutlets with vegetable oil | 115 | 19,4 | 7,6 | 16,3 |
| Fruit jelly | 180 | 0,18 | - | 36,3 |
| For the night | ||||
| Milk (1 glass) | 200 | 5,6 | 7,0 | 9,0 |
| All day | ||||
| White crackers | 100 | 18,4 | 1,4 | 68,2 |
| Sugar | 25 | - | - | 24,9 |
| Butter | 20 | 0,12 | 16,5 | 0,18 |
| Total... | 94 | 90 | 312 |
Sample diet menu No. 1 (3000 kcal)
| Name of dishes | Output, g | Proteins, g | Fats, g | Carbohydrates, g |
| First breakfast | ||||
| Soft-boiled eggs (2 pcs.) | 96 | 10,2 | 10,9 | 0,5 |
| Buckwheat porridge pureed milk | 200 | 7,1 | 8,3 | 30,2 |
| Tea with milk | 180 | 1,4 | 1,7 | 2,2 |
| Lunch | ||||
| Baked apple | 100 | 0,3 | - | 23,2 |
| Dinner | ||||
| Rice soup pureed milk | 400 | 7,7 | 14,8 | 32,010,5 |
| Meatballs steam | 110 | 15,3 | 13,2 | 10,5 |
| Mashed potatoes (garnish) | 200 | 4,0 | 5,7 | 32,3 |
| Fruit jelly | 126 | 2,6 | - | 23,4 |
| Afternoon snack | ||||
| Rosehip decoction (1 glass) | 180 | - | - | - |
| Crackers (from the daily bread allowance) | - | - | - | - |
| Dinner | ||||
| Boiled fish | 85 | 16,0 | 4,6 | 0,02 |
| Mashed potatoes (side dish) with vegetable oil | 200 | 4,0 | 5,7 | 32,3 |
| Tea with milk | 180 | 1,4 | 1,7 | 2,2 |
| For the night | ||||
| Milk (1 glass) | 200 | 5,6 | 7,0 | 9,0 |
| All day | ||||
| White bread | 400 | 31,6 | 7,6 | 210,8 |
| Sugar | 30 | - | - | 29,9 |
| Butter | 20 | 0,12 | 16,5 | 0,18 |
| Total... | 106,8 | 97,8 | 428,7 |
Egg dishes. Soft-boiled eggs, steam omelettes.
Milk, dairy products and dishes made from them. Natural milk, cream, freshly prepared unleavened and fresh factory-made cottage cheese in dishes (soufflé, casserole, lazy dumplings), non-acidic sour cream, calcined cottage cheese.
Fruits, berries, sweets. Fruits and berries of sweet varieties, ripe, boiled, pureed and baked. Sweet berry juices (raspberry, strawberry) half and half with water. Honey, jams, preserves from sweet varieties of berries and fruits, pastilles, marshmallows, marmalade without aromatic essences.
Sauces and spices. Milk sauce (bechamel), fruit sauces. Dill, parsley leaves (in small quantities).
Snacks. The cheese is mild.
Fats. Butter add to prepared dishes (do not fry). Sunflower oil in its natural form (if well tolerated).
Beverages. Weak tea with milk or cream. The raw material is vegetable (carrot, beet) juices. A decoction of rose hips and wheat bran.
Nutritional value of foods and dishes used in diet therapy for peptic ulcers. Gastric juice secreted under the influence of milk has low digestive capacity. Milk fats are in an emulsified state and are well absorbed by the body. Dairy diets have a dehydrating effect on the body, which reduces the tendency for an inflammatory response. Cottage cheese is especially useful among dairy products. For ulcer disease, you should eat fresh non-acidic cottage cheese; it is prepared by curdling fresh milk with calcium salts or 3% table vinegar. The acidity of such cottage cheese does not exceed 50° according to Turner.
Eggs are an equally valuable protein product. You should eat soft-boiled eggs when the egg whites have coagulated. Crude protein contains avidin, which is destroyed when the protein coagulates. Avidin can cause an allergic reaction, and if gastrointestinal diseases increases swelling of the gastric mucosa. The yolk of an egg contains a large amount of fat and promotes the secretion of bile during peptic ulcers, which is often accompanied by stagnation of bile in the gallbladder, leading to an inflammatory process; eating eggs has a choleretic effect.
A very valuable protein product is meat. It contains all the essential amino acids in the ratios required by the body. For peptic ulcers, eat meat that is devoid of extractive substances, i.e., boiled. To do this, the meat is placed in cold water and, with gradual heating, extractive substances from the meat are released into the broth. If you put meat in boiling water, it will become covered with a rather dense shell and the extractive substances will linger in it. Extractive substances irritate the stomach and increase gastric secretion. The source of complete protein in the diet of a patient with peptic ulcer disease is fish; Mainly used are river fish, low-fat ones (pike perch, pike, etc.). In addition to complete protein, fish contains vitamins A and D. For peptic ulcers, fish is consumed boiled. Fish and fish products are easily digested and absorbed by the body and do not irritate the stomach. A small amount of gastric juice is released into these foods.
Fats occupy a significant place in the diet therapy of peptic ulcers. Vegetable and animal fats are used to create complete diets.
For peptic ulcers, the diet includes both complex and simple carbohydrates. The main sources of carbohydrates in the diet of patients with peptic ulcers: bread, cereals, vegetables, fruits, sugar, honey. In the first stages of treatment, the amount of carbohydrates is limited; As health improves, carbohydrate intake expands to meet normal physiological needs.
A decrease in the excitability of the nervous system is facilitated by monotonous nutrition, frequent and fractional consumption of food, and a gradual expansion of the diet.
Anti-ulcer diets not only have a local effect on the stomach, but also affect the general condition of the body, a number of pathogenetic mechanisms that play a role in the development of peptic ulcer disease.
The patient should receive diet No. 1 for a long time and only with the permission of the doctor gradually switch to a varied diet. Diets containing qualitatively different fats have a positive effect on bowel movements and, as a rule, eliminate constipation.
The method of dietary therapy depends on the phase, stage, complications, as well as concomitant diseases. Dietary therapy is combined with other treatment methods. The variety of clinical forms of peptic ulcer disease requires differentiated complex therapy based on a combination of a number of methods, among which the leading place belongs to therapeutic nutrition.
In cases where a peptic ulcer proceeds almost without pain, dyspeptic symptoms (belching, heartburn, nausea, vomiting) are of little concern, but a gastroscopic and radiological ulcerative defect is determined either in the stomach or in the duodenum, and a diet without mechanical sparing is indicated.
An antiulcer diet without mechanical sparing has some stimulating and tonic effect on the body and therefore it should be prescribed for asymptomatic disease. In such cases, it leads to healing of the ulcer. A diet without mechanical sparing is also indicated during the period of remission of a peptic ulcer and as a transition from a strict course of antiulcer treatment to a varied diet. Food should be taken boiled, but pureed (i.e. meat and fish in pieces, crumbly porridge, ungrated vegetables). Avoid foods that strongly stimulate secretion. The diet is physiologically complete and contains qualitatively different fats. Chemical composition diet: proteins 100 g, fats 100 g (of which 1/3 are vegetable), carbohydrates 400-450 g. Amount of free liquid 1.5 l, table salt 12 g. Weight of daily ration 3 kg. Calorie content 3000-3200 kcal. The set of products is the same as for pureed diet No. 1,
Peptic ulcer disease in adolescence and adolescence is persistent and difficult to treat. This is due to the characteristics of a growing organism, mainly the state of the endocrine and nervous systems and the constant hyperproduction of hydrochloric acid. To treat this category of patients, it is necessary to carry out a course of dietary treatment, consisting of three consecutive cycles, lasting 10-12 days each. They start with the most gentle diet No. 1a with a gradual transition to more intense diets No. 16 and 1, containing an increased amount of proteins and fats (Table). The principles of chemical, mechanical and thermal sparing of the gastroduodenal system are preserved.
Table 34
Chemical composition of antiulcer diets containing increased amounts of proteins and fats for the treatment of peptic ulcer disease in adolescence and adolescence
The high effectiveness of diets containing increased amounts of proteins and fats is confirmed by the picture of ulcer scarring. In patients of adolescence and adolescence on this diet, according to X-ray and endoscopic studies, within 1.5 months the niche is scarred in 78% of cases, while during the same time on a diet with a normal content of proteins and fats - only in 66%Diet therapy for peptic ulcer disease in the elderly is carried out taking into account the underlying disease and the presence of age-related metabolic disorders, especially cardiovascular and atherosclerotic lesions. The diet must contain the required amounts of proteins, fats, carbohydrates, vitamins and mineral salts. Proteins should be used both animal and vegetable; Only with their combination and a variety of their sources in the diet is the most optimal ratio of essential and essential amino acids in food ensured. The amount of protein in the daily diet should be 90-100 g.
As we age, our digestive capacity generally decreases. digestive system Therefore, preference is given to milk and fish protein, which is easier to digest and assimilate. Eggs are limited to 2-3 pieces per week. There is no need to limit the consumption of egg whites. Low-fat varieties of meat are recommended (beef, turkey, chicken). Sea fish (cod, navaga, hake) and low-fat river varieties (pike, pike perch) are used.
Milk and dairy products are a source of complete protein; it includes almost all the substances necessary for the human body, balanced by nature itself. Valuable dairy products are cottage cheese and cheeses. These products are included in the diet of a patient with peptic ulcer disease. The diet should include animal (2/3) and vegetable (1/3) fats. The amount of fat in the daily diet is 90-100 g.
Carbohydrates are recommended in the amount of 350-400 g per day, mostly complex with a limit on simple ones (sugar consumption should be limited). The diet is mechanically, thermally and chemically gentle.
The calorie content of the diet is 2700-3000 kcal. The total amount of table salt is 12 g. The set of products is the same as for pureed diets No. 1a, 16 and 1.
Therapeutic nutrition for complications of peptic ulcer
The most common complication of peptic ulcer disease is bleeding. Therapeutic nutrition is prescribed to the patient after the bleeding has stopped or decreased. Food should be liquid and cold: mucous soups, milk, jelly, jelly, rosehip decoction are allowed (no more than 200 ml per day). If the course of the disease is favorable, the amount of food is gradually increased, meat soufflé and soft-boiled eggs are added. Next, the patient is transferred to the most gentle diet No. 1a. The patient should receive the most gentle diet until bleeding completely stops, and then he is transferred to diets No. 16 and 1.Therapeutic nutrition for peptic ulcers with concomitant diseases
The presence of inflammatory phenomena in the gallbladder, bile ducts and liver requires a change in diet.In case of peptic ulcer with concomitant disease of the liver and biliary tract, a sufficient amount of complete, easily digestible protein and large quantity vegetable fats. The amount of animal fat is reduced to 50 g, proteins are increased to 120-130 g. Foods containing cholesterol are limited. The diet includes carbohydrates, which promote the deposition of glycogen in the liver. Avoid foods that increase secretion. Food is prepared steamed, boiled and pureed. The amount of free liquid is 1.5 l. The weight of the daily diet is 2.5-3 kg. The diet is fractional (6 times a day).
Chemical composition and calorie content of lipotropic diets.
Diet No. 1a (maximally gentle). Protein 90-100 g, fat 70 g (of which 50% vegetable), carbohydrates 250 g. Calorie content 2000 kcal. Table salt 8 g. An approximate menu for lipotropic diet No. 1a is given in table.
Diet No. 16 (more stressful). Proteins 100-110 g, fats 75-80 g (of which 50% are vegetable), carbohydrates 350-400 g. Calories 2500-2800 kcal. Table salt 10 g. An approximate menu for lipotropic diet No. 16 is given in table.
Diet No. 1 (mashed). Proteins 120-130 g, fats 85-90 g (of which 50% are vegetable), carbohydrates 450-500 g. Calories 3200-3500 kcal. Table salt 12 g. An approximate menu for lipotropic diet No. 1 is given in table.
Sample menu for lipotropic diet No. 1a (2000 kcal)
| Name of dishes | Output, g | Proteins, g | Fats, R | Carbohydrates, g |
| First breakfast | ||||
| Protein omelet (from 2 eggs) | 110 | 8,2 | 6,4 | 3,3 |
| Milk (1 glass) | 200 | 5,6 | 7,0 | 9,0 |
| Lunch | ||||
| Fruit jelly | 180 | 0,18 | - | 36,3 |
| Dinner | ||||
| The soup is slimy oat milk | 400 | 7,7 | 15,7 | 21,2 |
| Steamed fish soufflé vegetable oil | 180 | 20,4 | 14,6 | 5,9 |
| Fruit jelly | 126 | 2,6 | - | 23,4 |
| Afternoon snack | ||||
| Rosehip decoction (1 glass) | 180 | - | - | - |
| Dinner | ||||
| Fish soufflé with vegetable oil | 180 | 20,4 | 14,6 | 5,9 |
| Oatmeal porridge pureed milk | 300 | 9,7 | 12,2 | 42,5 |
| Fruit jelly | 180 | 0,18 | - | 36,3 |
| For the night | ||||
| Milk (1 glass) | 200 | 5,6 | 7,0 | 9,0 |
| All day | ||||
| Sugar | 25 | - | - | 24,9 |
| Total | 80 | 78 | 218 |
Peptic ulcer disease, especially when the ulcerative defect is localized in the duodenum, is often accompanied by chronic or reactive pancreatitis.
For peptic ulcers with concomitant reactive or chronic pancreatitis, a diet with a high protein content should be prescribed! The purpose of a high-protein diet is to promote the normalization of the functional ability of the pancreas, increase the synthesis of protein used for the construction of pancreatic enzymes and their inhibitors, stimulate the processes of restoration of the mucous membranes of the stomach and duodenum, promote mechanical and chemical sparing of the stomach and intestines, as well as reduce the reflex excitability of the gallbladder . On average, the diet should be followed for at least a year.
Table 36
Sample menu for lipotropic diet No. 16 (2432 kcal)
| Name of dishes | Output, g | Proteins, g | Fats, g | Carbohydrates, g |
| First breakfast | ||||
| Curd soufflé | 150 | 16,3 | 20,5 | 38,3 |
| Oatmeal porridge with milk, pureed | 300 | 9,7 | 12,2 | 42,5 |
| Milk (1 glass) | 200 | 5,6 | 7,0 | 9,0 |
| Lunch | ||||
| Fruit jelly (1 glass) | 180 | 0,18 | - | 36,3 |
| Dinner | ||||
| Puréed oat milk soup | 400 | 14,1 | 22,1 | 40,3 |
| Fish cutlets with vegetable oil | 115 | 19,4 | 7,6 | 16,3 |
| Fruit jelly (1 glass) | 180 | 0,18 | - | 36,3- |
| Afternoon snack | ||||
| Rosehip decoction (1 glass) | 180 | - | - | - |
| - | - | - | - | |
| Dinner | ||||
| White omelette | 110 | 8,2 | 6,4 | 3,3 |
| Fruit jelly | 180 | 0,18 | - | 36,3 |
| For the night | ||||
| Milk (1 glass) | 200 | 5,6 | 7,0 | 9,0 |
| All day | ||||
| White crackers | 100 | 10,4 | 1,2 | 68,2 |
| Sugar | 25 | 24,9 | ||
| Total | 90 | 84 | 352 |
Sample menu of lipotropic diet No. 1 (3000 kcal)
| Name of dishes | Output, g | Proteins, g | Fats, g | Carbohydrates, g |
| First breakfast | ||||
| Steamed egg white omelette | 110 | 8,2 | 6,4 | 3,3 |
| Oatmeal porridge pureed milk | 300 | 9,7 | 12,2 | 42,5 |
| Tea with milk | 180 | 1,4 | 1,7 | 2,2 |
| Lunch | ||||
| Baked apple | 100 | 0,3 | - | 23,2 |
| Dinner | ||||
| Oatmeal soup pureed milk | 400 | 14,1 | 22,1 | 40,3 |
| Boiled fish | 85 | 17,4 | 11,8 | 2,3 |
| Mashed potatoes with vegetable oil | 200 | 4,0 | 5,7 | 32,3 |
| Fruit jelly | 126 | 2,6 | - | 3,4 |
| Afternoon snack | ||||
| Rosehip decoction (1 glass) | 180 | - | ||
| Crackers (from the daily bread allowance) | - | - | - | |
| Dinner | ||||
| Calcined cottage cheese | 100 | 13,8 | 11,1 | 8,8 |
| Tea with milk | 180 | 1,4 | 1,7 | 2,2 |
| For the night | ||||
| Milk (1 glass) | 200 | 5,6 | 7,0 | 9,0 |
| All day | ||||
| White bread | 400 | 31,6 | 7,6 | 210,8 |
| Sugar | 50 | - | - | 49,9 |
| Total | 109,8 | 87 | 472,4 |
Chemical composition and calorie content of the diet. Protein 125-130 g, fat 90 g, carbohydrates 300-350 g. Calorie content 2500-2800 kcal. The amount of free liquid is 1.5-2 l, table salt is 10-12 g. The weight of the daily ration is 3 kg.
The diet is split (5-6 times a day).
Food temperature: hot dishes - from 57 to 62°C, cold dishes - not lower than 15°C.
The set of products is the same as for the pureed version of diet No. 1. Milk is prescribed provided that it is well tolerated and there is no flatulence. Butter is added to prepared dishes (it is prohibited in its natural form with bread).
Approximate one-day menu for a patient with peptic ulcer with concomitant chronic or reactive pancreatitis (2500 kcal)
| Name of dishes | Output, g | Proteins, g | Fats, g | sch Carbohydrates, g |
| First breakfast | ||||
| Meatballs steam | 110 | 15,3 | 13,2 | 10,5 |
| Carrot puree (side dish) | 200 | 3,8 | 6,7 | 17,3 |
| Buckwheat porridge pureed milk | 200 | 7,1 | 8,3 | 30,2 |
| Tea | 180 | - | - | - |
| Lunch | ||||
| Jellied fish | 85 | 16,8 | 1.4 | 2,3 |
| Dinner | ||||
| Vegetable puree soup with rice (without cabbage) | 200 | 4,6 | 11,4 | 38,8 |
| Stuffed roll omelette | 125 | 16,915,0 | 11,28 | |
| Fruit jelly on xylitol | 125 | 0,2 | - | 5,04 |
| Afternoon snack | ||||
| Calcined cottage cheese | 100 | 13,8 | 11,1 | 8,8 |
| Rose hip decoction | 180 | - | - | - |
| Dinner | ||||
| Boiled fish | 85 | 16,0 | 4,6 | 0,02 |
| Potato Shore (side dish) | 200 | 4,0 | 5,7 | 32,3 |
| Tea | 180 | - | - | - |
| For the night | ||||
| Protein omelet | 110 | 8,2 | 6,4 | 3,3 |
| All day | ||||
| White bread | 200 | 15,8 | 3,8 | 105.4 |
| Sugar | 20 | 19,9 | ||
| Total... | 122,4 | 88 | 285,2 |
In case of peptic ulcer with concomitant chronic and reactive pancreatitis, the result is good, parenteral treatment with protein drugs (transfusion of native plasma, protein hydrolysates). Best results obtained by combining antienzyme therapies (trasylol, tsalol, iniprol, zymofray, contrical) with diet therapy
Treatment of gastric and duodenal ulcers is complex and individualized, but not a single remedy gives effect without dietary treatment.
