Peptic ulcer is a common chronic disease. Ulcers occur mainly in the stomach or/and duodenal bulb and are called peptic ulcers because their formation is related to the action of gastric acid and pepsin on their own digestion.
Common causes: enhanced secretion of gastric acid and pepsin; impaired mucosal barrier; Spirochete pylori; abnormal motor function of the stomach and duodenum: causing bile salts and pancreatic juice in duodenal reflux fluid to destroy the lipoprotein layer of the gastric mucosa; related nutritional factors, such as the effect of diet on gastric secretory function; the effect of diet on the gastric mucosal barrier; the effect of smoking on the stomach.
Therapeutic measures: adequate rest, relaxation and sleep; active freedom from psychological stress; appropriate physical exercise; prohibition of smoking and alcohol consumption; avoidance of aspirin and non-steroidal anti-inflammatory drugs.
Nutritional therapy: alleviate mechanical and chemical stimulation, relieve and reduce pain, give the stomach physiological rest, and minimize the stimulation of gastric acid secretion by diet; reasonable nutrition is conducive to improving nutritional status, correcting anemia, promoting ulcer healing, and avoiding complications; long-term attention to nutritional therapy can reduce recurrence triggers.
The basic principles of diet
(1) Reasonable collocation and no partial diet: Since many patients are under great sexual pressure and have the characteristic of being picky about their diets, it is necessary to make reasonable collocation of meals according to patients’ tastes and also to instruct patients not to be partial to their preferred diets. At the same time, the main and side dishes should be combined, which not only can enhance appetite, but also can improve the physiological value of protein, which is conducive to the repair of ulcers.
(2) Develop regular eating habits: The amount and regularity of eating in peptic ulcer patients is directly related to the occurrence of pain, and irregular eating destroys the rhythm of gastric juice secretion. When you are too hungry, there is no food in the stomach to neutralize gastric acid, so that the relative increase of gastric acid and pepsin, thus stimulating the ulcer, causing pain and difficult to heal; when you are too full, it will make the stomach wall overly dilated, and it is very easy to damage the self-protection mechanism of the stomach, thus aggravating the ulcer. During the attack period, a small number of meals, 5 to 7 meals per day, the amount of each meal should not be more, easy to choose soft and easy to digest food. After the disease is stabilized, 3 meals per day can be given to normal general food to ensure the balance of various nutrients.
(3) Pay attention to the main food and side food, dry food and thin food collocation: main and side food coordination can not only enhance appetite, but also improve the physiological value of protein, which is conducive to the repair of ulcers, the main food to achieve a reasonable collocation of coarse and fine grains, that is, the main fine grains, coarse and fine grains. The main side dishes are meat and vegetarian dishes, as well as the diversity of varieties.
(4) Food should be light: food should be made with less smoke and oil explosion, especially fish and meat. Salt intake should be controlled and should not exceed 8 grams per day, and vegetable oil should be used in the cooking process as much as possible.
(5) Food should be fresh: The diet of peptic ulcer patients should be fresh, and improperly stored or too long food may produce carcinogenic substances.
(6) Do not eat too cold and too hot food: because the gastric mucosa is delicate and can only withstand a temperature of 50-60 °, too cold or too hot food can stimulate the mucosa of the digestive tract, which is not conducive to ulcer repair.
(7) to develop a good habit of chewing and swallowing: eating can not be too fast, develop a good habit of chewing and swallowing, chewing and swallowing can increase the secretion of saliva, while reducing the secretion of gastric acid and bile, which is conducive to the protection of the stomach; if swallowing, food rough, it will increase the burden on the stomach, resulting in gastric mucosa damage, aggravating the ulcer.
(8) The attack period should be a small number of meals, regular ration, avoid overeating, tendency to attack or good season, should eat more neutral and alkaline food, less vinegar and spicy food.
(9) Be sure to eat breakfast on time every day and not to skip breakfast or postpone it for more than one hour for any reason.
(10) to develop good cooking and eating habits: the food eaten should be less salt, can choose to steam, boil, boil, soft boil, braise, stew and other cooking methods, should not use grease, frying, stir-fry, vinegar, cold and other methods. When eating should chew and swallow slowly to facilitate digestion.
(11) prohibit all kinds of ulcer-inducing drugs: patients are prohibited to take non-steroidal anti-inflammatory drugs, aspirin, corticosteroids steroids such as reserpine. Because these drugs can directly damage the gastric mucosa, stimulate increased secretion of gastric acid, inducing or aggravating ulcer formation.
Food selection
(1) Avoid foods with strong mechanical and chemical stimulation, which can damage the mucosal barrier, such as coarse grains, celery, leek, snow, bamboo shoots and dried fruits; as well as coffee, strong tea, strong wine, strong broth, etc.
(2) Choose foods with high nutritional value, soft and easy to digest, and supplement with enough energy, protein and vitamins.
(3) Protein to maintain the body needs, according to 1g/kg per day supply to promote ulcer repair, if anemia, at least 1.5g/kg should be.
(4) Carbohydrates neither stimulate nor inhibit gastric acid secretion, 300-350g per day can be supplied; choose easily digestible food, sucrose should not be too much, because it can increase gastric acid secretion and easy to flatulence.
(5) fat can inhibit gastric acid secretion, note that there is no need to strictly limit.
(6) Choose foods rich in B vitamins, vitamin A and vitamin C.
(7) eat some alkaline diet, can protect the gastric mucosa, such as peanut rice, milk pasta, etc.
Food taboos
Acid-producing foods, such as groundnuts, potatoes, overly sweet snacks and sweet and sour foods.
foods prone to gas production: such as raw onion, raw garlic, raw radish, garlic scapes, onion, etc.
Raw and cold foods, such as large quantities of cold drinks, cold dishes, etc.
Hard foods, such as bacon, ham, sausages, mussels, etc.
Strong condiments, such as pepper, curry powder, mustard, chili oil, etc.
Bad habits to be avoided
(1) Smoking For patients with peptic ulcer, the main harmful effects of smoking are: (1) reducing the secretion of pancreatic carbonate and interfering with the inhibitory effect of antisecretory drugs on nocturnal gastric acid secretion; (2) reducing the tone of the pyloric sphincter and lower esophageal sphincter, leading to the reflux of bile and gastric juice.
(2) Alcohol consumption Alcohol is very closely related to the occurrence of peptic ulcer. Since ethanol has a direct stimulating effect on the gastric mucosa, a long-term diet containing more than 40% alcohol can cause mucosal erosion and ulceration of the digestive tract. In the acute activity of alcohol consumption, will make the gastric mucosa significantly congested and increased blood flow, inducing bleeding.
(3) Drinking strong tea tea contains theophylline, a strong inhibitor of phosphodiesterase activity, can promote the secretion of gastric acid and destroy the gastric mucosal barrier. In addition, when drinking tea, if the water temperature is too high, can also damage the gastric mucosa, is one of the triggers of PU.
(4) Drinking coffee Coffee can stimulate the secretion of gastric acid, easy to produce indigestion symptoms after ingestion, can induce ulcer pain, so the onset of coffee should be prohibited.
Dietary guidance
(1) Period of attack
The main manifestations are epigastric pain, abdominal distension, nausea and vomiting. Patients mostly fast or eat less for negative psychological reasons such as not understanding the disease, pain and anxiety, but at this time a reasonable diet not only plays a role in diluting gastric acid, neutralizing gastric acid and relieving pain, but also plays a role in promoting the healing of the ulcer surface.
This period should be based on less frequent meals, light and easy to digest low-temperature semi-liquid food, so that the pH value in the stomach is maintained between 4 and 5. Strictly limit the food that is irritating to the gastric mucosa, and focus on protein and carbohydrates rich in easy to digest, such as milk and rice soup, etc. Eat once every 2 h, 6~7 times a day. If milk is not accustomed to or abdominal flatulence, use soy milk instead, or add rice soup dilution, other can give steamed egg custard, diluted lotus root powder, tofu brain, of which milk, soy milk can dilute gastric acid, but also can stimulate gastric acid secretion, so should not eat more. Limit the intake of meat soup, chicken soup, fish soup, because excessive intake of fat will promote gastric acid secretion and bile reflux.
(2) Remission period
In this period, the pain is reduced and the conscious symptoms are relieved after clinical medication and dietary adjustment. With the reduction of symptoms, the diet can be gradually changed to batter, thin porridge, egg soup, etc. Steamed meat cake, minced meat and egg soup, chicken soup, etc. can be added, and meals are eaten 5~6 times a day with 50 g of main food per meal, and milk and egg flower soup can be used for additional meals.
To ensure the supply of energy and nutrients required for normal metabolism and ulcer tissue repair, the diet should be quantitative (250 mL/time), regular (time/2~3 h), and should not be eaten too fast, but chewed and swallowed slowly. Take soft and easily digestible food as the main food, and pay attention to increase nutrition appropriately to avoid malnutrition, which will affect the healing of ulcer surface, and forbid eating chopped vegetables and food containing more slag.
(3) Recovery period
During this period, the patient’s condition is stable and the self-conscious symptoms are obviously reduced. Patients should be instructed to master the regularity of eating and prevent the recurrence of disease on the basis of adhering to drug treatment. The diet is still based on soft and easily digestible semi-liquid food, and the patient can eat 5 times a day, except 3 regular meals, and 1 snack in the morning and 1 in the afternoon. You can eat soft rice, noodles, small wontons, small steamed buns, steamed fish, blanching meatballs, etc. Avoid being too full to prevent bloating; in addition, you can add some vegetables that contain less fiber, such as winter melon, potatoes, yams, taro, radish, etc. Pay attention to chew and swallow slowly.
As peptic ulcers are highly prevalent in the stomach and duodenal bulb, if you don’t eat on time, the secretion of gastric acid increases during fasting, which directly acts on the damage site, destroying the protective barrier of gastric mucosa and affecting ulcer healing. Therefore, patients should be instructed to eat regularly, avoid acidic food, eat more alkaline food, and appropriately supplement protein and vitamins to promote early healing of the ulcer surface. Protein is mainly eggs, milk, meat and other foods, and fat is mainly vegetable oil.
(4) Stable period
After the disease is stabilized, 3 meals per day can be given to normal general food to ensure the balance of various nutrients and pay attention to avoid peptic ulcer triggering factors, such as overeating, alcohol consumption, non-steroidal drugs, etc.
Recipes for ulcer patients.
(1) 100 ml of potato juice 100 grams of white precarious, honey in appropriate amount. Take equal amount of potato juice, white precarious powder (3-5 grams) and honey and mix well. You can take it immediately. Take 1 tablespoon 3 times a day for two weeks. The effect, suitable for gastric ulcer and duodenal ulcer and bleeding and other symptoms.
(2) Sea jelly 500g dates 500g, brown sugar plus 200g. Remove the core of the dates and set aside. After washing the sea jelly, put it in a pot with jujube and brown sugar, add water and decoct it with a gentle fire until it is concentrated into a paste, then cool it and bottle it. Take 1 tablespoon twice a day. Take with warm water. It has the effect of nourishing the stomach and benefiting the qi.
(3) kumquat peel pork belly soup: kumquat 5, 10 grams of peel, 250 grams of pork belly, salt, pepper a little. The kumquat cut into small pieces and set aside; pork belly, kumquat together with water and stewed over moderate heat until the soup is less juicy, salt and pepper to taste. Eat the meat and drink the soup. Drink three times a day, has the curative effect of smooth gas and appetite treatment of gastric and duodenal ulcers.
(4) Loquat leaf porridge: 30 grams of loquat leaves, 100 grams of round-grained rice, a little rock sugar. First wrap the leaves in cloth, add water to decoct the juice, filter the juice, then add japonica rice and cook into porridge. Finally, put rock sugar to taste. Suitable for patients with duodenal ulcer.
(5) red dates glutinous rice porridge: red dates glutinous rice appropriate amount, sugar appropriate amount. Put the red dates into boiling water for 10 minutes, then put the glutinous rice into the porridge and finally add some sugar to take. It has the therapeutic effect of appetite and spleen.
(6) leek milk juice: leek 250 grams, 25 grams of ginger milk 250 grams. Wash the leek and ginger separately. Then put into a container to mash the juice (or put into a blender with water and mix). Then cook the juice with milk together with a gentle fire finally add some seasoning appropriately to drink at any time. It has the therapeutic effect of nourishing the stomach.
(7) barley lentils Buddha’s hand formula: 30 grams of barley, 30 grams of white lentils, Buddha’s hand 15 grams. The yam 30 grams. Put barley, white lentils, Buddha’s hand and yam together in a pot. Add 3 bowls of water and decoct with a gentle fire, with one bowl of water left to remove the fire. Take one dose daily for 7-10 days. It is effective for patients with gastric and duodenal ulcers.
What are the dietary misconceptions of peptic ulcer patients?
(1) frequent milk: recent studies have shown that frequent milk is not conducive to ulcer healing, because milk is rich in protein and calcium, both of which can promote gastric acid secretion. In particular, the high concentration of calcium in milk can promote gastrin secretion, gastrin in turn promotes gastric acid secretion, making the secretion of gastric acid to increase by 30% after drinking milk. So peptic ulcer patients often feel comfortable temporarily after drinking milk, not long after the role of milk buffer gastric acid is offset by its obvious stimulation of gastric acid secretion, but acid reflux, which is not conducive to ulcer healing.
(2) Eat less and more meals: In recent years, domestic and international research has concluded that eating less and more meals, eating irregularly, eating to relieve pain, not only can not reduce the symptoms of ulcer disease, but will aggravate the disease. This is because the food into the stomach, although can neutralize part of the gastric acid, but the food will stimulate the secretion of gastric acid, eat more meals will make the ulcer surface constantly eroded by gastric acid, will undoubtedly be detrimental to the healing of ulcers. So ulcer patients in addition to the acute period or comorbidities in the short term to eat more meals, usually or regular quantification of three meals a day and in the middle of the appropriate additional meals for good.
(3) Eat only soft food: recent studies have shown that the lack of fiber in food is also one of the reasons for the difficulty of healing and recurrence of ulcer disease. Fine and soft foods are chewed in the mouth for a short time and saliva is not fully secreted. Modern research believes that saliva not only helps digestion, but also has the effect of neutralizing gastric acid and improving the gastric mucosal barrier. Therefore, as long as the ulcer patients are stable, they can enter the ordinary diet.
(4) Avoid eating spicy food: chili will increase the blood flow of the gastric mucosa, and will stimulate the synthesis and release of prostaglandins in the gastric mucosa, which can effectively prevent damage to the gastric mucosa from harmful substances and play a protective role. As for garlic, it also has the effect of killing Helicobacter pylori in the stomach, which is currently considered to be one of the main causative factors of peptic ulcer. As a result, peptic ulcer patients can consume spicy foods such as chili and garlic according to their dietary preferences, just be careful not to overdo it.