- Features of the diet
- What diet is prescribed for exacerbation of
- Diet during remission
- Video on topic
With GERD, the lower part of the esophageal tube is inflamed, as hydrochloric acid enters the overlying compartment and burns the esophagus. Reflux develops due to a violation of the function of the lower esophageal sphincter, diaphragmatic hernia or due to increased pressure inside the abdominal cavity.
In a third of patients, pathology provokes the development of reflux esophagitis: with a constant casting of acidic stomach contents, the esophagus mucosa is damaged, which leads to functional disorders, the occurrence of superficial inflammation, the formation of ulcers or erosions.
It was initially thought that the inflammation affects the superficial layers of the esophageal mucosa, and then erosions and ulcers develop, that is, the catarrhal esophagitis precedes the erosive. However, conducted studies have revealed that the forms of the disease develop independently of each other and are not stages of the disease.
Reflux-esophagitis manifested with belching, tenderness behind the sternum, unpleasant sensations at the time when food passes through the esophagus, constant heartburn. The lack of treatment can lead to serious complications that threaten the patient's life( bleeding from strictures or erosions, the formation of Barrett's esophagus, adenocarcinoma), so the patient needs a long and competent therapy.
One of the appointments of the doctor will be compliance with a therapeutic diet that helps reduce the frequency of reflux and provides shivering of the gastrointestinal tract( GIT), thereby creating the conditions for reducing the inflammation and regeneration of the esophagus tissues.
Features of the diet
Disease causes a disturbance in diet, because the patient, when feeling painful when swallowing and passing food through the esophagus, refuses to eat. This leads to constipation, in addition, the body does not receive the necessary amount of nutrients, from which all its systems suffer.
Dietary nutrition contributes to the normalization of the digestive process, provides the body with the necessary trace elements and vitamins, includes only those products and methods of cooking that do not lead to the emergence of reflux and flatulence.
The diet for reflux esophagitis requires compliance with the following rules:
- portions should be small( 250-300 g).This way it will be possible to avoid overeating, the stomach will not be overfilled and during the peristaltic wave the esophageal sphincter will not allow reflux to arise. You can not eat at night( dinner 4 hours before bedtime), because when the stomach and esophagus is at the same level, then the contents of the stomach are thrown into the esophageal tube;
- it is necessary to provide GIT mechanical shchazhenie. All dishes should be cooked in a double boiler or boiled and served in a liquid or porridge form. Compliance with this rule will help to avoid injury to the mucosa of large particles of food, and the food lump will pass painlessly through the esophageal tube. Mechanical shaking also includes the rejection of products containing coarse fiber, since dietary fibers are capable of irritating the inflamed mucosa;
- food should be warm. Cold and hot food irritates the inflamed mucous and inhibits the regeneration process;
- the mucosa of the esophagus and stomach should be protected from substances that can cause irritation or lead to increased secretion of gastric juice. From the diet must be excluded fatty and fried foods, as well as foods containing essential oils, fruit acids, vinegar, seasonings, spices;
- excludes products that promote gas generation. With flatulence in the abdominal cavity, pressure increases, and this leads to reflux. To reduce the processes of fermentation in the stomach, you need to remove from the diet legumes, cabbage, whole milk, raw vegetables and fruits, fresh pastries, kvass, beer;
- needs to get rid of bad habits. Smoking and alcoholic drinks irritate the mucosa of the upper parts of the digestive tract;
- in the first half of the day you need to consume most of the calories from your daily diet, and at dinner eat easily digestible foods( boiled vegetables, cereals, dairy products, omelets);
- drink not more than a liter of water per day. You can drink drinks during meals, but it is not recommended to drink after eating. Carbonated drinks, coffee, beer, kvass and, in general, a large volume of liquid contributes to the emergence of reflux.
It's best to eat room temperature
If these rules are followed for two weeks, the frequency of reflux will decrease and the inflamed mucosa begins to recover. You can not deviate from the diet, as a new release of hydrochloric acid into the esophagus will bring to nothing all efforts.
The casting of acidic contents will not occur if, in addition to the diet, follow the recommendations:
- does not go to rest after eating;
- if necessary to reduce body weight, since obesity contributes to increased intra-abdominal pressure;
- to avoid leaning forward, lifting weights, tight clothes, as this reinforces regurgitation;
- raise the head of the bed by 15 cm;
- drink alkaline mineral water.
Which diet is prescribed for exacerbation of
During the exacerbation of reflux esophagitis, a therapeutic table No1A is prescribed, which presupposes chemical, mechanical and thermal shudder of the gastrointestinal tract. This diet is quite strict and unbalanced, therefore it is recommended to observe it for up to 10 days. It is especially important to adhere to it with erosive esophagitis, since irritation of the mucosa can lead to bleeding from erosion.
Diet No 1A does not allow the presence in the diet:
- bakery products;
- meat, fish broth;
- any vegetables and fruits;
- carbonated drinks;
- coffee, strong tea, cocoa, fruit juices;
- sauces, spices;
- fatty meat varieties.
During the exacerbation, the main dishes for the patient are mashed or mucous soups, liquid porridges, once a day, meat in the form of souffle, puree
It is allowed to use dietary meat( chicken or beef), lean fish( hake, pollock, pike) during an exacerbation, cod), mucous soups( semolina, oatmeal or rice), porridge( from flour to buckwheat flour, oatmeal or rice cereal).
Allowed is low-fat pasteurized milk, low-fat curd, low-fat cream, omelet or soft-boiled eggs, honey, sugar, tea with milk, broth from wheat bran or rosehip. Kashi is allowed to cook with the addition of milk, and soups filled with milk-egg mixture.
After the pain and heartburn have passed, the patient can switch to a less strict diet No 1B.It is recommended to observe it for two weeks. Dietary table No 1B allows you to add to the diet of mashed soups with chopped vegetables( beets, potatoes, carrots), meat and fish can be cooked in the form of cutlets, meatballs, dumplings, vegetables and fruits in the form of homogenized puree( baby food).
You can eat barley rye with good portability, vegetable purees( zucchini, potatoes, beets, carrots).Milk can be drunk up to 4 times a day, twice you can eat cottage cheese, you can add cream to soups. Vegetables and fruits can not be eaten raw.
Diet in remission period
After the phase of exacerbation of the disease( during remission), the patient is transferred to diet No 1. This is a full-fledged diet that prevents the occurrence of relapse, as it moderately spares the digestive tract.
It reduces the number of animal fats, as they reduce the tone of the sphincter( oils, fatty cream, fatty meat and fish, confectionery).Eating with reflux-esophagitis also excludes the use of products that irritate the mucous( coffee, strong tea, mint, onions, garlic, chocolate, tomatoes).
It is recommended to include more proteins in the menu as they increase the sphincter tone
Diet No 1 with reflux-esophagitis allows use:
- vegetable soups that are seasoned with butter or egg-milk mixture. Pass the vegetables can not. Cereals should be well-brewed, and vegetables are wiped;
- dried bread, crackers( not more than 200 g);
- dietary meat( beef, turkey, lamb, chicken).It needs to be scrolled twice in a meat grinder, and then make steam cutlets, knels, soufflé.You can meat and bake without the formation of a coarse crust( in foil);
- of lean fish. Can be used as a piece or in the form of cutlets;
- porridge( rice, buckwheat, semolina).They are prepared with semi-tangles, they can add milk;
- milk, kefir, medium-fat cottage cheese;
- creamy( up to 20 grams) and vegetable oil. Add to ready meals;
- boiled vegetables. It is allowed to eat potatoes, beetroot, cauliflower, carrots, pumpkin, zucchini in the form of mashed potatoes;the wiped fruit. Prepare jelly, jelly, compotes, mashed potatoes. The use of citrus fruits and raw fruits is excluded;
- weak tea, diluted sweet juices, herbal drinks.
To avoid acidity of the gastric juice, irritation of the mucous and flatulence, it is recommended to remove from the menu:
- pickled, salted, pickled vegetables;
- fatty meat or meat with veins and tendons;
- smoked meat, canned food;
- fried and spicy dishes, stews;
- sauces( mayonnaise, mustard, ketchup);
- sour or fiber-containing vegetables and berries, fruits( tomatoes, onions, garlic, radish, cabbage, radishes, cucumbers, asparagus, sorrel, lemon and other citrus fruits, grapes, gooseberries);
- sour cream, curdled milk, sour kefir, cream fatty 35%, cheese with mold;
- puff, butter, yeast dough;
- seasonings, spices;
- millet, corn and pearl rump;
- sour juices( from tomatoes, pomegranates, citrus, currant), carbonated drinks, alcohol, beer, kvass, coffee, strong tea;
- chocolate, halva, ice cream;
- nuts, dates.
In catarrhal esophagitis, the diet may not be as severe, but if pains occur during passage of the food lump, you need to wipe the food to eliminate mechanical irritation of the esophagus. Heartburn is eliminated with milk, so if it is well tolerated, you can drink it for breakfast, dinner and at bedtime, add to milk porridge.
As the mucosa is restored and the reflux disappears into the soups, you can add twisted lean meat or meatballs. Fish and meat cutlets are served with garnish or vegetable puree. If erosive esophagitis has developed, then dietary nutrition must be adhered to constantly.
In catarrhal esophagitis, the diet is not so strict, but it is still necessary to exclude products that cause heartburn and consume only boiled dishes.
What can be eaten with esophagitis in each case, the doctor will determine, as the recommendations should take into account co-occurring diseases. As the diet needs to be adhered constantly, the menu at a reflux-esophagitis should be made together with the dietician.
The specialist will calculate how many calories the patient needs to consume, taking into account his age, sex, body weight and physical activity, and the dishes will contain the amount of vitamins and minerals corresponding to the age norms. The doctor will also tell you what foods in the diet should be present daily, and which not for every day.
In the treatment of reflux esophagitis, medicinal therapy is also prescribed, which is intended to eliminate symptoms, reduce the acidity of gastric juice and accelerate the recovery of the mucosa. Before using them, you should read the instructions and follow it strictly, so that the medicine does not damage the inflamed tissues.
For example, proton pump inhibitors only work if they are taken half an hour before meals, and if they are used incorrectly, they will increase the stress on the excretory organs and will not have therapeutic effect. Reflux esophagitis may require surgical treatment, but it is better not to bring it to him, but to comply with all the prescriptions of the doctor and strictly follow the diet.