- Basic principles of the diet
- Selection of products for the diet
- Examples of the menu
- Related videos
The gastric mucosa can be exposed to a variety of negative factors. These are certain food products and beverages, acute and chronic stress, the introduction and reproduction of the microorganism Helicobacter pylori. As a result, the integrity of the mucosa is disturbed, and sites of ulceration or erosions are formed around which inflammatory foci are formed.
Erosive gastritis, and this is the name of this pathological condition, differs from peptic ulcer in terms of morphological characteristics. Erosions can be numerous and of various sizes, but they never affect the muscular layer of the gastric wall, affecting only the mucosa and submucosa. When they are healed, scarring is never formed, that is, the mucous layer is completely restored morphologically and functionally. However, a patient suffering from an erosive lesion of the stomach also suffers from such symptoms as "hungry" pains, nausea and vomiting, belching, bloating, eating and stool disorders.
In a massive erosive process, along with the destruction of the mucous layer, destruction occurs and blood vessels. Blood is poured into the cavity of the stomach, appears in the vomit masses and stools. This condition is called an erosive hemorrhagic gastritis, which can be both acute and chronic, with regular exacerbations. In addition, it is often diagnosed a combination of inflammation of the antral part of the stomach( located in the transition of the stomach into the small intestine) with duodenal ulcers, often with bulbitis, or the entire small intestine( gastroduodenitis).Virtually all these types of pathologies are characterized by the presence of bleeding erosions, require rapid diagnosis and comprehensive treatment.
To correct it and speed up the regeneration of the mucous membrane, complex therapy is used. It consists of antibacterial agents if Helicobacter Pylori is detected, as well as medications that reduce the secretory activity of the stomach and the acidity of the juice that affect the restorative capacity of mucosal cells. However, no less important direction of treatment is the diet with erosive gastritis. Competent selection of dishes and their processing, as much as possible sparing for mucous stomach and intestines, allow to achieve the disappearance of erosions and, consequently, the improvement of the patient's condition, within 3-4 weeks after the beginning of the application of therapeutic nutrition.
The erosions in the stomach are caused by many factors, including the Helicobacter pylori bacterium
. Basic principles of the
diet Each patient who has erosive pathologies of the gastrointestinal tract determines his level of acidity, the degree of secretory and motor function of the stomach. Gastritis can occur against the background of Helicobacter pylori infection or be combined with various background pathologies. All these factors are necessarily taken into account both in the preparation of the therapeutic regimen, and in the appointment of therapeutic nutrition.
For all types of erosive lesions, Table 1 is shown for Pevzner, which has two more varieties( A and B), each of which is assigned according to the diagnosis and condition of the patient and is designed to achieve the following objectives:
- maximal sparing or absolute rest for the gastric mucosaand small intestine;
- slowing down the process of acid formation;
- decreased reflex excitability of the stomach;
- optimization of motor activity of the stomach;
- elimination of clinical manifestations of gastritis.
When the manifestation of acute erosive gastritis, as with exacerbation of the chronic form, the patient's condition in most cases is regarded as severe or of moderate severity. The patient is necessarily hospitalized and, on the background of intensive drug therapy, is subjected to complete starvation within the first 1-2 days. If the symptomatology remains still alarming, then the fasting period, with the use of only free liquid, can be prolonged for several more days. During this period, the patient is fed parenterally.
Then he is assigned a table 1A, which is characterized by maximum exclusion of the gastric mucosa. Gradually introduce mucous decoctions, kissels, berry broths, meat soufflé.With stable improvement, the patient is transferred to the table 1B and begins to receive weak broths, steam dishes from meat and fish, boiled vegetables, rusks from wheat bread. Such a diet with erosive gastritis of the stomach lasts up to 2 weeks, when the ulceration of the mucous membrane is completely "tightened" with a new tissue, and the patient's condition will improve much.
Certain clinical indicators give grounds to further transfer the patient to table number 1, in which the diet is more extended, and the person begins to fully receive all the necessary nutrients and energy. The main characteristics of the diet with erosive gastritis( at stage table number 1) are as follows:
- have an energy value of a daily diet of 3000 kcal;
- full balance in fats, carbohydrates, proteins;
- fractional food intake, that is, 5-6 times a day, which should be eaten in small volumes of 200-250 grams( approximately 1 cup);
- daily amount of liquid - 2 liters;
- significant reduction in the amount of animal fats;
- exclusion of products that increase the rate of gastric juice production and acidity, accelerate the peristalsis of the stomach and intestines, irritate the mucous membrane, stimulate the reflex excitability of the stomach;
- maximum chemical, thermal, mechanical shading of the mucous membranes.
In the first days of an exacerbation, you can drink only warm water
On the last point it is worth to stop in more detail. The mucous layer of the stomach needs some time to cope with the inflammatory phenomena, carry out the regeneration process and completely restore its integrity and functionality. In order not to disturb and not to violate these physiological processes, in the first days of acute manifestations the patient in general should not eat anything. Then, the methods of preparing food and processing food should be such that not only does not make it difficult, but also contribute to the early regeneration of the mucous membrane.
Chemical shchazhenie implies the exclusion from the menu of all foods and beverages that aggressively and irritatively affect the stomach and intestines. For example, marinades, smoked products, spicy spices. Also it is impossible to fry in oil or to prepare on a grill( at considerable improvement of a condition of the patient it is possible to bake products).Recommended methods of cooking products - boiling, quenching, "steamed".
Thermal shoe means the use of only warm dishes, in no case hot or cold, which can adversely affect the still weak mucous membrane. Eating with erosive gastritis should also be mechanically sparing. This means that the dishes should be in the form of broths, broths, mashed potatoes, minced meat or small pieces.
Roasting products completely excluded
Selection of products for the
diet In most clinical cases, ulceration of the mucosa is provoked by increased acidity. Therefore, this factor determines to a greater extent what can and can not be eaten by the patient. All products that reduce and normalize the level of acidity of gastric juice are allowed, and what is irritating to the stomach and provoking its accelerated activity is limited.
More conveniently allowed and forbidden products to present in the form of the following table:
|You can eat||You can not eat or should be restricted|
|The first dishes in the form of soups on light vegetable, meat, fish broths||Soups and borscht on strong broths|
|Groats - manga, buckwheat, rice, oatmeal, which are added to soups or cooked as cereals||Sausages|
|Pasta from small fractions||Mushrooms|
|Low-fat meat - veal, chicken, turkey, rabbit||Raw vegetables with coarse fiber - legumes, radish, turnips, cabbage, white|
|Low-fat river or sea fish - haddock, mintfish, carp||Animal fats, including margarines, mayonnaise, cooking oil|
|Chicken eggs boiled or in the form of omelets on milk||Fatty meat and fish types|
|Vegetables - cauliflower, potatoes, carrots,beetroot, squash, squash, squash||Groats - millet, barley, barley, corn|
|Bread from wheat flour dried||Eggs in the form of fried eggs|
|Not pastry pastry||Smoked meat, marinades, pickles, canned meat, fish, vegetables,pickled vegetables|
|Butterin small quantities||Hot spices and sauces - garlic, mustard, horseradish, bitter pepper, ginger, tomato paste, ketchup|
|Dairy products( milk, cottage cheese, non-sharp cheese)||Baked bread, fresh black and white bread|
|Non-acidic fruitand berries in boiled or baked form, as well as desserts based on them, fresh watermelon and melon in small quantities||Sour milk products( curdled milk, kefir, yoghurt, sour cream), hot cheeses|
|Drinks - loose tea and coffee with milk, broth of wild rose,fruit drinks from sweet berries and fruit||Acid berries and fruits|
|Drinks - strong tea and coffee, alcohol, carbonated drinks, kvass|
|Chocolate, ice cream, candies|
As you can see from the list of allowed products, a patient with erosions in the stomach can eat a lot, eat fully and diversely, receivethe necessary amount of energy and vitamins, be active at the same time and have a positive psycho-emotional mood. You should strictly adhere to the rules of cooking: do not fry foods, try to grind them and eat them warmly.
Marshmallows, pastilles, marmalades, various mousses with erosive gastritis are resolved
Examples of the menu
When leaving hospital for outpatient treatment, the patient receives a detailed list of recommendations that also apply to nutrition. Based on the list of allowed products, it is more convenient to calculate the ration at once for a week, this can provide a maximum variety in the patient's diet.
Here is an approximate recommended menu for erosive gastritis:
Breakfast 1 : Rice porridge on milk, a piece of dried white bread, loose sweet tea;
Breakfast 2 : two baked apples of a sweet variety;
Lunch : chicken broth with vermicelli, boiled buckwheat with steam beef from beef, white bread, jelly;
Snack : omelet from two eggs, not strong tea;
Dinner : vegetable ragout with pollock "on a pair", a piece of bread, compote.
Breakfast 1 : semolina porridge on milk with a spoon of strawberry jam, bread, tea;
Breakfast 2 : vegetable casserole, mors;
Lunch : soup with cod and potatoes, white dried bread, "hedgehogs" with beef and rice, compote of dried fruits;
Snack : a glass of loose tea and 2-3 pieces of marshmallow;
Dinner : mashed potatoes with a piece of boiled chicken, bread, tea.
Breakfast 1 : oatmeal porridge on milk, not strong coffee with milk, bread;
Breakfast 2 : a glass of tea and 2-3 pieces of dry biscuit;
Lunch : soup on meat broth with rice, bell pepper stuffed with carrots, bread, compote;
Snack : two baked pears;
Dinner : casserole from cottage cheese, jam from raspberry or strawberry, tea.
All products required for therapeutic nutrition are affordable and relatively inexpensive. Of these, you can make a varied menu, without which the effective treatment of erosive gastritis is impossible.