Peptic ulcer of the stomach and duodenum remains a frequent pathology among the population, affecting mainly people of working age.
Despite the evidence of the infectious nature of these diseases in the form of the Helicobacter pylori bacterium, an important factor in its development, the frequency of occurrence of relapses and the severity of their manifestations is the stress factor.
- Triple barrier of protection
- Chemical
- Mechanical
- Thermal
- Recommended diets
- Table №1
- Table №1a
- Table №1b
- It is important to know
Along with etiotropic therapy aimed at eliminating the root cause of the disease - pathogenic microflora,in complex therapy, a protective regimen is acquired, equally important during periods of remission and, especially, in the acute phase.
Triple barrier of protection
One of the main components of this mode is therapeutic nutrition.
The main goal is to create favorable conditions for the body, maximizing the healing of the damaged surface of the stomach and intestines, and stimulating the body's own protective properties.
In addition, the therapeutic and dietary diet includes a complete complex of easily assimilated nutrients, vitamins and minerals necessary to enhance the immune and reparative properties of the body.
This diet will speed up the healing process and reduce the likelihood of relapse.
The basic principles laid down in the basis of dietary nutrition in gastric and duodenal ulcer - mechanically, thermally and chemically sparing the composition and mode of food intake.
First of all, this is achieved by maximum restriction in the diet of diseased products that stimulate the production of gastric juice.
This is because the main damaging factor in the pathogenesis of the disease is hydrochloric acid, which breaks the integrity of the walls of the stomach and intestines, and eventually forms a peptic niche.
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Chemical protection
Achieved by eliminating the use of products - exciters of secretion, which, in the first place, fall:
- all spices - mustard, vinegars, cinnamon, pepper, horseradish;
- meat, mushroom, fish and vegetable sauces;
- strong non-alcoholic, alcoholic and carbonated drinks - black coffee, all kinds of alcohol and strong tea, mineralized drinks and water;
- concentrated decoctions, broths and dishes based on them;
- fried dishes - from vegetables, fish or meat;
- canning products, pickles;
- black bread, pastries, chocolate.
Consumption of table salt that provokes fluid retention in the body, fraught with irritation of the gastric mucosa and intestines, is limited.
Simultaneously with the complete exclusion from the menu of acid-forming products, the formed niche is replaced by a food set with a very weak ability to stimulate gastric secretion.
These include:
-
milk and non-acidic dairy products, cottage cheese, grated choppy cheese; - dietary boiled meat and meat products;
- steam and boiled fish;
- mucous and vegetable soups and brews - from potatoes, cauliflower, carrots and beets, dairy;
- eggs in the form of steam omelettes or boiled soft-boiled;
- bread of yesterday's baking;
- demineralized non-strong alkaline drinks and water;
- liquid non-rough porridge.
Mechanical protection
Designed to minimize mechanical irritation of the gastric mucosa and intestines. Achieved by the exclusion from the list of food products saturated with fiber:
- vegetable crops( turnips and asparagus, cabbage, radishes and radish, legumes);
- of immature berries and fruits of milk ripeness, having peel( gooseberries, grapes, currants), dried fruits;
- of baked goods on a coarse flour;
- meat products with a coarse-fibrous tissue( cartilage, veins or skin).
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Thermal protection
For the thermal shoe , food that is taken away from the patient is treated with hot or cold dishes and ice cream.
The temperature of the prepared dish is approximated to body temperature, ranging from 20 to 50 degrees C.
The curative menu formed on these principles consists of products quickly evacuated from the stomach, which do not cause excessive secretion, and do not irritate the mucous membrane of the gastrointestinal tube.
In combination with other medical measures - this leads to a rapid remission of the ulcerative process and a significant improvement in the patient's condition.
Recommended diets
Nutrition of patients with peptic ulcer of the duodenum and stomach is differentiated depending on the stage of the disease and the severity of the patient's condition by using several diet options.
Table №1
The main one, used in the period of complete and incomplete remission, is diet number 1, or a mashed diet.
It promotes the subsidence of inflammatory phenomena and the healing of ulcers and erosions on the surface of the mucosa.
It is prescribed in the absence of severe pain symptoms and irritation phenomena of the gastric and intestinal membranes.
The diet number 1 includes products that regulate the secretory and motor-evacuation functions of the digestive tract, while completely providing the physiological needs of the organism in food ingredients.
is excluded from food: foods containing fiber and stimulators of gastric secretion. It is used exclusively steam and the frayed ways of preparation of all dishes.
Multiplicity of nutrition when using diet number 1 at least five times a day, in small portions, with a daily calorie content of at least 2500-3000 calories.
food package is presented as:
- of wheat bread and pastry baked goods, dry biscuits and biscuits, uncomplicated pies filled with jam, apples, boiled fish, eggs or meat;
- vegetables with low fiber content in the form of puree or steamed puddings - potato, beet, squash, carrot, pumpkin;
- low-fat meat( teltina, young mutton, rabbit, edged pork, chicken, chicken, turkey) and predominantly river fish( perch, pike, pike perch, cod) without fascial interlayers, skin and tendons;
- whole milk, cream, fresh cottage cheese in the form of casseroles and souffle, non-acid sour cream;
- fresh eggs in the form of steam omelets or soft-boiled;
- sweet and ripe berries and fruits in the form of jam, jam, pastille or marmalade, mashed puree or baked. Sweet fruit juices( raspberry, strawberry) must be diluted with water in equal parts.
- fats in the form of creamy or refined vegetable oils, which are added to the dishes in their natural form, without roasting.
To get a good therapeutic effect, diet number 1 is used for 6-12 months from the onset of an exacerbation.
Sample menu No. 1 consists of dishes cooked with boiled, ground or baked:
-
rubbed soups - cereals, vegetable( except for cabbage) or dairy, with mashed carrots, beets or mashed potatoes, with the addition of creamy, olive and other vegetable refined oils; - of mashed or chopped meat and fish cutlets, soufflé or rolls, or welded in water whole large pieces;
- of milk wiped or semi-viscous cereals, steam puddings( except wheat), curd and souffle, boiled pasta or vermicelli, cutlets from grated cereals;
- drinks in the form of a weak tea with milk or cream, vegetable juice( beet and carrot), decoction or compote of rose hips or wheat bran.
- sweets in the form of boiled or baked berries and fruits, mashed potatoes, milk kissels, mousses, honey and jelly, cream, honey, marshmallow and pastille.
For filling dishes you can use milk and fruit sauces, as well as finely chopped parsley or dill.
Table №1а
Diet N 1a, or the most gentle diet, is used at the height of exacerbations of the ulcerative process, when the symptoms of irritation of the stomach and intestines are strongly pronounced.
Usually, such a diet is prescribed simultaneously with bed rest.
Diet No. 1a is characterized by a more severe restriction of mechanical and chemical stimuli, in comparison with the previous version.
All dishes are prepared exclusively with steam or frayed methods, the consistency is liquid or semi-liquid. Fraction of food up to 6 times a day with a temperature of dishes from 15 to 65 degrees C.
Completely excluded from the diet:
- all bakery products;
- vegetables in any form;
- any snacks, sauces, condiments and spices.
Exemplary menu No. 1a consists of:
- mucous soups of oats, semolina, buckwheat or rice;
- steamed fish and meat souffles - no more than once a day. Low-fat meat( veal, rabbit), fish( pike perch, pike, cod, perch) or poultry( turkey, chicken) are used, excluding tendon, skin and fascia;
- liquid mashed porridge in water with milk or cream from cereals, excluding wheat - not more often than a single meal a day;
- whole milk, non-acidic milk products, cream, curd mousse or soufflar;
- dishes from eggs - steam omelettes, soft-boiled eggs( one to three pieces per day);
- drinks in the form of fruit and berry jelly from sweet varieties, diluted with water juices, broth of rose hips or wheat bran;
- butter - as an additive to prepared dishes.
Steam cutlets, zrazes, beef stroganoffs from boiled pulp, knels, crochets and soufflé are also allowed.
This strict restrictive diet is indicated in the first two weeks after the onset of an exacerbation of the ulcerative process.
It is also used in patients in the postoperative period after surgery on the stomach or intestine.
Table №1b
Appointed in a later period, immediately after the completion of the course of treatment using the table number 1a.
Diet differs from the previous ratio of proteins, fats and carbohydrates and higher caloric value.
It also significantly limits the list of mechanical and chemical stimuli of the stomach and intestines.
In the diet there is bread in the form of white rusks of higher grades, meat and fish cutlets, meatballs or knals.
Besides rubbed soups, rinsed porridges are allowed in the ration, the multiplicity of their use is also increased..
Dishes are also prepared in liquid or porridge form, and you need to eat 5-6 times, vegetables, fruits and bread are banned.
Important to know
Dietary nutrition in the treatment of peptic ulcer of the stomach and duodenum serves as a necessary and reliable background for the subsidence of "inflammation fire" in the cavity of the stomach and intestines.
Look at the popular prescription for treatment of stomach and duodenal ulcers.
