With gastroesophageal reflux disease, the contents of the stomach rises to the esophagus, as the sphincter, which should prevent it, is relaxed andis not able to fulfill its function. Reflux occurs as a result of increased intra-abdominal pressure, which may be due to obesity, pregnancy, constipation, increased gas production, stomach or duodenal disease, and age-related changes.
The main symptom of the disease is severe heartburn. Complication of the pathology is considered reflux-esophagitis. It develops in about a third of GERD patients and is characterized by heartburn, regurgitation( gastric juice rises to the pharynx), difficulty swallowing, eructation with a liquid( specific manifestation).Also, patients talk about voice changes, coughing, frequent hiccups, belching of the air, regurgitation of food, nausea after eating.
Often, with pathology, pain in the chest occurs along the course of movement of the food lump, since benign strictures are formed in the esophagus, which lead to narrowing of the lumen. If the lumen of the esophagus is less than 13 mm, difficulties arise when swallowing only solid foods, if the width of the tube is less, the patient is difficult to swallow fluid and even saliva.
The course of the disease goes through 4 stages. At grade 0 macroscopic changes in the esophageal mucosa are absent, pathology is detected only after histological examination. At 1 degree, one or several inflammatory foci, hyperemia of the mucosa or exudate are noticeable. On 2-3 stages erosion diseases merge and become circular, and in 4 stages, chronic damage to the mucosa of the esophagus is already visible.
General recommendations
Diet for esophagitis helps to reduce the frequency of reflux, which helps to eliminate the inflammation and healing of erosion. Since a person experiences discomfort during eating and nausea after, the regime and volume of food are often disturbed, constipation appears, the therapeutic diet should take into account these factors.
The diet assumes observance of following rules:
- refusal of fat and fried food;
- it is necessary to eat often, but in small portions;
- is not before going to bed;
- to provide chemical and mechanical shining of the digestive system;
- not to drink alcohol;
- remove from the diet all products provoking increased gas formation;
- drink no more than 1 liter of liquid per day.
Nutrition during an exacerbation
During the exacerbation of the disease, the diet should be as gentle as possible, so the treatment table №1А is shown. The list of allowed products is not diverse, so the diet can not be called physiologically complete, and therefore, stick to it for a long time should not be. Maximum diet number 1A should be observed for 10 days.
When exacerbation of reflux esophagitis, the basis of the diet is mucous or rubbed soups and liquid porridge, and meat dishes can be eaten no more than once a day.
In the acute period of the pathological process, the patient can include in the menu:
- dishes from dietary meat( chicken, beef, rabbit, turkey).It can be a souffle, mashed potatoes. And the meat should be twisted twice in a meat grinder or whipped with a blender;
- low-fat fish( cod, hake, pike, pollock).It must also be well ground;
- mucous soups from oat, semolina or rice cereals. Groats are cooked in water until completely boiled. Instead of cereals, flour for baby food can be used. The soup does not add broth or vegetables. It is filled with a milky egg mixture( a well-placed boiled milk with a raw egg is added to the cereal broth), you can also add a little butter;
- porridge from milled cereal. You can take buckwheat, oatmeal or rice and grind it on a coffee grinder or buy ready-made flour. Porridge should be liquid, you can add milk to it;
- pasteurized milk with low fat content, cottage cheese, low-fat cream;
- steam omelet or eggs with soft yolk;
- jelly, berry jelly, sugar, honey;
- weak tea with milk, decoction of rose hips or wheat bran.
After the inflammatory process has subsided a little, the patient can switch to the diet number 1B.It is not so strict and it can be adhered to for up to 14 days. The diet is expanded by milk proteins, because they are considered to be easily digestible. In the soup can already be vegetables( potatoes, beets, carrots), but they should be well-boiled and wiped.
Meat is allowed not to be beaten, although it can not be eaten by a piece. From it prepare cutlets, meatballs, meatballs, knels. Vegetables and fruits can be consumed in the form of homogenized puree( you can buy baby canned).You can also eat vegetable puree from potatoes, carrots, zucchini, beets. In day you can eat up to 3 eggs.
Diet in remission period
After the condition is normalized and the clinical symptoms of reflux esophagitis pass, you can eat within the diet table number 1.This diet is physiologically complete and is moderately sparing, it can be adhered to for a long time.
According to her, the diet should reduce the number of animal fats, as they reduce the tone of the esophageal sphincter, which means that the menu excludes fatty milk and cream, butter, fatty meat and fish, confectionery. Chewing gums and sweets for resorption are not recommended for inflammation of the distal esophagus.
Also removed are all products that are capable of enhancing the secretion of gastric juice or promote increased gas production. The diet should have more protein, since it increases the tone of the sphincter. The main part of the daily diet should be eaten in the morning, so as not to eat up at night, and in the evening it is better to eat easily digestible foods, for example, vegetable dishes, sour-milk drinks, omelets, porridges.
Therapeutic diet number 1 allows you to consume:
- dried wheat bread or crackers( maximum 0.2 kg per day);
- mashed vegetable soups;
- lean meat( beef, lamb, chicken, turkey, rabbit).It can be eaten in baked form provided that there is no coarse crust( you need to bake it in foil);
- fish. It can be prepared by a piece or chopped;
- porridge. The most sparing manna, oat, buckwheat and rice. Porridge is cooked on water or on milk, but they should still be well-boiled and liquid;
- milk up to 3.2% fat and cream to 10% fat, kefir, curd 5% fat( it needs to eat fresh, can be diluted with milk for a more liquid consistency);
- butter and sunflower oil( can be added only to ready meals);
- boiled vegetables( potatoes, pumpkin, zucchini, beets, carrots, cauliflower);
- sweet fruit puree;
- jelly, marmalade, marshmallow;
- steam omelet, boiled eggs with liquid yolk;
- compotes, kissels, tea with milk, sweet fruit juices, herbal decoctions( mint under the ban), broth of wild rose, mineral still water.
Relaxes the lower esophageal sphincter chocolate, peppermint, tomatoes and its products, orange and pineapple juice, so they must be abandoned forever.
Prohibited products
The diet in esophagus esophagus requires completely to exclude or restrict the use of the following foods and dishes:
- sauerkraut, pickled vegetables, mushrooms in any form;
- fatty and coarse meat( with cartilage, streaks);
- canned food, smoked sausage, stew;
- any smoked, dried fish;
- rich meat and fish broth;
- dishes, dressed with sauces( mayonnaise, mustard, tomato paste, dressings with vinegar or lemon juice, etc.);
- pasta;
- millet, pearl, corn and barley;
- tomatoes, onions, garlic, radish, radish, cucumber, sorrel( as they contain extractives that make digestion difficult);
- legumes, black bread, whole milk, white cabbage( since they contribute to bloating);
- sour fruits and berries( grapes, gooseberries, currants), nuts and peanuts, dates;
- raw vegetables in the period of exacerbation;
- sour kefir and cottage cheese, moldy or feta cheese,
- sour juices( currant, citrus, pomegranate), carbonated drinks, alcohol, strong coffee or tea, cocoa;
- chocolate, halva.
Nutrition, depending on the form of the disease
Eating with catarrhal esophagitis( when the inflammation affects only the surface layer of the esophageal mucosa) may not be so strict, but in any case, if there is soreness in the chest when passing the food lump, then all the food should be wiped,to minimize the mechanical effect on the tissues of the esophageal tube.
Heartburn can eliminate milk. Since it is alkaline, it is able to deactivate the acidic environment of the stomach. In addition, it is a protein product containing a large number of antacids, which neutralize hydrochloric acid. Milk has an enveloping action and is able to "calm" the walls of the stomach and esophagus. That is why when esophagitis is recommended to use milk porridge twice a day and at night to drink a glass of milk.
With GERD nutrition should be dietary constantly, only this way it will be possible to avoid the occurrence of ulcers and strictures of the esophagus. If erosive esophagitis has developed, then exacerbation of the pathology can occur every time after consuming fatty, fried, spicy food or alcohol. Dietary nutrition not only prevents the occurrence of relapse, but also helps to get rid of heartburn, belching, pain in the esophagus and heaviness in the abdomen.
If there is milk intolerance, then it can be replaced with yogurt without fruit additives or non-acid curd
When esophagitis is observed, dieting is often the only prescription of the doctor, since there is only symptomatic treatment of the disease, aimed at eliminating a specific symptom. Antacids, proton pump inhibitors, H2 blockers and prokinetics are prescribed for a short time. After drug therapy, 80% of patients experience a relapse within six months.
Make a correct diet will help a dietician. The doctor will take into account the age and physical load of the patient, the pathology clinic, concomitant diseases, taste preferences. With the help of a specialist, you can not only make a menu for a week, but also pick up an alternative to boring dishes while maintaining a daily nutrient rate.
