PEPTIC ULCER

Peptic ulcers are open sores that form on the stomach lining and the upper region of the small intestine.  Stomach discomfort is the most prevalent sign of a peptic ulcer.

Overview of Peptic Ulcer

Peptic ulcers are open sores that form on the stomach lining and the upper region of the small intestine.  Stomach discomfort is the most prevalent sign of a peptic ulcer.

A mucous layer coats the digestive system, which generally protects it from acid. However, if the amount of acid or mucus is increased, the ulcer situation begins.

When acid in the digestive tract tears away at the inner surface of the stomach or small intestine, peptic ulcers form. The acid might cause an uncomfortable open sore that may bleed.

There are two types of peptic ulcers:

  • Those that form within the stomach called as gastric ulcer
  • Those that form inside the upper part of the small intestine called as duodenum ulcer

Etiology

Multiple factors contribute to the development of peptic ulcer.

  • Alcohol and nicotine are two environmental factors that have been shown to diminish mucus and bicarbonate production and increase acid secretion.
  • Children of parents with duodenal ulcer have a threefold increased risk of developing ulcer themselves.

Causes

  • Infection with the bacteria Helicobacter pylori (H. pylori) is the most prevalent cause of peptic ulcers.
  • Non-steroidal anti-inflammatory medication (NSAID) and aspirin usage in the long term
  • No correlation exists between stress and peptic ulcers. But they may aggravate condition instead.

Symptoms

  • Pain in the abdomen that worsens after eating,
  • A feeling of fullness
  • Bloating, or belching
  • Sensitivity to fatty foods
  • Heartburn
  • Nausea, vomiting, or vomiting blood
  • Dark blood in the stools
  • Difficulty breathing
  • Dizziness
  • Weight loss
  • Changes in appetite

Nutritional Treatment

Nutrition and dietary guidelines are used to enhance health, reduce the risk of illness, and treat existing conditions. With the goals of healing and maintaining the gastrointestinal lining, better digestion, pain relief, and supporting a healthy nutritional status, food therapy has shown to be an important part of Peptic ulcer prevention and treatment.

5.1. Nutritional Recommendation:

Nutrients

Acute phase

Recovery phase

Carbohydrates (%)

50-60

50-60

Protein (g/kg/weight)

1.2

1.5

Lipids (%)

25-30

25-30

Zinc (mg)

11

40

Selenium (ug)

55

400

Vitamin A(ug)

900

3000

Folic acid (ug)

400

400

Iron (mg)

45

45

Fibers (g)

20-30

20-30

Probiotics (UFC/day)

109-1011 lactic acid bacteria

109-1011 lactic acid bacteria

 

5.2. Peptic ulcers and dietary fibers: 

  • People with peptic ulcers tend to have diets low in fiber and antioxidants.
  • Fibers act as buffers, decreasing concentrations of bile acids in the stomach and the intestinal passage time, leading to less abdominal bloating and, in turn, decreased discomfort and pain in the gastrointestinal tract.
  • The World Health Organization recommends a high-fiber diet (20-30 g/day) for people with peptic ulcer.

 

 

5.3. Probiotics and peptic ulcer:

  • Probiotics are a kind of dietary supplement made from living microorganisms that have been shown to have therapeutic effects on the human body by maintaining a healthy microbial balance.
  • Although probiotic organisms do not seem to eliminate H. pylori but they do have the capacity to lower the bacterial load and infection.
  • Therefore, it is suggested that one consume between 109 and 1011 CFU of lactic acid bacteria daily.

5.4. Antioxidants and peptic ulcer:

  • Vitamin C (antioxidant) has been shown to have significant impacts on the eradication of bacteria in patients with peptic ulcer.
  • Patients with peptic ulcer caused by H. pylori can take up to 500 mg/day of vitamin C for a period of three months, which does not exceed the recommended UL of 2000 mg according to DRIs, because lower doses were more effective than higher doses.

5.5. Milk and peptic ulcer:

  • Due to its buffering effect and significant effect on gastric acid secretion, milk is no longer recommended for the treatment of peptic ulcers.
  • However, in the early 20th century, a diet based on milk and milk cream was used in combination with antacids to treat gastrointestinal ulcers on the theory that this would provide gastric alkalization and relieve pain.

5.6. Peptic ulcer and the use of micronutrients:

  • In addition to protein, there are particular micronutrients like zinc, which is necessary to maintain the function of the immune system, as a reaction to oxidative stress, and to repair wounds, that may speed up the healing process.
  • There is some evidence that seleniumhelps fight off infections and speeds up recovery.
  • Vitamin Aas a supplement, however the evidence for this is weak since extremely high doses don’t help treatment and excessive consumption may be harmful.

Allowed foods, foods that should be consumed and foods that must be avoided

  • 6.1. Food allowed during peptic ulcer:

    • High-fiber meals including oats, brown rice, whole-grain bread, fruits, and vegetables are beneficial to digestion and bowel regularity.
    • The majority of people tolerate lean proteins like skinless chicken, fish, tofu, beans, and lentils.
    • Choose low-fat or skim milk, yogurt, and cheese since they are less likely to aggravate the condition.
    • Olive oil, avocados, and almonds (in moderation) are examples of healthy fats to add to diet.
    • The majority of people have no problems eating non-citrus fruits including bananas, apples, pears, and melons.
    • Vegetables that have been cooked, such as carrots, spinach, and zucchini, are often better tolerated than raw vegetables.
    • Calming herbal drinks like chamomile or ginger are great alternatives to coffee.
    • Hydration is crucial for proper digestion and general well-being, so drink plenty of water.

    6.2. Food not allowed during peptic ulcer:

    • The stomach lining may be easily irritated by spicy meals like hot peppers, chili, and others.
    • Limit intake of acidic foods including oranges, grapefruits, tomatoes, and vinegar.
    • Coffee, black tea, and caffeinated soft drinks may all stimulate the formation of stomach acid.
    • High-fat meals, including fried dishes, might aggravate symptoms by slowing digestion.
    • Carbonated drinks: they might cause pain by increasing gas and bloating.
    • Alcohol: It might aggravate the stomach lining and cause more acid to be produced.
    • Chocolate: Its chemical makeup may cause the lower esophageal sphincter to relax, which in turn makes acid reflux worse.
    • Mints, especially peppermint and spearmint, have been linked to a decrease in lower esophageal sphincter tone and an increase in acid reflux.

Recommendation

  • The high fiber content (20-30g/day) of apples, pears, whole grains, granola, flaxseed, and oatmeal is beneficial for treating ulcers by reducing acid, lessening swelling and discomfort in the stomach, and facilitating fecal excretion more rapidly.
  • Yogurt is rich in probiotics (109 to 1011 CFU/day), which may help reduce bacterial load and infection, and ulcerative colitis sufferers should eat 1 to 2 servings per day.18
  • Vitamin A, which is found in spinach, carrots, melons, and beef liver (900-3000 ug/day), may help to heal and prevent peptic ulcers.
  • Guava, strawberries, kiwis, and broccoli are all good sources of vitamin C (75-500 mg), which may aid in protecting against ulcers and promoting wound healing.
  • Drinking milk was recommended as a treatment for ulcers back in the day when there weren’t any other effective options. Because milk has an acidic pH, the belief never had a chance.
  • Yogurt is a superior replacement for sour cream.
  • In case of ulcer or are prone to getting one, refrain from drinking alcohol and smoking. Ulcers may become more severe as a result.
  • Avoid fried foods since they are harder to digest and may lead to gas and bloating. As a result, they may aggravate ulcer.
  • In case of lot of discomfort after eating spicy food, don’t eat it.
  • The effects of caffeine, and coffee in particular, on ulcers remain controversial. However, limiting their use is preferable.

References

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