Dietary nutrition for stomach ulcers. Diet for stomach ulcers

With peptic ulcer, there is a reduced resistance of the gastric mucosa to the acid-peptic activity of gastric juice. In this case, ulcerative defects appear. One of the factors in the appearance of ulcers is nutritional errors. Any food that irritates the lining of the stomach aggravates the course of the disease, reducing the quality of human life. The disease has a chronic course with periods of relapses and remissions. Therefore, the diet for gastric and duodenal ulcers is one of the main factors in the effective treatment of pathology.

Diet for exacerbation of stomach ulcers involves sparing nutrition. The menu contains not too hot and not cold dishes. Mechanical sparing involves the use of only liquid, puree and mushy food. The principles of dietary nutrition include chemical sparing of the mucous membranes of the gastrointestinal tract. Any irritating food is excluded from the diet.

1. The combination of products somewhat reduces the aggressive effect on the digestive organs. For example, the combination of proteins and fats inhibits hypersecretion.
2. Regular and fractional meals facilitate the process of digestion and absorption of nutrients.
3. The diet contains the necessary nutrients, which not only provide the body with micro and macro elements, but also contribute to the healing of ulcerative defects.
4. Products are selected taking into account their positive effect on the nervous and endocrine systems.

The period of exacerbation proceeds in several stages, and at each a diet for a stomach ulcer should be observed.

Diet in the first 12 days after exacerbation

The goal of diet therapy at the first stage is to create rest for the mucous membranes of the gastrointestinal tract in order to maximize the regenerative processes. All dishes should be boiled or steamed, liquid and pureed. The Pevzner diet is classified as 1 a. During this period are allowed:

1. Mucous soups: semolina, rice, barley. For taste, add the egg-milk mixture or cream during cooking.
2. Meat soufflé made from lean meat or fish. You can: rabbit, chicken, pike perch, pike, turkey, veal. The skin is removed during cooking.
3. Boiled and grated cereals: rice, buckwheat, oatmeal, semolina (except for millet).
4. Steam omelets.
5. Steamed curd soufflé or unleavened curd with added sugar.
6. Drinks: weak tea with milk, rosehip broth, milk, non-acidic juices and fruit jelly,

A little butter is added to ready-made dishes, and whole low-fat milk is allowed to be poured into cereals. Limit salt to 6 g per day (a teaspoon with a slide).

What needs to be excluded:

• flour dishes;
• baking;
• fat meat;
• marinades;
• sauces;
• mushrooms;
• cheeses;
• kvass;
• coffee;
• tomatoes;
• cabbage;
• cucumbers.

During this period, patients need an increased intake of proteins that can stimulate recovery processes, reducing the aggressiveness of gastric juice. Food with simple carbohydrates (sweets, pasta, bread) stimulates the autonomic system, worsening the symptoms of the disease.

Nutrition for the next 10–12 days

During this period, usually acute processes subside. Patients have reduced pain, dyspeptic symptoms (nausea, heartburn). The objectives of diet therapy are the healing of ulcerative defects, providing the body with nutrients in a more active lifestyle. At this stage it is recommended:

1. White bread crackers (no more than 100 g).
2. Mucous soups with pureed cereals.
3. Steamed lean meat. Served in chopped form. You can cook steam cutlets, quenelles or meatballs.
4. For garnish: vegetable purees, pureed cereals.
5. Non-acidic cottage cheese and soufflé from it.
6. Milk soup.
7. Drinks: cream, milk, jelly, tea with milk and honey, sweet juices from fruits and berries, rosehip broth.

Ready meals are seasoned with butter, olive oil. Prohibited foods are the same as in the first stage of the diet.

Nutrition after 24 days from the onset of an exacerbation

From the fifth week, the process of healing of the ulcer and scarring of the ulcer ends. The patient normalizes the regulation of nervous and hormonal mechanisms. The tasks of diet therapy include reducing the inflammatory process, accelerating reparative processes.

Patients become more active, so they pay attention to calorie content (3500 kcal) to make up for energy costs. The amount of salt can be increased up to 10 g.

The menu at this stage of medical nutrition is more diverse. Dishes are also steamed or boiled, but no longer wiped. Baked foods are allowed. The patient should have such food for at least two months.

What is possible:

• dry bread (yesterday);
• biscuits or biscuits;
• oatmeal cookies or other non-butter;
• jam from berries or fruits;
• vegetable soups with cereals (not grated) with the addition of cream;
• lean meat and fish (in this period, you can slice it);
• offal: tongue, liver;
• bone broth;
• jellied meat or fish;
• meat pies;
• sausage without lard;
• liver pate;
• herring;
• boiled vegetables: potatoes, carrots, squash, pumpkin, peas.
• ripe tomatoes and lettuce;
• pasta, noodles;
• porridge is not pureed, crumbly;
• sweet berries and fruits;
• marmalade, marshmallow, caramel.

In this period, you can have weak coffee with cream, fresh curdled milk, cheeses. For taste, they include milk-cream sauces, sauces from milk and berries. They are sometimes allowed to drink a glass of dry wine.

What should be excluded from the diet:

• cabbage;
• radish;
• onion and garlic;
• sour greens: spinach, sorrel;
• pickles and sauerkraut;
• okroshka;
• canned food;
• very cold drinks;
• fatty meat and fish;
• spices;
• yeast drinks.

A gradual transition from one stage of diet therapy to another eliminates frequent relapses of the disease, provided that adequate treatment is provided.

Prohibited foods for stomach ulcers

One of the basic principles of nutrition is to take into account the effect of products on the secretion of gastric juice and gastric motility. In this regard, dishes that are strong pathogens are excluded from the diet:

• extractive substances contained in strong broths and vegetable broths;
• spices;
• smoked meats;
• salty dishes;
• meat dishes stewed in own juice;
• pickled products;
• hard boiled eggs;
• black bread;
• dairy products;
• strong drinks with caffeine and tannin;
• sweet soda;
• sour fruits;
• fiber-rich foods: legumes, grapes, corn;
• stringy meat.

Large portions also cause an exacerbation of the disease.

Diet for ulcer remission

In order to avoid seasonal relapses in spring and autumn, it is recommended to stick to a diet during the interictal period. Those products that irritate the hepatobiliary system are excluded from the menu. Patients with stomach ulcers on a diet are shown the following list of products:

• stale white bread;
• milk and dairy products;
• cracker;
• ripe sweet fruits and berries;
• tea with honey and lemon;
• granular caviar;
• jam and jam;
• lean meat;
• jellied meat and fish;
• soups on a weak broth, not fried;
• boiled and stewed vegetables;
• side dishes: pasta, crumbly cereals;
• soft-boiled eggs or omelets.

The duration of the anti-relapse diet is 4 weeks. The main thing is to observe the mode of fractional nutrition. During the day, there should be two breakfasts, lunch, afternoon tea, dinner and a small snack 3 hours before bedtime.

Sample diet menu for stomach ulcer menu:

1. First breakfast: a slice of bread with butter and tea with honey, lemon or milk.
2. After 2-3 hours, a second breakfast: a sandwich with meat or fish, rosehip broth or tea.
3. After 3 hours, lunch: soup, meat or fish with a side dish (porridge or vegetable puree), jelly or a fermented milk drink.
4. Afternoon snack: biscuits with tea.
5. Dinner: low-fat cottage cheese, porridge with milk, tea.
6. 3 hours before bedtime: scrambled eggs, milk.

To avoid irritation of the gastric mucosa, you can not eat dry food.

Nutritionists recommend including Hercules porridge in the daily diet, which reduces the acidity of gastric juice and promotes rapid healing of ulcers. Fractional and frequent meals prevent the development of inflammatory processes and constipation.

Nutrition after stomach surgery for ulcers

Patients with stomach ulcers often end up on the operating table. After surgical intervention (gastric resection) for at least two months, patients are shown a “wiped diet”.

Sometimes this period is delayed up to 4 months, depending on the state of health. In the future, a person is gradually transferred to the “uncleaned” version of the diet over the course of a year.

It is worth noting that after the operation, the stomach becomes smaller, the secretion of gastric juice decreases. Therefore, the amount of food at one meal is reduced. In this case, a person should eat fully with a sufficient amount of protein.

Milk should be introduced into the diet carefully. Other dietary guidelines after ulcer surgery include:

1. Limitation of sweets.
2. The use of only crackers.
3. Replacing fresh vegetables and fruits with baby purees.
4. Eating at least 6 times a day.
5. Exclusion of hot and cold dishes.
6. According to the doctor's indications, take cabbage and potato juice.

Diet for complications after surgery

After the operation, patients are forced to protect the health of the gastrointestinal tract throughout their lives, following a sparing diet. Sometimes there are side effects after surgery.

With dumping syndrome and afferent loop syndrome, the following diet is followed:

• gradual introduction of carbohydrate and dairy foods;
• drink half an hour after eating no more than 200 ml at a time;
• exclusion of simple carbohydrates;
• eating warm food and drink;
• after eating, you need to lie down for half an hour;
• in severe cases of dumping syndrome, they take food in the supine position.

The duration of such diet therapy is 4 months after surgery. In asthenic syndrome with impaired secretory and motor function of the remaining part of the stomach (stump), simple carbohydrates, dairy and fatty foods are excluded, a high-protein diet is prescribed, and nutrient mixtures are included in the diet.

If the secretion of gastric juice decreases after the operation, broths, fruit juices, and foods that moderately stimulate secretion and motility are carefully introduced into the diet.

When bile is thrown into the esophagus, food should only be liquid and mashed. It is not recommended to drink water or drinks in between meals.

Despite the fact that with a stomach ulcer, simple carbohydrates can be included in the diet, if the patient has signs of autonomic disorders, it is recommended to temporarily limit sweets.

The diet should be dominated by protein foods. With weight loss, poor healing of ulcerative defects, the energy value is increased by introducing vegetable fats and carbohydrates.

During bleeding from an ulcer, do not give food for 2-3 days. In the hospital, patients are shown parenteral nutrition.

After stopping bleeding, patients are allowed liquid chilled food every 2 hours. Per day give no more than 200 ml of such products:

• milk;
• jelly;
• slimy soup;
• sweet fruit juice;
• rosehip compote.

As the patient's condition improves, the diet is enriched. Soufflé from meat or fish, butter, very liquid semolina are introduced into the menu. Food is consumed after 2 hours in small portions. After discharge, a standard diet is indicated for exacerbation.

• I limit starch-containing foods: porridge, bread, potatoes;
• increase the intake of protein foods;
• reducing the amount of fluid to a liter per day;
• canceling dinner before bed.

It is advisable to replace compotes and juices with jelly or mousse.

Diet with comorbidities

If, in addition to peptic ulcer, the patient has pancreatitis, simple carbohydrates and fats are reduced in the diet, and protein foods are introduced. Butter is added to ready meals, but not spread on sandwiches. Patients can:

• cottage cheese;
• omelets without yolks;
• fish;
• mashed porridge.

If there are concomitant pathologies of the hepatobiliary system, increase carbohydrates in the diet, but reduce fat intake. From protein foods, cottage cheese and steamed scrambled eggs without yolks are useful. With diarrhea, milk and foods that stimulate intestinal motility are prohibited. Exclude foods rich in fiber, sweets (cause fermentation).

Recipes for dietary meals during exacerbation

The most common dish during an exacerbation is slimy soup. To prepare it properly, you will need the following ingredients:

• milk;
• rice groats;
• egg;
• butter.

Rice groats are boiled in water until a viscous broth is obtained. Then pour it into a separate container, add a little sugar and a pinch of salt, boil. Beat the egg with milk and pour, stirring, into the broth. Butter is added before serving. Instead of rice cereal, you can use Hercules oatmeal. The technology of preparation does not change.

Steam omelet

For breakfast during an exacerbation, a steam omelet is recommended. To prepare it, use a deep baking sheet. In a bowl, beat milk with an egg, add a little salt. Grease a baking sheet with oil and pour in the egg-milk mixture. Place in preheated oven for 15 minutes.

Drizzle with melted butter before serving. You can cook an omelette in a deep metal steamed dish. The pot with the resulting mixture is placed in another container in which there is water.

Meat soufflé

Chilled lean meat is passed through a meat grinder several times. A little milk, egg white, salt are added to the minced meat. Ready for a couple. Instead of milk, it is recommended to add white sauce to the minced meat. To prepare it, high-grade flour is fried in a dry frying pan and milk or sour cream is gradually poured in, stirring.

Soufflé from cottage cheese

Pour 1 yolk and milk into the grated cottage cheese, add sugar and a little semolina (flour is possible). Separately, whip the protein until a thick foam and add it to the curd mass. Cook in a deep pan for 20 minutes in an oven heated to 180 degrees. Drizzle with warmed butter before serving.

Summing up

Diet for stomach ulcers has a significant impact on the healing process. However, in addition to diet, patients should receive drug therapy, quit smoking and alcohol, change their lifestyle, and avoid stressful situations.

Diet therapy should be prescribed by a gastroenterologist in accordance with the severity and stage of the disease, comorbidities and the age of the patient.

Treatment of erosive processes in the stomach and duodenum consists not only of medications, but also provides for a strict correction of the diet. The main goal of proper nutrition is not to irritate the mucous membranes of injured organs, but to support and restore them. Diet for gastric and duodenal ulcers is an integral part of the successful treatment of the disease and the prevention of further relapses.

The task of a diet for an ulcer is not to irritate the walls of diseased organs.

Principles of diet for gastric and duodenal ulcers

Patients suffering from pathologies of the digestive tract (ulcer, gastritis), during an exacerbation, you must adhere to a strict diet No. 1. In remissions, you can use table 5 (a more extended menu).

Therapeutic nutrition for ulcer patients consists of several important principles:

1. Cooking. Products can be baked (without a golden crust), boiled, steamed. Forget about the fry.
2. Nutrition. Despite many restrictions, the foods used must be selected so that the diet contains a sufficient amount of nutrients.
3. Fractional nutrition. Increase the number of meals to 5-6 times a day, and reduce portions so that they are not used to 200-300 g.
4. Minimal salt intake.
5. Refusal of alcoholic beverages, as well as any liquids with gas.
6. Drink more water. You need to drink at least 2 liters of fluid per day.

A diet for ulcers involves stimulating the work of the enzyme system and helps to restore injured tissues. Therefore, it is strictly forbidden to eat food with a temperature below 17 and above 36 degrees. Only warm food is not capable of harming an irritated organ.

Table "List of useful and harmful products for peptic ulcer of the stomach and duodenum"

Diet for exacerbation of stomach ulcers

Exacerbation of peptic ulcer requires the strictest adherence to a special diet. Food should envelop the injured shell of the organ and help heal the wounds.

To do this, you need to follow the basic rules in food:

• give preference to steam cooking;
• all dishes should be consumed in grated form;
• cook soups only on lean vegetable broths;
• Take food in small portions, increasing the number of meals per day.

With a stomach ulcer, you need to cook food for a couple

In the first 4-7 days of an exacerbation, it is important to remain calm and strictly adhere to a diet, which at this time looks like this:

1. At the beginning of the acute period for breakfast, you need to eat a steam omelet and drink 150-200 ml of boiled warm milk. After 2 hours, you can use jelly from berries (non-acidic). For lunch - liquid rice puree, chicken soufflé and fruit jelly. Snack - weak herbal tea, and dinner - raspberry jelly, fish puree and oatmeal (ground).
2. On the 3rd and 4th day, you can add 1-2 slices of yesterday's wheat bread, fresh vegetables and fruits (non-acidic species), crushed to gruel, a little sour cream sauce to the listed dishes.
3. On the 5th day and the next week, the diet is allowed to eat cottage cheese with a banana, milk jelly and soups with buckwheat, semolina, steam cutlets from dietary meat, porridge with the addition of butter (butter or lean).

It is important to remember that grated food to gruel should be eaten for another 2-3 weeks after the exacerbation of ulcerative processes. This will help the wound heal faster.

Diet after gastric perforation surgery

A fundamental factor in recovery after surgery for a perforated gastric ulcer is a special diet. It consists in the minimum consumption of carbohydrates and fats.

At the beginning of the recovery period (the first 3 days) after surgery, doctors recommend starving. The stomach needs to be given time to adapt to the new state. On the 4th day and for 1–2 days, it is allowed to drink a slightly sweetened rosehip broth and berry jelly (in a small amount).

Soup with rice and rabbit is good for stomach ulcers

Boil rice and meat well (separately). Skip the rabbit several times through a meat grinder, rice through a sieve. Mix everything, dilute with vegetable broth and boil for 3-5 minutes. Pour the liquid from the yolk, milk and butter into the ready, slightly warm soup.

Using a grater, grind the pumpkin to make 1 cup of raw materials, pour water and boil for 20-25 minutes. Drain the water, pour 2 cups of milk, boil and add 1 cup of cereal. Boil for 5-7 minutes, sweeten (25 g of sugar) and salt a little.

Oatmeal with pumpkin - a tasty and healthy dish

Boil until tender 200 g of pulp without veins and grind in a meat grinder. Mix minced meat with rice (boiled) and pass through a meat grinder again. Salt the porridge-like mass a little, beat in the egg white, mix and make small balls. You need to cook the dish for a couple of 15 minutes.

Meat for meatballs needs to be scrolled several times in a meat grinder

Boil 200 g of beets, cool under cold water, peel and chop on a grater (fine). Add 70 g of washed canned peas, 2 tbsp. l. vegetable oil, stir.

Beetroot and pea salad is a simple and tasty dish

In a glass of warm water, dissolve 2 tbsp. l. honey. You need to drink a healthy liquid one hour before meals (breakfast and lunch) and 2.5–3 hours after dinner. The main thing is not to exceed the daily dose (4 tablespoons).

Honey drink should be drunk one hour before meals

A strict diet for ulcerative processes in the organs of the digestive tract is an important part of complex treatment. Eating right and strictly adhering to the basic principles of food preparation helps not only to alleviate the general condition of the patient, but also to quickly restore damaged organs and achieve long-term remissions.

Diet for stomach ulcers is an essential and strict condition for the patient. From its observance depends on how successful the treatment will be and the prevention of relapse. This article will tell you more about the menu for this diagnosis.

Understanding and following the general provisions of the diet for stomach ulcers, you can create a suitable diet yourself, which will not lead to a deterioration in the patient's condition. Let's take a closer look at these rules.

The paramount point is maintaining a diet (permissible and prohibited foods - later in the article).

Food must be stewed, boiled, blanched or steamed, but not fried.

It is worth adding here that salt can be present in the most minimal amount, ideally - dishes without salt.

It is very important to adhere to a sparing menu, i.e. eat something that will not irritate the gastric mucosa. The main rule is a balanced diet and a moderately high-calorie menu.

• The energy value should not be lower than 3000 kcal.
• Eat in limited quantities every 3 hours.
• One serving should fit in the palm of your hand.
• Eat only warm meals. Burning or ice food has a bad effect on the formation of enzymes, which will slow down the recovery process.
• In the absence of contraindications from the thyroid gland and the genitourinary system, it is advisable to drink up to 2 liters of fluid per day.

It is necessary to take into account the time of digestion of food. For example, a glass (200 ml) of water, broth or tea stays in the stomach for about 90 minutes; meat, vegetables and bread - 180 minutes.

Of course, each person is different. The preparation of the menu is influenced by the stage of the disease, the location of the ulcer, how old the person is and what his body weight is, as well as the presence of concomitant diseases.

Types of diets for stomach ulcers

Diet can eliminate dyspepsia, pain and general malaise. In general, it is aimed at healing the ulcer. A properly composed menu reduces acidity in the stomach and activates the regeneration process. Regular small portions of food gently affect the mucous layer of the stomach and allow you to eliminate inflammation.

General guidelines for all diets at any stage of the disease - eat what will quickly come out of the stomach (puree-like food and liquids).

There are different diets for gastric and duodenal ulcers. They are recommended, focusing on the periods of the disease. Now about this in more detail.

• Diet No. 1 is prescribed for three weeks to those who have a period of exacerbation or recovery. You need to eat every 3 hours only grated, steamed food, which will gently envelop the walls of the stomach. The proportions of carbohydrates, fats and proteins are five to one to one. You can eat dairy and vegetable soups, boiled not very fatty fish, dairy products, baked fruits and yesterday's muffins.
• Diet No. 1a is built on the basis of Diet No. 1, but the list of products is stricter here. Applicable in the active phase of the ulcer. Food that increases the secretion of gastric juice is strictly prohibited. The daily calorie intake is no more than 2 thousand. Proteins, fats and carbohydrates - in a ratio of two to one to one. A diet without flour products and vegetable dishes. Soups-puree, cereals on cereals, jelly and soufflé are allowed.
• Diet No. 5 is prescribed if the ulcer is in remission. This table has a fairly extensive list of permissible dishes. In fact, this can be called complete nutrition, restoring the functioning of the patient's digestive tract. Food should be prepared from foods that are rich in vitamins and minerals. You can eat light soups, feast on cheese, caviar and tongue. It is worth paying attention to fruit and vegetable gifts, which are among the permitted ones. Say no to onions and garlic, and to all fried and fatty foods.

Allowed products for illness

At first, you can imagine the dishes allowed for an ulcer as tasteless. However, do not be skeptical about this in advance. The list of what you can eat is quite wide. You don't have to be a chef to cook something healthy and appetizing at the same time.

So, you can eat:

• vegetables without coarse fibers;
• non-acid fruits and berries;
• milk and dairy products;
• white and lean meat;
• fish;
• stale pastries;
• ground cereals.

All of the listed products should be low-fat, lightly salted and not very acidic.

Wholly or partially restricted products
With an ulcer, the patient's diet changes significantly. Most foods and drinks are becoming restricted or banned. Products that irritate the gastric mucosa and increase the secretion of gastric juice are excluded.

So, you can not feast on:

• mushrooms;
• dried fruits;
• nuts;
• citrus;
• sweets;
• sausages;
• fatty cheeses;
• alcohol.

Diet menu for stomach ulcers

A stomach ulcer, like gastritis, is associated with a specific diet that does not tolerate fried, fatty and spicy. Ideally, these are tender, steamed or oven-made, lightly salted and unseasoned dishes. To avoid exacerbations, gastroenterologists advise dieting constantly, and not just after surgery.

In order for the ulcer to heal quickly, the body needs vitamins and nutrients. Fasting is appropriate if the ulcer bleeds and in the first 48 hours after the intervention of surgeons. However, only a doctor who will assess the patient's health has the right to allow food. You need to eat at regular intervals in small portions. Daily caloric content - no more than 2.5 thousand kcal.

When forming the menu, one must remember about the calorie content of the ingredients, the ratio of proteins, fats and carbohydrates.

The main block of the diet is preferably protein food, where fats and fiber are contained in minimal quantities.

With an exacerbation, you need to reduce the proportion of carbohydrates consumed, because they can cause pain.

Drinking fresh fruit juices will help replenish the beneficial substances in the body. For example, an ulcer strictly forbids eating white cabbage (even boiled), but its juice will be useful.

It is important to supplement your regular diet with low-fat milk. Soups and cereals are prepared on the basis of fermented milk products, and they are also drunk in their usual form. By the way, honey and propolis strengthen the immune system and help the mucosa recover faster.

Features of the diet after surgery, and at the stage of exacerbation

After the surgical intervention, it is necessary to adhere to a “soft” diet. Supplementing the diet with a new dish should be carried out carefully, it is important to take into account the patient's condition.

• For the first two days after the operation, it is forbidden to eat any food. The person is on medical fasting. Nutrient solutions through a dropper provide the natural vital activity of the body.
• From the third day, liquid food is introduced into the diet in small doses. A stomach ulcer is a very dangerous disease that affects the gastrointestinal tract. That is why specialists monitor the patient's condition after each meal.
• After three days, you can replenish the diet with jelly or herbal decoction (do not overdo it with the amount).
• After 6 days, the menu is replenished with weak vegetable soups, liquid food, steam omelettes and grated rice.
• After 7 - 8 days, steamed chicken cutlets and vegetable purees are allowed.

• All food that damages the mucous membrane and increases the production of gastric juice should be removed. The diet should consist of boiled or steamed, tender food in liquid or mushy form and practically without salt.
• It is recommended to eat little by little about 6 times a day.
• The right end to the day would be a glass of warm milk before bed.
• In general, per day you need to eat no more than 2 kg of food with a calorie content not exceeding 2 thousand kcal.

Diet Recipes

The diet of a person suffering from a stomach ulcer is not as diverse as we would like. However, making the menu tasty, healthy and nutritious is still not difficult.

Creamy Pumpkin Soup

Pumpkin puree soup is an excellent component of the diet menu for ulcers.

Prepare the ingredients:

• 800 grams of pumpkin;
• 2 potatoes;
• 1 carrot;
• 100 ml 20% cream.

Cut the orange fruit into cubes and send to the pan. Then add carrots and potatoes, cut into small pieces. Pour in 2 cups of water, add a little salt and cook for about 25 minutes (until the vegetables soften). We remove the saucepan from the stove.

We make puree with a blender (do not pour out the broth). Pour the cream, mix and put on fire again. Stir for a few minutes until the soup warms up, then remove from the stove, without waiting for the boil. Can be served with rye breadcrumbs.

Baked fish cutlets

1. We twist a pound of pike perch or pollock through a meat grinder.
2. Add a raw egg and lightly salt.
3. Then boil 1 carrot, pass through a meat grinder and add to the minced meat.
4. There we also send 3 pieces of a loaf soaked in milk.
5. The resulting mass is well mixed.
6. Lay parchment paper on a baking sheet and place minced meat balls there. You can lightly press them down with your hands so that they look like ordinary meatballs.
7. We cook the dish for about 40 minutes at a temperature of 260 degrees. It should be eaten cold.

Curd-banana dessert

An ulcer diet may include desserts, the preparation of which does not require much effort and time.

Take 200 grams of cottage cheese, 1 egg and 1 tablespoon of granulated sugar. Mix all ingredients well. At the bottom of special forms for cupcakes, put banana circles and fill them with curd mass (1.5 tablespoons will be enough). The dessert is cooked in the oven for approximately 15 minutes.

Damage to the mucous membrane of the stomach or duodenum with the formation of ulcers is associated with the predominance of aggressive factors (pepsin, hydrochloric acid, bile acids) over the protective factors of the mucosa itself. An important role in this is Helicobacter pylori, causing inflammation of the mucosa and destroying local protective factors.

The most characteristic symptoms are pain in the upper abdomen on an empty stomach (in the morning, between meals and at night). Symptoms of a hungry ulcer make the patient eat more often, including at night, the pain subsides 30 minutes after eating. Less specific in peptic ulcer disease are decreased appetite, nausea, vomiting, fullness, and weight loss.

A patient with peptic ulcer should be aware of life-threatening complications.

• Perforation of an ulcer is the formation of a through defect in the wall of the stomach or duodenum. A perforated ulcer is one of the most dangerous complications, since the contents of the stomach enter the abdominal cavity and cause diffuse peritonitis .
• Bleeding - is manifested by staining feces in black.
• Malignancy.

Violation of the diet and eating food that irritates the gastric mucosa is the cause of peptic ulcer disease and its exacerbations, along with alcohol consumption, smoking and nervous tension. Therefore, therapeutic nutrition and diet are an integral part of the treatment of this disease.

The purpose of the therapeutic diet is to create conditions for the elimination of pain, dyspeptic symptoms and ulcer healing. Diet can reduce the activity of the acid factor of the stomach, reduce its excitability and stimulate regeneration processes. Eating at the same time and in small portions has a gentle effect on the mucous membrane and helps to eliminate inflammation.

It is difficult to unequivocally answer the question of what kind of diet is needed for a stomach ulcer, since it differs in different periods of the disease. In the treatment of peptic ulcer with high acidity, different treatment tables are sequentially assigned:

• - with the maximum restriction of various types of effects (mechanical, chemical and temperature) on the stomach, for a period of 6-10 days;
• - with a mild limitation of all types of aggression on the stomach, the average treatment time is up to two weeks;
• - with moderate sparing of the stomach, for up to six months.

However, it can be said for sure that the therapeutic diet for gastric ulcer at any stage of the disease provides for the exclusion (to one degree or another) of strong stimulants of gastric secretion and mucosal irritants. Preference is given to products that quickly leave the stomach (mushy and liquid food).

A sparing regimen is facilitated by regular and fractional meals - it facilitates the digestion and assimilation of food. Consistent appointment of therapeutic diets with a gradual expansion of the list of permitted products and methods of their processing, consolidates the obtained therapeutic result, gradually prepares the organs of the gastrointestinal tract and prevents exacerbation in the future.

Proper nutrition with a stomach ulcer creates conditions for eliminating inflammation and repairing the mucosa. It should be excluded mucosal irritants.

Mechanical irritation of the gastric mucosa is caused by:

• a large amount of food at one time;
• taking a large amount of coarse fiber contained in radishes, turnips, beans, gooseberries, grapes, currants, raisins, dates, bran bread;
• the use of sinewy meat, cartilage and poultry skin.

Chemical irritation of the mucosa is caused by products:

• having an acidic environment (sour foods, sour unripe fruits);
• stimulating gastric secretion: broths, strong vegetable broths, spices, fried foods, canned food, smoked meat and fish products, tomato sauce, pickled and pickled vegetables, meat and fish stewed in their own juice, hard-boiled eggs, fermented milk products; rye bread, rich dough, whey, overheated edible fats; skimmed milk, strong tea, coffee, alcohol, carbonated drinks, raw vegetables, sour fruits and berries.

The thermal effect is exerted by excessively cold or hot food.

In this regard, the diet should include warm, rough, mashed dishes with a weak juice effect: milk, eggs, milk porridge, boiled meat (in variations). Milk protein contributes to ulcer scarring, and frequent meals with the exception of rough meals cause mechanical sparing of the mucosa.

Diet for stomach ulcers during an exacerbation

During this period, all factors of adverse effects on the mucosa should be maximally limited. This food option is prescribed for 6-8 days, since it is not balanced (the lower limit of the norm, proteins and fats, carbohydrates are significantly limited). However, in bed rest, the diet provides the physiological needs of the body.

Nutrition during an exacerbation has the following principles:

• Six meals a day are organized, and the amount of food taken at a time is limited. Eating sparing meals at the same time helps reduce inflammation.
• Considering that patients are on bed rest, food is prepared only in liquid form (may be in mushy) and jelly-like. Such nutrition helps the process of reparation of ulcers, reduces the activity of the inflammatory process. Porridges are first boiled, and then wiped and diluted to the desired state with water or milk.
• Any causative agents of secretion (all broths, sour drinks, fermented milk products) and mucosal irritants (coarse foods, all vegetables, coarse cereals) are excluded.
• Hard-to-digest foods (mushrooms, tough meat with fascia, tendons and skin in poultry and fish) are excluded.
• No bread is allowed.
• Soups are allowed only mucous on water or milk from oatmeal, semolina, rice groats. Mucous soups maximally mechanically spare the stomach. In fact, these are decoctions obtained during long-term cooking of cereals. They are filtered, but not ground, lightly salted and put oil. To speed up cooking, soups are made from flour for baby food or from ground cereals.
• Cereal dishes (from buckwheat, oatmeal, rice groats) are prepared in the form of liquid porridge in milk, rubbed and butter is added to the finished one.
• From dairy products, milk, calcined cottage cheese, milk jelly and cream (in soups) are allowed. Whole milk - 4 glasses a day.
• Soft-boiled eggs or steam omelet (up to 2 pieces) are allowed.
• Excessively cold and hot dishes are excluded. Hot dishes should have a temperature of 50-55 ° C, and cold - 15-20 ° C. Cold food slows down the regeneration of the mucosa, and too hot food also adversely affects the mucosa.

Thus, this food creates all the conditions for reducing inflammation, since it does not contain coarse food and products that irritate the mucous membrane. A decrease in the volume of one-time food intake, and fractional nutrition causes mechanical sparing. A sufficient amount of protein is necessary for the ulcer to heal faster.

Diet for a bleeding ulcer

With ulcerative bleeding, a specialized diet is used. If indicated, the patient can receive parenteral nutrition until the bleeding stops. After its cancellation, it is allowed to take 200 ml of liquid cold food per day. It can be milk, jelly, jelly, cream, after a while sour cream and raw eggs, slimy soups are added. As a result, the patient is transferred to Table №1A with extension to variant Table number 1 .

To fight anemia prescribe food with a high content of proteins (140-150 g), while limiting fats somewhat (60-70 g). It is necessary to enrich the diet with iron, cobalt, copper, manganese, cyanocobalamin, so it is advisable to introduce dishes with liver and yeast. With satisfactory health, after 1.5 months, non-chopped food is allowed with the addition of fresh vegetables and fruits. Plums, apples, peaches can also be used in a non-mashed form.

What kind of nutrition is indicated when the process subsides and recovers?

This is a moderately sparing, physiologically complete nutrition within Table number 1 . It must be adhered to for a long time (up to six months), since peptic ulcer requires a long-term diet. It is also necessary to carry out anti-relapse treatment in parallel.

The absence of strong irritants in food at any stage of the disease (meat, mushroom broth, fish soup, strong tea, fried foods, coffee, carbonated drinks, marinades, mustard, alcohol) creates the conditions for successful treatment and a long relapse-free period. The stepwise expansion of the diet prepares the digestive tract for the transition to a common table, in which it is still worth limiting too spicy, spicy, very hot foods and alcohol, and maintaining a regular meal.

If the patient has peptic ulcer and concomitant, then nutrition is almost the same, however, the amount of protein consumed increases to 140-160 g, since essential proteins are necessary to prevent the negative effect of the enzyme trypsin . The amount of fat must be reduced to the lower limit (80 g), including the exclusion of high-fat dairy products.

Usually, with good health for patients, it becomes difficult to observe for such a long time Diet #1 and the duration of stay on it is reduced to 2-3 months. The diet is expanded, unpurified food is introduced, and raw vegetables and fruits are added. These include sweet plums, peaches, nectarines, apples, and from vegetables, tomatoes. In the future, when conducting anti-relapse treatment in the autumn-spring period, you should again switch to sparing nutrition for 2-4 weeks (first Table No. 1B, and then No. 1).

There is no need to do anything to lose weight with an ulcer. First of all, because the patient's appetite worsens during an exacerbation, there is vomiting after eating, and he is afraid to eat normally. In addition, the prescribed medical nutrition itself contributes to weight loss, since the list of allowed foods is very limited (especially Tables 1A and 1B, they have a reduced calorie content) and frying dishes in oil is excluded for a long period.

Sweets and other simple carbohydrates limit because they increase the excitability of the nervous system. If you exclude smoked meats, flour, fatty, alcohol from the diet, then the issue of weight loss will disappear. It is enough to adhere to the recommendations regarding nutrition, and it will decrease.

It is absolutely impossible to starve in the presence of diseases of the gastrointestinal tract. It is also contraindicated to add spices to drinks (ginger and cardamom), which speed up the metabolism. Any spices are prohibited, as they provoke the release of digestive enzymes. It is also impossible for the patient to refuse white bread in favor of black, which is always recommended for diets. As you can see, the desire to lose weight can cause an exacerbation.

Diet for gastric ulcer in the period of unstable remission:

• Avoid foods that increase secretion as much as possible (rich broths, spicy, pickled, smoked and fried foods, alcoholic beverages, coffee, tea, carbonated drinks).
• Avoid irritating foods (citrus and acidic fruit juices, cranberries, tomatoes, onions, peppers, garlic, turnips, radishes, coffee, tea, ginger, chocolate, alcohol) and foods that increase gas formation.
• Reduce the amount of food consumed - a portion the size of a fist at a time.
• Frequent meals (5-6 times a day). The last dose is no later than 3 hours before bedtime.
• Eat foods warm, as cold foods take a long time to digest, and hot foods irritate the mucous membranes.
• Increase protein intake and reduce fat (fatty pork, goose, duck, lamb, cream, butter, cream cakes).
• The main methods of cooking are boiling, stewing, baking in the oven, starting from the third week of exacerbation.
• Do not mix foods that do not combine (proteins and carbohydrates) to avoid rotting and fermentation.
• Include bananas, wild strawberries, cherries, blueberries, potato juice, oats decoction, sweet apples in the diet.
• During a stable remission, nutrition is close to that of a healthy patient, but with restrictions on spicy foods.

By following these dietary recommendations, eliminating smoking, which increases the risk of relapse, and drinking alcohol, you can achieve a long-term (several years) relapse-free course of the disease. Patients suffering from peptic ulcer should avoid taking non-steroidal anti-inflammatory drugs.

Approved Products

The first courses are prepared on potato broth or vegetable broth with mashed vegetables and cereals (semolina, buckwheat, oatmeal, rice). You can use milk vermicelli soups, as well as mashed soups with the addition of mashed meat (chicken). Egg-milk mixture is introduced into soups and seasoned with oil.

Steam and boiled dishes are prepared from lean meat. Meat baked in the oven is allowed. Use beef, young lamb and lean pork, chicken and turkey. You can cook steam cutlets, quenelles, mashed potatoes, aspic, soufflé, meatballs, zrazy, beef stroganoff (only from pre-boiled meat).

Lean fish can be steamed and baked. Prepared in a piece (previously remove the skin) or in chopped form (balls, meatballs, meatballs, zrazy).

Rice, semolina, buckwheat or oatmeal, vermicelli or thin noodles are added to the side dish and soups. Porridges can be boiled in milk or water, boiled well to a semi-viscous state, buckwheat must be wiped. It is allowed to make puddings from cereals with the addition of cottage cheese, which can be steamed and baked without a crust.

Vegetables (potatoes, beets, young peas, carrots, cauliflower) are steamed and served as a side dish in pureed form (mashed potatoes, soufflé). Only pumpkin and zucchini can be not pureed. Dill is added in small amounts to soups. Butter and vegetable oil are added to ready meals.

Wheat bread is allowed stale or dried. You can eat a dry biscuit or low-fat cookies. Once a week, baked savory pies stuffed with apples, jam, cottage cheese, as well as meat or fish are allowed.

From dairy products, milk and cream, non-acidic yogurt and kefir, fresh non-acidic cottage cheese and sour cream are allowed. From cottage cheese you can cook lazy dumplings, cheesecakes, puddings. Infrequently, mild cheese (preferably grated), 2 eggs twice a week, which are cooked soft-boiled or in the form of an omelet, can be introduced into the diet.

From snacks (on a non-wiped table), you can include a salad of chopped boiled vegetables, boiled meat and fish, liver pate, milk sausage, low-fat ham, aspic fish (on vegetable broth), low-fat herring and sturgeon caviar.

Sweet desserts are steamed from pureed berries, adding semolina. In baked or boiled form, you can eat sweet berries and fruits. Puree, jelly, jelly, sambuki, compotes are also prepared from them. Milk jelly, meringues, non-sour jam, marshmallows, marshmallows, honey are allowed as desserts. From drinks - fruit juices, rosehip broth, tea with milk or cream, weak coffee with milk.

Table of allowed products

Wholly or partially restricted products

It provides for the complete exclusion of vegetables rich in fiber (radishes, turnips, white cabbage, beans, peas, rutabaga, fruits with peel) and products with connective tissue (cartilage, veins, skin).

From meat products are prohibited: fatty pork, duck, lamb, goose, canned meat and smoked meats. highly extractive broths and rich vegetable decoctions for soups are excluded. From the first courses it is necessary to exclude cabbage soup, okroshka and borscht. Of vegetables, it is not allowed to use sorrel, dill, parsley, spinach, onions, as they contain a large amount of organic acids or irritating essential oils. Under the ban mushrooms, as a difficult to digest product.

It is forbidden to use pickled and pickled vegetables, canned vegetables that cause an increase in secretion. Indigestible are: millet, pearl barley, barley and corn groats, so they are excluded from the diet for a long time. Fatty fish and canned fish are banned.

Remember that fried eggs and hard-boiled eggs are poorly digested, so it is not recommended to use them in this form. You can not eat irritating mucous meat sauces, tomato sauce, horseradish, mustard, pepper. Animal fats are also excluded from the diet.

Any fresh bread, rich and puff pastry, dried fruits, chocolate and ice cream are prohibited. You can not eat sour-milk products with high acidity, as they stimulate secretion. For the same reason, sour fruits and berries are excluded. Limit sour cream in the diet, it is better to use it as an additive to dishes.

Table of prohibited products

Diet menu for stomach ulcers (Diet)

The nutrition menu for gastric ulcer depends on the stage of the process (exacerbation, unexpressed exacerbation or attenuation of exacerbation, remission). Since, with a pronounced exacerbation, nutrition is organized in a hospital, when the condition improves, the therapeutic diet is not followed for long, and the nutrition during the recovery period and in remission is longer (up to 6 months), it is more expedient to bring the menu for a week for this period.

This is already physiologically complete nutrition (90-100 g of proteins, 100 g of fats and 420 g of carbohydrates). Nutrition is fractional, the volume of one-time food intake is reduced and balanced in terms of vitamins and minerals.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Diet Recipes

Below are recipes for preparing dishes in different periods of the disease. Dietary dishes have different cooking and heat treatment technologies.

Mucous dietary soups are used in the initial stages of the disease with severe inflammation. They are strained decoctions of long-cooked cereals, but without rubbing the cereal itself. The broths are slightly salted, seasoned with an egg-milk mixture and butter is added. The finished dish has a homogeneous cream consistency, without food particles and curdled egg flakes.

Milk soups are used in Diets 1A and 1B . They are cooked with cereals, in milk with the addition of water (1:1). Cereals are pre-cooked until tender, and then boiled milk is added. Groats in the finished dish should not retain their shape, so they are rubbed, the color of the soups is white, and they have a sweet, slightly salty taste.

Pureed soups are the basis of the first table. They are boiled in water with cereals, potatoes and carrots. Well-boiled ingredients are wiped, salted and oil is added.

For ulcers, cooking is preferable: steaming and boiling in a water bath. For a greater removal of extractives, the meat should be boiled in small pieces, then the primary broth is drained, and the meat is boiled in fresh hot water until tender. It is used as a semi-finished product for stews and chopped dishes.

When cooking with steam, the product should not come into contact with the liquid, therefore, the loss of nutrients is less. Cooking in a water bath is carried out at a temperature of 40-70°C in a container lowered into a large container with water. In the diet, omelettes, sauces, egg porridge and puddings are prepared in this way.

First meal

Hercules is poured into the water and boiled for at least an hour until completely boiled. The broth is filtered through a sieve without rubbing, salt and sugar are added.

Milk soup with meat puree

Boiled meat is beaten in a blender and rubbed. Meat puree is mixed with ready-made rice mucus broth, salted, boiled. When cooled to 70 ° C, pour in the egg-milk mixture and beat well with a whisk. At the end add butter.

Main courses

Carrots are crushed on a grater, stewed with water and with the addition of butter.

Rice is boiled for 20 minutes, rubbed and hot milk is poured in. Add stewed carrots, sugar, continue to cook for another 30 minutes or 45-50 minutes. At the end add a piece of butter.

Chicken cutlets (steam)

Prepared from raw poultry meat, using fillet and leg meat. Minced meat is twisted, butter, salt, milk and wheat bread are added. Small cutlets are formed, steamed on a wire rack.

desserts

Soak the gelatin in cold water and heat a little until it dissolves. Peeled and seeded apples cut and bake in the oven with the addition of water.

Grind baked apples, add sugar. Whip chilled egg whites. Combine applesauce, protein mass and pour gelatin. Stir gently and pour into molds. Cool down.

Curd soufflé

Grated cottage cheese, milk, sour cream, semolina and yolks are whipped in a mixer. Add beaten egg whites and mix. The curd mass is laid out in a mold and steamed.

Content

Diet for exacerbation of stomach ulcers is an integral part of the complex treatment of this disease. Indeed, the speed of recovery of the patient, as well as how long the remission will be, as a rule, depends on a properly composed diet.

Therapeutic nutrition, in addition to scarring the ulcer, helps to quickly restore digestive function.

Basic principles of nutrition

When compiling a dietary menu during an exacerbation of a stomach ulcer, it is necessary to rely on the following principles:

1. All dishes should be cooked with a temperature of no more than 50 degrees and not lower than 20. Such parameters are considered more favorable for good digestion of foods.
2. The patient should give up alcohol, carbonated drinks, strong coffee.
3. Products from the diet should contain the maximum amount of nutrients, vitamins A, B and C. Nutrition for a stomach ulcer during an exacerbation should be made so that the body receives no more than 100 grams of fat.
4. The patient should observe a fractional type of nutrition. You need to eat often (5-8 times per knock), but in small portions. Meals - every 3 hours.
5. Table salt should be limited (no more than 10 g per day), but it is better to completely abandon it.
6. The menu during an exacerbation of the disease should contain products that promote the healing of the ulcer. For example, vegetable soups, pureed first courses without irritating, hard ingredients, dairy products, liquid cereals, dried bread.
7. The patient needs to chew food thoroughly, facilitating the process of digestion. In addition, overeating should be avoided.
8. You need to drink at least 1.5 liters of water per day (if there are no problems with the urinary system and thyroid gland). In addition, you can use weak green, herbal tea, non-acid fruit drinks, jelly.
9. Nutrition during an exacerbation of an ulcer should exclude such heavy foods as grapes, apples with a peel, gooseberries, legumes, cabbage and sauerkraut.
10. The patient should control the chemical composition of the products. This means that you will need to reduce the use of salt, pepper, garlic, onions, vinegar. Such ingredients in dishes can cause an increase in the secretion (excretion) of gastric juice.
11. It is necessary to limit the use of spicy, fried, pickled foods that irritate the gastric mucosa.

Table of prohibited and permitted products

With a stomach ulcer, the patient needs to consult with a gastroenterologist about what you can eat during an exacerbation, and what is better to refuse.

An approximate list of prohibited and permitted products is presented in the table:

Menu

The diet for gastric ulcer during the period of exacerbation, if possible, should be balanced and contain all permitted foods. A sample menu for 4 days is presented in the table:

Features of nutrition during exacerbation with bleeding

Often, with an exacerbation of an ulcer with bleeding, heartburn, nausea, dull cutting or stabbing pain in the epigastric region appears. Such a period will require the patient to comply with a strict sparing diet No. 1a according to the classification of treatment tables according to Pevzner. It is used in the initial 8 days of ulcer therapy to reduce any impact on the damaged gastric mucosa. In this case, the patient needs to remove from the diet all foods that provoke an increase in acidity (citrus fruits, zucchini, cereals, etc.).

In addition, patients are shown boiled, steamed, pureed food, in a mushy and liquid state.

The total mass of the daily diet should be 2000 g, calorie content - 1900-2000 Kcal. It is necessary to eat in small portions 6-8 times a day and adhere to the ratio between carbohydrates, proteins and fats - 2: 0.8: 0.8. The patient is allowed to use:

• soft fruit without skin;
• meat, fish of low-fat varieties;
• dried bread;
• milk porridge in grated form;
• boiled, steam vegetables;
• milk, sour cream, low-fat cottage cheese;
• fruit, milk sauces;
• greens;
• rosehip decoction;
• baked fruits (apples, pears);
• non-carbonated water, tea with milk;
• vegetable juice.

List of prohibited ingredients during an exacerbation of a stomach ulcer with bleeding:

• fatty fish and meat products;
• legumes;
• smoked meats, pickles;
• turnip, radish;
• cauliflower, Brussels sprouts;
• fried, spicy dishes;
• kvass, coffee;
• chocolate, yeast products.

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