Dietary treatment for peptic ulcer of the stomach and duodenum is based on the principle of exposure to:
a) the clinical manifestations of the disease;
b) impaired metabolism; c) other regulatory systems. Clinical nutrition should be based not only on clinical symptoms, but also on the characteristics of the metabolic processes in the patient’s body, for which it is necessary to provide the body with indispensable nutritional factors, in particular amino acids, essential fatty acids, and vitamins. The correct rhythm of nutrition is of great importance. A meal is recommended every 3-4 hours, in small portions. Exclude too hot and cold food. To relieve the inflammatory process in the gastroduodenal the system limit table salt to 10-12 g per day.
When building diets, the effect of food on the secretory and motor functions of the stomach is taken into account.
All nutrients can be divided into weak and strong pathogens of gastric secretion. Weak pathogens of gastric secretion: milk, cereal or vegetable soups (from potatoes, carrots and beets); liquid milk porridges; well-boiled meat and fresh boiled fish; milk and dairy products; soft-boiled eggs or as an omelet; yesterday’s white bread; alkaline waters that do not contain carbon dioxide; weak tea. Strong secretion pathogens include: spices (mustard, cinnamon, horseradish, etc.); all dishes of plant and animal origin prepared by frying; canned food; all dishes containing extractive substances (for example, meat, fish, mushroom broths; strong navar from vegetables); black bread; strong tea, coffee; drinks containing alcohol and carbon dioxide.
However, the same product, prepared in different ways, presents a completely different burden for the stomach; a piece of fried meat is a strong causative agent of gastric secretion, and boiled meat causes a slight excitation of the secretory process. Fat, for example, has a
biphasic action, ou suppresses secretion followed by saponification products of fat in the intestine to stimulate it.
The consistency of impoverishment also affects the secretion of gastric juice. So, a piece of meat is longer in the stomach than a meat souffle. Liquid and mushy foods leave the stomach faster than solid foods. The chemical composition of food is also essential. Carbohydrates leave the stomach quickly, proteins more slowly and fats remain in it for the longest time.
The longer the food is in the stomach, the more it irritates the mucous membrane and increases its secretory function.
The diet should not include products that mechanically irritate the gastric mucosa, containing coarse cell membranes (turnip, radish, radish, asparagus, beans, peas); unripe and rough-skinned fruits and berries (gooseberries, currants, grapes, dates); bread made from wholemeal flour; products containing coarse connective tissue (cartilage, skin of poultry and fish, sinewy meat). When building sparing diets, food substances are prescribed that weakly excite secretion, quickly leave the stomach and slightly irritate its mucous membrane.
Under the influence of sparing diets, as a rule, all clinical manifestations of the disease disappear. By changing the chemical composition of the diet, it is possible to influence a metabolic disorder, stimulate the healing of a ulcer defect, and influence the regulatory function of the nervous system. The antiulcer diet should be complete, balanced in terms of protein, fat, carbohydrate, mineral salts and vitamins (mainly C, D1 and A). Proteins included in the diet should contain all the necessary amino acids in optimal proportions. This is done by introducing into the diet a variety of products of both animal and plant origin. Antiulcer diets are enriched with vegetable oils by reducing animal fat. Vegetable fats are administered in an amount of 1/3 of the total fat content in the diet. Vegetable oils are added to cereals, soups and fish products. This normalizes disturbed metabolic processes in patients with peptic ulcer disease and promotes ulcer healing. The diet includes homogenized vegetables (mashed beets, carrots, pumpkins). They are added to mucous soups, mashed cereals and other dishes. The use of homogenized vegetable purees can significantly improve the appearance of food, increase the taste and nutritional value of dishes.
Of sufficient importance is the sufficient content in the diets of mineral salts and vitamins. Vitamin C is the most; contained in rose hips, so it is advisable that the patient receives a rosehip decoction daily. Vitamin C enhances oxidation- reduction and regenerative processes, has a desensitizing property and inhibits the secretion and motility of the stomach in patients with peptic ulcer disease. Liquid cereals from buckwheat, oatmeal, barley groats, as well as mucous soups from wheat bran contain a large amount of vitamin W, which favorably affects the nervous system and lowers the acidity of gastric juice. A significant amount of carotene (provitamin L) contains carrots; a rich source of vitamin L is milk and dairy products. All antiulcer diets must include milk.
Qualitatively different diets can influence not only metabolic processes, but also, if possible, normalize the nervous and humoral regulation of the body, stimulate recovery and compensation processes, and reduce inflammatory and allergic reactions.
Under the influence of a diet rich in carbohydrates, the excitability of the autonomic nervous system increases, and the clinical symptoms of an “irritated stomach” increase. The carbohydrate-restricted diet has the opposite effect.
In order for the recovery processes to proceed actively, the nutrition of patients with peptic ulcer disease must be complete and varied with an increased amount of animal protein against the physiological norm.