Diet for Ulcers and Constipation

Ulcers

All sores that erode mucous membranes or the skin and penetrate the underlying muscle are referred to as ulcers. Those that occur in the lower part of the esophagus, the stomach, or the duodenum are known more specifically as "peptic ulcers," because they form in areas exposed to stomach acids and the digestive enzyme, pepsin. When the erosion occurs in the duodenum, the upper part of the small intestine, the term duodenal ulcer is used to describe the lesion; an ulcer in the stomach is called a gastric ulcer.

A person with an ulcer may describe the pain as gnawing or burning and can often pinpoint the exact spot. The pain usually occurs 2 to 3 hours after eating, is worse when the stomach is empty, and can be relieved by eating a small amount of food or taking an antacid.

Some people never have ulcer pain; however, they may develop intestinal bleeding, heartburn, bloating, and gas, possibly together with nausea and vomiting.

Medical Treatment

Better understanding of the causes of ulcers has enabled doctors to devise new treatments. If tests confirm the presence of H. pylori, "triple therapy" is initiated. This includes an antibiotic to eradicate the bacteria, bismuth subsalicylate (Pepto-Bismol) to protect the intestinal lining, and an acid secretion inhibitor to prevent secretion of acids by the cells of the stomach. The bacteria are usually eradicated in a couple of weeks.

Smoking is one factor closely linked to poor healing and ulcer recurrence. Cigarette smokers often continue to suffer from ulcers until they quit.

People with ulcers caused by NSAID use must discontinue the offending drug. Individuals who need ongoing pain relief for other conditions, such as arthritis, should ask their doctor to prescribe a safer alternative.

Mindful that "it's not what you're eating, it's what's eating you," people with ulcers may benefit from relaxation techniques and biofeedback to cope with stress. Regular exercise promotes the release of endorphins, brain chemicals that dull pain and elevate mood.

Risky Home Remedies

Many people self-treat pain due to ulcers, heartburn, and indigestion with over-the-counter drugs or with home remedies concocted from baking soda (sodium bicarbonate) to neutralize stomach acid. This approach is risky.

Long-term use of antacids containing aluminum hydroxide can prevent the body from absorbing phosphorus and result in the loss of bone minerals. Prolonged ingestion of baking soda or antacids containing calcium carbonate may lead to a buildup of calcium and alkali, resulting in nausea, headache, and weakness, with a risk of kidney damage. Check with a doctor before using acid-suppressant drugs, as they can interfere with proper digestion.

Diet and Ulcers

A bland diet was once the mainstay of treatment, but it is no longer necessary, although it may still be prescribed for some patients. People with ulcers need a balanced, varied diet to promote healing. There is no proof that high-fiber foods irritate ulcers, and spices-except for black pepper and chili powder-do not cause pain or slow healing.

People with ulcers should avoid certain foods and seasonings that cause pain. Triggers vary for individuals, but common offenders are coffee (including decaffeinated), caffeine in beverages and chocolae, peppermint, and tomatoes and tomato-based products. Fatty foods can slow down stomach emptying and stimulate acid release. Milk and dairy products temporarily relieve pain but can cause a rebound increase in acid secretion.

Bleeding from untreated ulcers can lead to iron-deficiency anemia. People with ulcers should eat plenty of lean meat, poultry, seafood, fortified breads and cereals, and dried beans and other legumes. Dried fruits, especially apricots, are also rich in iron. Unless they cause pain, citrus fruits and other good sources of vitamin C should be included to promote iron absorption.

Patients with complicated chronic ulcers may need surgical treatment that can have permanent effects on digestion and the absorption of nutrients. They should consult a dietitian for nutritional advice after surgery.

Eating Patterns

When and how people eat may be more important than what they eat. Doctors no longer recommend frequent small meals, which can provoke rebound symptoms. Rather, they suggest sever-al moderate-size meals spaced at regular intervals. Late-evening snacks should be avoided, because they stimulate acid secretion during sleep.

Eat Plenty of

Lean meat, poultry, fortified breads and cereals, seafood, legumes, and dried fruits for iron lost through bleeding.

Citrus fruits-if they don't cause symptoms-to promote iron absorption.

Cut Down On

Coffee, including decafteinated, and other sources of caffeine,

Avoid

Smoking.

Fatty foods.

Late-night snacks.

Submitted By:
Stethoscope Dietitian

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• Disease and Treatment
• Diet & Nutrition