Peptic ulcer is a general disorder. Ulcer is formed in the gastrointestinal tract where gastric juice comes in direct contact with mucous membrane. This type of ulcer usually occurs in the first part of the duodenum and stomach. In some cases ulcer occurs in the lower part of esophagus. Peptic ulcer is called as ‘a disease due to hurry, Worry and curry’ because this disease is seen among them who are always in tension and who work very hurriedly. Besides this, low intake of protein and high intake of spicy food causes ulcer.
Types:
There are mainly two types of ulcer –
Gastric ulcer –
Ulcer of stomach is known as gastric ulcer which includes poor nutrition, poor mucosal blood flow.
Duodenal ulcer –
Ulcer of duodenum is known as duodenal ulcer. In this case excessive secretion of acid is occurred.
Prevalence:
- Peptic ulcer is found in most middle adulthood between 45 – 55 years of age.
- It is found more in men than women.
Symptoms:
- Feeling hungry after 2 to 3 hours of eating.
- Discomfort in the upper central abdomen.
- Motility of digestive system enhances.
- When ulcer is in severe stage, bleeding is common and appeared black stool like tar.
- Hematemesis (bloody vomit) is occurred.
- Heart burn is occurred.
- Iron deficiency anemia can be seen for bleeding ulcer.
- Weight loss is common in peptic ulcer.
Causes:
- Bacterial infection:
Helicobacter Pylori is the main bacteria which causes ulcer. It can be treated by antibacterial treatment.
- Irritant substances:
Excessive consumption of tea, coffee and alcohol can cause peptic ulcer. Besides these, excessive smoking, consumption of tobacco, spices causes ulcer. Use of some drugs like NSALD and corticoids for long time causes ulcer.
- Heredity factor:
Hereditary factor is strongly related to the occurrence of ulcer.
- Genetic factor:
Peptic ulcer is common in people with blood group ‘o’ than people with other blood group.
- Eating habits:
Eating quickly, improper chewing of food, missing of meal and low intake of protein are related to peptic ulcer.
- Personality:
Mental stress, nervousness, anxiety may cause hyper secretion of acid. Besides these people who work hurriedly, they more prone to peptic ulcer.
Dietary management:
Calorie –
Patient’s calorie will be modified on the basis of his or her age, sex, height, weight and life style.
Protein –
Protein should be given 50 % more than requirement of normal person. Protein is required for tissue synthesis as a result it promotes healing. Milk protein is good for peptic ulcer patient. But calcium and amino acid of milk stimulate excess acid production as a result milk protein may affect adversely on the healing role of ulcer. But milk neutralizes stomach acid so milk can be given in moderate amount. For healing egg and other proteins can be included in the diet.
Fat –
40 % should come from fat of total calorie as excess intake of fat strongly related to atherosclerosis. Fat delays the emptying of stomach. Fat helps to decrease acid secretion and motility of stomach. Vegetable oil which is the source of essential fatty acid and fat of milk are good for peptic ulcer patient.
Carbohydrate –
40 – 45 % should come from carbohydrate of total calorie. High fibre rich foods should be eliminated from the diet such as whole meal, unpolished rice etc. polished rice and refined flour should be included in the diet. Vegetable should be low fibre rich such as raw papaya, bottle gourd, ridge gourd, potato etc. Other vegetables can be included without seeds and peel. Spinach contains cellulose so, it is better to avoid herbages and raw salad.
Vitamin –
Vitamin C can be given for healing ulcer and better iron absorption but many vegetables and fruits have to be avoided in this disease so lack of vitamin C can occur. So, multivitamin table should be given to patient. Vitamin A and vitamin E is an effective element to cure peptic ulcer.
α – linolenic acid –
α – linolenic acid has anti ulcer properties. It is an essential fatty acid in the w6 family which is found in plant based oil.
W3 fatty acid –
W3 fatty acid reduces the risk of ulcer.
Probiotics –
Healthy and friendly organisms are called probiotics. Probiotics protect us from the entrance of bad infection which can cause this disease. Lactobacillus Acidophilus is most common probiotics. This probiotic and other probiotics are able to slow down the growth of Helicobacter Pylori which causes peptic ulcer.
Food recommendation:
Stage I and stage II –
When patient is suffering from severe pain and gradually reliefs from pain and he or she on bed rest then patient should be given curd, custard, cheese, refined cereals, cooked eggs, soft cooked vegetables and fruits.
Stage III –
Patient follows these following foods throughout his life as it can occur again. Well cooked cereals, vegetables, milk, cheese, egg etc should be given with above foods if the patient is able to tolerate.
Foods included:
Polished rice, refined flour, semolina, flattened rice, puffed rice, bread, sago, egg (not fried), dhal without shell ( well boiled), milk, sweet made from curdled milk, custard, fish, chicken stew or boiled chicken, low fibre rich vegetables and fruits and fruit juice, cheese, butter, sugar, honey, light tea etc.
Foods excluded:
Roti (bread) made from wheat flour, whole cereals, nuts, spicy foods, fried foods, vegetables such as cauliflower, cabbage, peas, onion, radish, pickle, chutney, cake, pastry, halwa, chocolate, alcohol, cold drinks, strong tea or coffee, betel leaf, tobacco and very hot or very cold food.
Dietary guidelines:
- Eat small quantity of food at short interval and chew the food properly and slowly.
- Eat digestible fat such as milk, egg yolk, butter, cream etc but keep in mind that fat should be intake in moderate amount.
- Try to avoid caffeine beverages like coffee, strong tea, cola and alcohol.
- Stop smoking.
- Avoid use of tobacco.
- Avoid spicy food.
- Bland diet should be given to patient.
- Avoid the use of aspirin or other drugs as these can damage the stomach lining.
- Patient should take physical and mental rest.
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| Treatment of ulcer |
A sample menu of peptic ulcer patient:
Calorie- 2121.41 kcal
Protein- 85 gm
Fat- 33.6 gm
Carbohydrate-370 gm
Meal
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Food stuff
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Amount
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Breakfast
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Mid-morning
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Lunch
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Evening snacks
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Dinner
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