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Diet and nutrition in ulcer disease.

Abstract

In this era of H2-inhibitors, the available evidence does not support the need to place peptic ulcer disease patients on restrictive diets. The major goal of diet is to avoid extreme elevations of gastric acid secretion and the direct irritation of gastric mucosa. In view of this, only slight modifications in the patient's usual diet are recommended. Table 1 depicts a sample menu for chronic peptic ulcer disease. Frequent milk ingestion as previously prescribed is not encouraged. This is owing to the transient buffering effect and significant gastric acid secretion effect of milk. The fat content of milk has no influence on these effects. Spices, in particular black pepper, red pepper, and chili powder, may produce dyspepsia. One study shows red chili powder to have no detrimental effect on duodenal ulcer healing. It has also been proposed that daily pepper ingestion may have a beneficial adaptive cytoprotective response. While still controversial and under evaluation, peptic ulcer patients should avoid any spice that causes discomfort, especially during exacerbation of peptic disease. Currently, studies indicate that it is prudent to avoid alcohol. This is especially true for the concentrated forms, such as 40% (80 proof) alcohol. Coffee should be avoided on the basis of its strong acid secretagogue property. Coffee can induce dyspepsia. Whether noncoffee caffeine-containing beverages (tea, soft drinks) induce peptic ulcer is unknown, but they are acid secretion stimulators. Decaffeinated coffee has an acid stimulating effect as well. It is reasonable to have peptic ulcer patients restrict decaffeinated coffee and all caffeine-containing beverages. There appears to be no evidence to restrict dietary fiber. Some fiber-containing foods may possess factors that are protective against ulcer disease. According to the Mayo Clinic Diet Manual, previously recommended small frequent feedings have not been shown to be more effective than three meals per day in the treatment of chronic peptic ulcer disease. This reference cites authorities advising against extra feedings because of increased acid secretion and unnecessary complication of eating patterns. However, some patients claim to be relieved of symptoms with more frequent feedings, especially during acute phases. Citric acid juices may induce reflux and cause discomfort in selective patients. Stomach distention with large quantities of food should be discouraged. Although there is now little role for dietary therapy, one should note that bland and ulcer diets probably are not detrimental to most persons if they are used for a short time and may have some psychological benefit.(

ABSTRACT

TRUNCATED AT 400 WORDS)

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Nutrition Support Service, Norwalk Hospital, Connecticut.

    Source

    The Medical clinics of North America 75:4 1991 Jul pg 967-79

    MeSH

    Alcohol Drinking
    Animals
    Caffeine
    Condiments
    Dietary Fats
    Humans
    Milk
    Peptic Ulcer

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    2072799

    Citation

    Marotta, R B., and M H. Floch. "Diet and Nutrition in Ulcer Disease." The Medical Clinics of North America, vol. 75, no. 4, 1991, pp. 967-79.
    Marotta RB, Floch MH. Diet and nutrition in ulcer disease. Med Clin North Am. 1991;75(4):967-79.
    Marotta, R. B., & Floch, M. H. (1991). Diet and nutrition in ulcer disease. The Medical Clinics of North America, 75(4), pp. 967-79.
    Marotta RB, Floch MH. Diet and Nutrition in Ulcer Disease. Med Clin North Am. 1991;75(4):967-79. PubMed PMID: 2072799.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Diet and nutrition in ulcer disease. AU - Marotta,R B, AU - Floch,M H, PY - 1991/7/1/pubmed PY - 1991/7/1/medline PY - 1991/7/1/entrez SP - 967 EP - 79 JF - The Medical clinics of North America JO - Med. Clin. North Am. VL - 75 IS - 4 N2 - In this era of H2-inhibitors, the available evidence does not support the need to place peptic ulcer disease patients on restrictive diets. The major goal of diet is to avoid extreme elevations of gastric acid secretion and the direct irritation of gastric mucosa. In view of this, only slight modifications in the patient's usual diet are recommended. Table 1 depicts a sample menu for chronic peptic ulcer disease. Frequent milk ingestion as previously prescribed is not encouraged. This is owing to the transient buffering effect and significant gastric acid secretion effect of milk. The fat content of milk has no influence on these effects. Spices, in particular black pepper, red pepper, and chili powder, may produce dyspepsia. One study shows red chili powder to have no detrimental effect on duodenal ulcer healing. It has also been proposed that daily pepper ingestion may have a beneficial adaptive cytoprotective response. While still controversial and under evaluation, peptic ulcer patients should avoid any spice that causes discomfort, especially during exacerbation of peptic disease. Currently, studies indicate that it is prudent to avoid alcohol. This is especially true for the concentrated forms, such as 40% (80 proof) alcohol. Coffee should be avoided on the basis of its strong acid secretagogue property. Coffee can induce dyspepsia. Whether noncoffee caffeine-containing beverages (tea, soft drinks) induce peptic ulcer is unknown, but they are acid secretion stimulators. Decaffeinated coffee has an acid stimulating effect as well. It is reasonable to have peptic ulcer patients restrict decaffeinated coffee and all caffeine-containing beverages. There appears to be no evidence to restrict dietary fiber. Some fiber-containing foods may possess factors that are protective against ulcer disease. According to the Mayo Clinic Diet Manual, previously recommended small frequent feedings have not been shown to be more effective than three meals per day in the treatment of chronic peptic ulcer disease. This reference cites authorities advising against extra feedings because of increased acid secretion and unnecessary complication of eating patterns. However, some patients claim to be relieved of symptoms with more frequent feedings, especially during acute phases. Citric acid juices may induce reflux and cause discomfort in selective patients. Stomach distention with large quantities of food should be discouraged. Although there is now little role for dietary therapy, one should note that bland and ulcer diets probably are not detrimental to most persons if they are used for a short time and may have some psychological benefit.(ABSTRACT TRUNCATED AT 400 WORDS) SN - 0025-7125 UR - https://www.unboundmedicine.com/medline/citation/2072799/full_citation L2 - https://linkinghub.elsevier.com/retrieve/pii/S0025-7125(16)30424-2 DB - PRIME DP - Unbound Medicine ER -