Diet In Peptic Ulcer

Introduction

Chronic ulcer formed in the region of the gastrointestinal tract where the gastric juice comes in direct contact with the mucous membrane is known as peptic ulcer. Such ulcers usually occur in the duodenum (duodenal ulcer) and in the stomach (gastric ulcer). Duodenal ulcer is associated with hyperacidity, while gastric ulcer is not.

Diet

The diet is the most important factor in the treatment of peptic ulcer. Peptic ulcer treatment includes three types of diets.

Name Of The DietIngredients
(1) Sippy’s diet and its modification by HurstHourly feeds of milk, cream and olive oil with antacids medications.
(2) Lenhartz dietFluid diet based on milk and eggs.
(3) Meulengracht dietA mixed bland diet containing milk, egg, meat and fish (minced and strained)- given once in 2 hours.

Sippy’s diet consisting of milk and olive oil was used widely. Since it is monotonous and not adequate to meet the calorie needs, it has been replaced by a bland diet containing large quantities of milk.

Dietary Management

Calories: Calorie intake should be adequate according to age, sex and occupation.

Proteins: Proteins intake should be 50% higher than the recommended allowances. Atleast 50% of dietary protein should be taken from milk.

Fats: Fat should be incorporated 50-60 g in the diet depending on the calorie requirements. About 50% of the fat should be provided by milk and the remaining by vegetables fats rich in essential fatty acids, eg: sesame oil, sunflower seed oil, safflower seed oil etc.

Carbohydrates: About 40-50% of the calorie requirements is provided by carbohydrates. Only milled cereals with low fiber content should be consumed. The vegetables consumed should have low fiber content.

Vitamins: The diet should contain all the vitamins in adequate amounts. As usually one multivitamin tablet providing the daily requirements of all the vitamins should be consumed.

Foods To Be Consumed

  • Milled cereals (milled rice, refined wheat flour & semolina).
  • Dhal (split legumes).
  • Milk.
  • Eggs.
  • Tender vegetables (fiber free).
  • Meat and fish (limited amounts).
  • Fruits (fiber free).
  • Fats and oils.
  • Sugar.

Foods To Be Avoided

  • Whole cereals and whole millets.
  • Legumes with husk (Bengal gram, field bean, cow gram, dried pea etc.).
  • Vegetables containing fiber, raw onions, garlic etc.
  • Pickles, spices and condiments.
  • Meat soup and extractives.
  • Fried foods.
  • Alcohol and alcoholic drinks.
  • Chewing betel leaves, tobacco.

Diet For Adults Suffering From Peptic Ulcer (g/caput/day)

FoodstuffsVegetarianNonVegetarian
Milled rice and refined wheat flour or bread and biscuits200200
Dhal (decuticled split legumes)5050
Milk18001500
Cheese50_
Eggs_30
Meat or lean fish_60
Fats & oils (2/3 as vegetable oils rich in essential fatty acids)6060
Sugar6060
Tender vegetables5050
Potato5050
Fleshy fruits (banana, apple and mango)100100

NOTE: One vitamin C (100 mg) tablet must be taken once daily.