At present there is no specific dietary treatment to cure a peptic ulcer. Mainstream medical opinion considers that drug therapy offers the most cost-effective treatment for ulcers, with surgery as an option in only the most severe cases. Even so, studies show an association between certain foods and the risk of developing ulcers, and doctors continue to warn that unbalanced diets can make symptoms worse. A permanent cure for ulcers may yet involve a combination of medication and diet.

What Is An Ulcer?

An ulcer is a small sore or break in the lining of the stomach or just beyond the stomach in the first part of the intestine, called the duodenum. Once the break occurs it is gradually eroded and deepened by the corrosive effect of acidic gastric juices to form an ulcer. An ulcerous condition may develop quickly or over a long period of time. An estimated 5-10 percent of people suffer from an ulcer at some point in their lives. Ulcers affect people of all ages and are equally common in men and women.

Difference Between Duodenal and Stomach Ulcers

A duodenal ulcer is located in the duodenum. This type of ulcer is about three times more prevalent than a gastric ulcer which forms in the stomach. Collectively, they are known as peptic ulcers.

What Causes a Peptic Ulcer?

An ulcer develops when the balance between the acidic digestive juices and the protective lining of the stomach and intestines (mucous membrane)is disturbed. This leads to a corrosion of the lining, permitting ulcers to form. Experts now understand that a common cause of developing peptic ulcers is a bacterium (a germ) called Helicobacter pylori.

Researchers estimate that up to 70 percent of the world's population is infected with H.pylori. The bacteria lives in the lining of the stomach, and is found in virtually all duodenal ulcers and 8 out of 10 gastric ulcers.

Another cause of ulcers is the use of non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin.

What Are The Symptoms Of An Ulcer?

Most ulcers cause recurring episodes of abdominal pain, sometimes radiating to the back. These episodes may be separated by periods of remission lasting from several weeks to years. The pain, often causing a burning sensation, is typically reduced by food but returns when the stomach empties. Pain experienced during the night is a common indicator of a duodenal ulcer. Other symptoms may include indigestion, nausea, vomiting, weight loss and black tarry stools. In a very small percentage of cases, the ulcer may rupture a blood vessel, causing vomiting of blood. Peptic ulcer disease can be very distressing and, if left untreated, can cause premature death in extreme cases.

How Is An Ulcer Diagnosed and Treated?

Diagnosis of an ulcer is typically performed either by endoscopy (a viewing tube passed down the throat into the stomach) and tissue sample (biopsy), or by giving the patient a barium meal and then an X-ray examination. Helicobacter pylori bacteria can be diagnosed by endoscopy, or a relatively simple "urea breath test", or by a blood test.

Where the ulcer is related to H.pylori infection, a permanent cure can be achieved through medication alone. A stomach-acid reducing drug combined with antibiotics usually eradicates the bacteria and either cures the ulcer in a matter of weeks or leads to long term remission. Where the ulcer is unrelated to bacteria, stomach-acid reducing medication may be prescribed on an ongoing basis to protect the stomach lining. Although the majority of peptic ulcers respond well to such treatment, many patients suffer a relapse within 12 months. Thus the search for a permanent cure continues.

Diet And Ulcers

In general, if you want to ease the symptoms of an ulcer, or reduce your risk of developing one in the first place, you should avoid eating large meals, as they encourage the production of excessive amounts of stomach acid to digest the food. In addition, diets which are high in fat and sugar, but low in fiber are known to cause a variety of adverse effects in the gut. Here are some specific dietary tips which may help to reduce the symptoms and formation of peptic ulcers.

Reduce Your Intake of Spicy Foods

Although there is no clear evidence to suggest these foods cause ulcers, they have been shown to aggravate symptoms. So avoid foods like: chili peppers, black pepper, mustard, curry and other strong spices.

Reduce Alcohol And Caffeine Intake

Both alcohol and caffeine can be problem foods for anyone with an ulcer, or at risk from an ulcer, and should be avoided or consumed sparingly. These items typically increase the acidity of the stomach and therefore can contribute to ulcer development or aggravate symptoms of existing ulcers.

Reduce Your Intake Of Sodium

An American study has linked high intakes of salt and soy sauce to a higher risk of stomach ulcers. So avoid adding salt to your the food on your plate and use food labels to check for low-sodium varieties. Foods commonly high in sodium include: canned soup, tortilla chips, potato/corn chips, salted nuts, salted meats (eg. bacon), blue cheese, cornflakes. Switching to a diet containing fewer packaged or processed foods, will definitely reduce your sodium intake.

Add Oily Fish To Your Diet

Some studies suggest that omega-3 fatty acids - found in oily fish, like salmon, mackerel, sardines and herring - may help reduce the risk of ulcers. It seems that these omega-3 fats increase our production of prostaglandins, compounds that help to protect the lining of the alimentary canal, that is, the entire digestive passage, including the lining of the stomach and intestines.

General Advice About Dietary Vitamins And Minerals

The protective antioxidant effects of certain micronutrients should help to lower the risk of ulcers and ease symptoms when an ulcer has already formed. For instance, some nutritionists recommend eating more vegetables and fruit, such as carrots, kale, red/green peppers, cabbage juice, apricots and kiwi fruit, for their beta-carotene and vitamin C content, in order to help protect the lining of the stomach and intestine. Vitamin E from foods like wheatgerm, hazelnuts, cold-pressed sunflower seed oil, soybean oil, should also help, as should zinc from seafood and whole grains.

Other nutritionists are strong advocates of the healing properties of amino acids, the basic building blocks of proteins, and recommend L-Glutamine for peptic ulcers. Good food sources include: wheatgerm, cheddar cheese, almonds, sunflower seeds and sesame seeds.

Possible Herbal Remedies For Ulcers

In some tests, a tablet form of licorice root - which has been treated to remove an acid which may raise blood pressure - has been shown to protect against ulcers caused by the adverse effects of aspirin on the stomach lining. Camomile tea may also ease the symptoms of ulcers.

Lifestyle And Risk Of Ulcers

Damage caused by smoking increases the risk of ulcer formation and slows ulcer healing. Another reason to quit! The effects of stress on ulcer development are less easy to assess, although a stressful lifestyle clearly impacts on eating habits, alcohol consumption and smoking. So if you want to lower your risk of an ulcer, taking steps to alleviate the stress in your life is almost certain to be beneficial.caused by smoking increases the risk of ulcer formation and slows ulcer healing. Another reason to quit! The effects of stress on ulcer development are less easy to quantify, although a stressful lifestyle is known to affect eating habits, alcohol consumption and smoking. So if you want to lower your risk of an ulcer, taking steps to alleviate the stress in your life is almost certain to be beneficial.

Linda Smith B.Sc., RD, aged 51, is a qualified dietitian and nutritional consultant. She is part of the editorial team at Diet-i.com which provides a range of information about diet, nutrition and weight management to more than 5 million visitors per year.

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