This Nutritional Care and Dietary Treatment Can Reduce the Risk of Peptic Ulcers In Elderly
In the past patients with peptic ulcers were given very restricted bland diets consisting of little else but milk, products containing milk, and carbohydrates, and they were advised to continue with such diets long after their original ulcers had healed. It was thought that these regimens would reduce the production of acid and it was not realized until recently that they were ineffective and could lead to under nourishment. It has now been demonstrated that patients with peptic ulcers who eat a mixed diet recover much more quickly then those who are maintained on a milk drip. Far from suppressing the secretion of acid, as was originally thought, it has now been shown that milk may increase it.
The principles of dietary treatment for patients with peptic ulcers are now as follows:
1. Eat Regular Meals
Patients should be encouraged to eat their meals at regular intervals throughout the day, and to intersperse them with snacks. A good rule of thumb is to eat something every 2- 2 1/2 hours, especially during Times of stress. The rationale behind this is that the acid in the stomach fluctuates less when food is taken regularly because it is buffered by the food, It is better, however, not to eat last thing at night as a snack or meal then stimulate the production of more acid than can be buffered by a small amount may of food Meals should not be rushed; patients should chew fond well before swallow. ing it and rest for about 30 minutes after a meal.
2. Avoid Large Meals
Patients should be encouraged to eat small meals. Large quantities of food distend the stomach and cause the secretion of acid.
3. Eat as Normal a Diet as Possible
The diet should be adequate in all nutrients and contain enough protein for the healing of an active ulcer. It should also contain enough energy. This can be supplied by a mixture of foods containing fat and carbohydrate. Fat is known to suppress gastric motility and secretion and therefore should not be unduly restricted, our fried foods may upset some people and should be avoided by them.
4. Avoid Gastric Acid Stimulants
Caffeine, black pepper, and meat extract act as stimulants to gastric acid and should be avoided Also, it is advisable that patients avoid alcohol, strong coffee, and tea if they find they cause problems.
5. Identify Particular Irritants
A patient may find there are some other foods that upset him or her. They will vary from patient to patient and will be found only by trial and error. Examples are tough meat, rich pastries, fried foods, chili, spices, mustard, pickles. Some patients, especially if they have an active ulcer, may find they cannot tolerate the skins and pips of fruit or food with coarse fibers.
It is important, as always, that each patient should be treated as an individual. With the help of the dietitian, each patient must work out a diet that enables him or her to eat as wide a range of food as possible without discomfort.
In the past malnutrition has resulted from the inappropriate milk diets prescribed for adults. A low intake of vitamin C, resulting in scurvy, was a particular problem. Patients with duodenal ulcers in particular may be obsessional and susceptible to stress and adhering to strict dietary regimens may make things worse.
In rare instances, other complications may occur. Consuming too much soluble alkali can lead to alkalosis and tetany Milk-alkali syndrome has occurred in patients who drink large quantities of milk (1 liter or more per day) together with soluble alkaline antacids such as Aludrox and Milk of Magnesia: the syndrome results in weakness, lethargy, and anorexia. Hypercalcemia (high levels of calcium in the blood) is present and can lead to the calcification of soft tissues, and sometimes there are psychological disturbances.