Definition
Gastroduodenal ulcer is a lesion of the mucosa of the stomach (gastric ulcer) or the duodenum (duodenal ulcer), which then comes into contact with the acidic gastric secretions of the stomach or duodenum. It can also be found on the mucosa of the esophagus. The ulcer is characterized by a significant loss of substance of the internal mucosal wall of the stomach or duodenum, deeply eroding this wall down to the outer muscular layer.
Etiology
The etiology of gastroduodenal ulcer is multifactorial. It generally occurs when there is an imbalance between the aggressive agents and the protective factors of the digestive mucosa, making it more sensitive to acidity. The aggressive agents can be endogenous (internal), such as hydrochloric acid and pepsin secreted by the stomach, or exogenous (external), such as pathogenic bacteria (Helicobacter pylori), chemical agents, aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs), stress, etc. The defense factors of the digestive mucosa include mucus, bicarbonate, blood flow, cellular tissue (epithelium), and prostaglandins, hormones present in the body. The most common causes of gastroduodenal ulcer are infection with Helicobacter pylori (H. pylori) and the use of NSAIDs.
Symptoms
The most common symptom of gastroduodenal ulcer is pain in the upper part of the abdomen (epigastrium). This pain can sometimes be accompanied by nausea, vomiting, and weight loss.
Medical treatment
Medical treatment of gastroduodenal ulcer may include the use of antibiotics to eliminate the bacterium H. pylori when it is the cause of the problem, and the use of medications to reduce acid secretion inside the stomach or duodenum. In rare cases, surgical treatment aimed at reducing acid production may be used.
Nutritional approach
Studies do not show that a particular diet can promote healing or prevent recurrences of gastroduodenal ulcer. Therefore, there is no specific therapeutic diet for this digestive tract disorder. The goal of the nutritional approach is to improve the individual's well-being and provide adequate food intake according to individual tolerance.
Dietary recommendations
Since there is no specific therapeutic diet for gastroduodenal ulcer, dietary recommendations consist of promoting a balanced and individualized diet according to issues, symptoms, and individual intolerances to improve the person's comfort. Dietary recommendations may include:
- Having three meals a day and snacks as needed to avoid prolonged fasting periods. Diet usually helps alleviate symptoms of gastroduodenal ulcer, especially in the case of duodenal ulcer.
- Consuming an adequate amount of fiber (e.g., fruits and vegetables, cereal products).
- Moderating the consumption of foods containing methylxanthines (e.g., coffee, chocolate, cocoa, cola), caffeine, and alcohol.
- Consuming spices according to individual tolerance.
- Quitting smoking, as it slows the healing process of ulcers and increases the risk of recurrence.
There is no specific therapeutic diet for gastroduodenal ulcer. Therefore, the dietary approach does not cure or prevent recurrence of this digestive tract disease. In the case of gastroduodenal ulcer, the nutritional approach aims rather to promote the individual's comfort and offer a balanced and individualized diet according to each person's tolerance. Finally, the main dietary recommendation is generally to avoid foods that cause or worsen symptoms, tobacco, and alcohol.
References
- Bouthillier, Lise. January 2019. "Digestive Tract Diseases." NUT 2047 – Clinical Nutrition 2. Montreal: University of Montreal.
- D’Aoust, Louise. January 2019. "Pathophysiology of the Digestive System." NUT 2047 – Clinical Nutrition 2. Montreal: University of Montreal.
- https://www.merckmanuals.com/fr-ca/professional/troubles-gastro-intestinaux/gastrite-et-ulc%C3%A8re-gastroduod%C3%A9nal/ulc%C3%A8re-gastroduod%C3%A9nal
- https://www.merckmanuals.com/fr-ca/accueil/troubles-digestifs/gastrite-et-ulc%C3%A8re-gastroduod%C3%A9nal/ulc%C3%A8re-gastroduod%C3%A9nal?query=Ulc%C3%A8re%20gastroduod%C3%A9nal
- https://www.merckmanuals.com/fr-ca/accueil/les-faits-en-bref-troubles-digestifs/gastrite-et-ulc%C3%A8re-gastroduod%C3%A9nal/ulc%C3%A8re-gastroduod%C3%A9nal