Perforated stomach ulcer - what is it? Postoperative diet menu for stomach ulcers

It is important for the patient to follow the approximate menu after surgery for a perforated ulcer, which is determined by the attending physician. Dietary nutrition is one of the most important elements in the treatment of a disease that causes a number of serious consequences for the body. With the help of a diet, it is possible to reduce the load on the mucous membrane of the gastrointestinal tract.

What's the ailment?

A perforated or perforated ulcer is a neoplasm in the mucous membrane of the digestive tract, which has a through character. As the disease progresses, hydrochloric acid begins to corrode the walls of the stomach, which causes perforation. As a result, the contents of the gastrointestinal tract flow into the peritoneum, which contributes to the formation of purulent inflammatory processes, which sometimes lead to death if the patient is not provided with timely medical care.

It is possible to get rid of a perforated ulcer only through surgical intervention. During it, harmful substances are pumped out of the abdominal cavity, after which the perforations in the walls of the gastrointestinal tract are sutured. Often, during the intervention, the surgeon eliminates a certain area of ​​\u200b\u200bthe stomach if the ulcer has a large volume or an advanced stage. At the same time, recovery after surgery takes a long time. At this point, the patient is prescribed a special dietary food that will improve the condition.

Features of the diet for perforated ulcer

With the help of a diet, it is possible to reduce the load on the mucosa of the gastrointestinal tract. In order for the epithelium to recover faster, the patient will need to eat soft food that is well digested. It is important to exclude food that has aggressive effects on the walls of the gastrointestinal tract. In addition, the products should not contribute to an increase in the release of acid, which provokes the onset of pathology.

The attending physician adjusts not only the patient's diet, but also the conditions of food consumption. You will need to eat in small portions at least 5 times a day. It is mandatory to refrain from drinking alcohol and smoking. This is due to the fact that alcohol burns through the mucous membrane, which causes a powerful pain syndrome. If we talk about the harmful substances that are in cigarettes, they also irritate the walls of the digestive tract. Because of this, serious consequences often occur after surgery. Treatment prohibits the use of carbonated drinks, as well as strong tea and coffee.

In addition, the patient will need to remember the following rules of nutrition for gastric disease:

• Do not drink large amounts of liquid or overeat, as this provokes stretching of the walls of the stomach.
• Watch the temperature of the food, which should not be excessively cold or hot.
• Chew food thoroughly.

What can you eat?

The diet after surgery for a perforated or duodenal ulcer involves the inclusion of the following food in the menu:

• steamed protein omelettes;
• weak broths from vegetables and meat;
• crackers;
• low-fat dairy products;
• vegetables, which contain a small amount of fiber;
• steam cutlets from lean meats;
• fruit;
• paste;
• jam;
• marshmallow.

What should not be consumed?

A diet for a bleeding stomach ulcer involves a ban on such foods:

• bakery products;
• legumes;
• unnatural sweets;
• sour fruits;
• strong coffee and tea;
• seeds;
• marinades;
• conservation;
• semi-finished products;
• fast food;
• soda;
• various sauces;
• spices and spices.

Salt is also limited. The exact amount that the patient is allowed to add to the diet is determined by the attending physician.

sample menu

When a patient is diagnosed with a perforated stomach ulcer with or without bleeding, the doctor sets the diet. However, it is important for each person to know what approximate menu involves the postoperative period. Food at this moment can be not only healthy, allowing you to improve the activity of the gastrointestinal tract, but also tasty. Approximate diet for 1 day:

• Breakfast:
  • oatmeal with sweet fruits;
  • steamed protein omelet;
  • weak green tea.
• Lunch:
  • low fat yogurt.
• Dinner:
  • vegetable soup puree;
  • steam turkey cutlet;
  • compote.
• Afternoon snack:
  • cottage cheese casserole.
• Dinner:
  • pike perch baked in the oven;
  • vegetable salad dressed with olive oil;
  • a glass of kefir.

How to eat after surgery?

After 5 days have passed after the surgery, a person is allowed to consume a small amount of drinks. With the help of them, it is possible to improve the functioning of the digestive organs and strengthen the immune system. It is recommended to make a decoction of wild rose, in which it is permissible to add a little honey. Kissels based on non-acid fruits are also allowed. Such a drink envelops the walls of the gastrointestinal tract, which helps to reduce the negative effects from the outside. Such drinks are drunk not only after surgery, but throughout life.

10 days later, the menu after the operation of a perforated stomach ulcer includes some dishes that improve the activity of the gastrointestinal tract. It is permissible to eat vegetable puree soups, viscous cereals, steamed protein omelettes, steam cutlets from lean meats. The patient will need to follow such a diet for at least 30 days. If after a month the person's condition has not been noticed to worsen, the diet is slightly expanded. However, a fairly strict diet will need to be observed throughout life.

Peptic ulcer of the stomach has many unpleasant and dangerous consequences. One of them is the perforation of the ulcerative defect of the wall of the specified organ. As a result, gastric contents are poured into the abdominal cavity, which can lead to the development of peritonitis (inflammation of the peritoneum), which threatens a person's life.

This dangerous condition is called a perforated stomach ulcer and requires mandatory urgent surgical intervention. The causes of occurrence are chronic and acute stomach ulcers. Certain factors contribute to the perforation of the organ wall:

• lack of treatment for an exacerbation of an ulcer;
• gross violations of the diet;
• severe overeating;
• frequent stressful situations, constant mental and mental stress;
• heavy physical exertion and increased pressure inside the abdominal cavity;
• long-term use of glucocorticosteroids and salicylic acid preparations.

Most of all, ulcers located on the anterior wall of the stomach in the pyloric and prepyloric sections are prone to perforation.

Signs of perforated pathology of the stomach

Symptoms of a perforated ulcer and their severity depend on the clinical form of perforation. She may be:

• typical (into the free cavity of the peritoneum; including covered);
• atypical (into the space behind the peritoneum, between its sheets, into the interadhesion area).

The classic picture of the signs of a perforated ulcer is observed with perforation into the free abdominal cavity, which occurs in 90% of cases. It has 3 periods:

• primary "abdominal shock" (chemical inflammation);
• latent period (bacterial);
• diffuse purulent peritonitis.

Each of the periods has its own special symptoms. The primary shock phase, lasting 6-10 hours, is characterized by the appearance of a sudden sharp "dagger" pain in the epigastric region, often diverging along the phrenic nerve to the area of ​​the right shoulder, shoulder blade and outer part of the neck.

Outwardly, a sick person looks pale, haggard, with sunken eyes. A characteristic sign is a forced immobile position of the body, lying on its side, with legs brought to the stomach. Breathing shallow and frequent, cold sweat on forehead. "Board-like" tension of the abdominal muscles, which is not involved in the act of inhalation and exhalation.

The phase of bacterial peritonitis is also called the period of imaginary well-being. There is a decrease in the symptoms of pathology, the cessation of pain. The face becomes normal color, pulse and respiration normalize. When palpated, there is pain in the epigastric region and signs of muscle tension in the abdomen.

After 12-24 hours from the moment of perforation, a picture of diffuse peritonitis unfolds. Symptoms resume with renewed vigor, the patient's condition worsens. Pain increases sharply, there is repeated vomiting, nausea, hiccups. Breathing is frequent and shallow, the pulse quickens, body temperature rises, the stomach swells.

Ulcer Therapy Methods

Perforated gastric ulcer of any shape and localization is an absolute indication for urgent surgical intervention. Therefore, when people, having got to the hospital with the indicated diagnosis, ask if the operation is mandatory, there can be no other answer than in the affirmative. And the sooner it is done, the better the prognosis and the lower the likelihood of complications.

Treatment without surgery is carried out in extreme cases, when a person is categorically against surgery. It consists in the constant aspiration of the contents of the stomach through a probe against the background of intravenous administration of water-salt solutions and antibiotics. The effectiveness of this method is possible at the earliest stages of the development of the disease, when the contents of the stomach did not have time to pour into the abdominal cavity. But often these activities only waste precious time and do not give an effect. For this reason, in the end, the person agrees to the operation, but it happens that it is already too late.

Treatment at the prehospital stage for suspected perforated gastric ulcer includes intravenous infusion of saline solutions, drugs that narrow blood vessels, oxygen inhalation. Narcotic painkillers should not be administered, as they "lubricate" the true picture of the disease. For this reason, an incorrect diagnosis in a hospital can be made. Before the operation, the gastric lavage is carried out using a probe to remove all its contents.

In surgical treatment, methods are used:

• suturing perforation;
• removal of part of the stomach (resection);
• excision of the ulcer with vagotomy (dissection of the vagus nerve).

Usually, operative access to the organ is carried out by laparotomy. With the necessary equipment, it is possible to perform operations endoscopically, under the control of a videoscope, through several holes in the abdominal wall, without a wide incision. If diffuse peritonitis and an intra-abdominal inflammatory process are detected during the course, they proceed to laparotomy.

The choice of the surgical method is carried out in accordance with the patient's condition, his age, type of ulcer, the presence of concomitant diseases, the time from the onset of the perforation process. Any chosen method is aimed at curing the patient and saving his life.

Perforation suturing is used if more than 6-12 hours have passed since the onset of its formation, in young people with a recent gastric ulcer, in the elderly, with a general serious condition of a person.

Removal of part of the stomach (resection) is performed when:

• a long-standing ulcer that cannot be cured with medication;
• detection during the operation of an old ulcer that cannot be sutured;
• suspicion of malignancy of the ulcer;
• perforation of several ulcers at the same time.

Treatment after surgery includes:

• taking antiulcer drugs (Kvamatel, Zantak; Maalox, Almagel);
• the use of antibacterial agents (Ampioks);
• taking proton pump blockers (Omez);
• intravenous administration of solutions to improve microcirculation and wound healing (Trental, Actovegin, Reopoliglyukin, Solcoseryl).

After completion by any of the selected methods, sanitation is performed and the outflow of the emerging inflammatory fluid from the abdominal cavity (drainage) is ensured. Sometimes they put two probes: in the jejunum - for nutrition, in the stomach - for decompression.

In the postoperative period, early activation of the patient, breathing exercises and exercise therapy are recommended. Contribute to the restoration of health walks in the fresh air, rest, exclusion of physical exertion and psycho-emotional stress, good nutrition according to the rules of the necessary diet.

With the help of modern methods of laser therapy, scars formed after surgical intervention are removed. Such measures can be carried out only with complete healing of the postoperative wound, in the absence of any complications, after control gastroscopy.

Features of the diet after surgery

Often, the patient's relatives have a question about what kind of nutrition is indicated after the removal of a perforated ulcer. On the first day, it is only allowed to drink water from a spoon in a small amount, the next day they give 200-250 ml of liquid food (porridge). On the third day, the volume of food is 500 ml, then it increases to 1 liter.

After 7 days, the patient is transferred to the main diet, similar to the treatment table used for exacerbation of gastric ulcer. It is a diet table No. 1a according to Pevzner. A week later, they switch to diet No. 1b, and then, after 10-12 days, to table No. 1, which must be followed for 8-12 months.

When eating in accordance with diet No. 1a, food is consumed in boiled, mashed, steamed, maximally liquefied form. All vegetables, bakery, sour-milk and confectionery products, raw fruits, spices, snacks, carbonated drinks, coffee are excluded.

When switching to diet No. 1b, steam cutlets, jellied fish, a baked apple or grated raw are added. Treatment table No. 1 is not as strict as No. 1a. It allows the use of non-rigid meat and fish in pieces, wheat bread made from premium flour, boiled and mashed vegetables, slightly acidic kefir, cottage cheese, yogurt. The methods of cooking remain the same - boil, stew, steam, wipe tough food.

Complications of the disease and prognosis

The earlier an accurate diagnosis of a perforated stomach ulcer is made, the higher the likelihood of getting rid of this serious condition. With the correct timely diagnosis (in the first 12 hours) and the necessary surgical treatment, the prognosis is favorable.

Complications after surgery develop infrequently and can be presented:

• bronchopneumonia;
• purulent processes (abscesses under the diaphragm, between intestinal loops, in the subhepatic space);
• violation of the exit of food from the stomach;
• intestinal obstruction;
• bleeding (gastric or abdominal).

Each of these conditions, with any degree of symptom severity, requires careful treatment and, if necessary, reoperation.

Prevention of bronchopneumonia is facilitated by washing the trachea and bronchi, removing fluid from the pleural cavity, early activation of the patient and breathing exercises. In case of violation of the passage of food through the stomach, all contents are removed from it through the inserted probe. At the same time, they are struggling with the slowdown of the intestines, giving a large amount of fluid and intravenously injecting proteins and electrolytes.

If gastric obstruction persists, gastroscopy is performed to detect the cause of the disruption of the stomach, a possible mechanical obstruction that arose during the operation or as a complication, and to resolve the issue of the need for repeated surgical intervention.

An unfavorable outcome is usually observed as a result of a person's late seeking medical help, when symptoms are overt. Deaths occur due to diffuse purulent peritonitis, postoperative pneumonia and concomitant severe diseases. In recent years, the mortality rate among people diagnosed with perforated ulcers in surgical treatment has decreased significantly to 5-7%.

Long-term complications of the operation depend on its type and the correct choice of method. Re-perforation of the gastric wall occurs in less than 2% of operated people.

A perforated ulcer is considered a serious gastrointestinal disease, which is accompanied by a difficult postoperative period. To restore health, a patient after surgery for a perforated stomach ulcer needs a diet, long-term medication and bed rest. This article will tell about the symptoms of this dangerous ailment, the causes and treatment.

Description of the disease

A stomach ulcer is considered a common and dangerous disease, which is called the "scourge" of our time. Complications of the disease, especially a perforated ulcer, are no less dangerous. With late diagnosis and untimely treatment, the disease can be fatal.

A perforated or perforated stomach ulcer is a through hole in the wall through which the contents of the digestive organ enter the human abdominal cavity. The patient can be helped if you immediately respond to the symptoms of the disease and urgently perform an operation. But this is not enough. It is important not to neglect the prescriptions of doctors, which they give after such an intervention. Only in this case the danger to life will pass away and the lost health will gradually be restored.

When the contents of the stomach leak into the peritoneum, food is not digested and does not support vitality. In addition, it infects other organs and leads to the development of dangerous infections. In case of untimely or inadequate treatment of peritonitis, the prognosis for the future will be disappointing

On a note! It cannot be said that there is a specific risk group for this disease. But peritonitis occurs more often in men aged 20-40 and in patients with a stomach or duodenal ulcer.

The first sign of ulcer perforation is acute unbearable pain.

Doctors constantly remind about the need for treatment, prevention of peptic ulcer and adherence to a special diet. Otherwise, patients will have to constantly struggle with chronic attacks or complications that lead to premature death.

Symptoms of the disease

Symptoms of perforation of a stomach ulcer, as a rule, are very pronounced. But sometimes the disease is asymptomatic, and then the patient's state of health deteriorates sharply and it is not possible to help him.

Note! It is sometimes difficult to make a diagnosis of a perforated gastric ulcer due to the fact that other diseases of the gastrointestinal tract and, first of all, the presence of an ordinary ulcer interfere with this.

Perforated stomach ulcer

This disease goes through three stages, each of which is characterized by its own symptoms and signs. Let's dwell on each of them in more detail:

1. shock stage. Shock causes acute, sudden pain in the abdomen. It is so strong that it is compared with the blow of a cold weapon and therefore is called "dagger".

The suddenness of the pain syndrome can cause a single vomiting. The patient takes a specific position - lies on the right side, bends the legs at the knees and pulls them to the stomach. The person's face turns pale, and the forehead is covered with sweat. Breathing becomes chesty, shallow and rare, and the limbs are cold and clammy. Acute pains spread throughout the abdomen and can radiate to the area above the shoulder or to the neck - on both sides or only on the right. This stage is characterized by bradycardia, but then the pulse quickens, but is characterized by weak fullness. The patient's abdomen is drawn in, the muscles of the peritoneum are in tension. Any attempt to change the position of the body, cough or strain the abdominal muscles is accompanied by increased pain.

1. hidden period. It is characterized by imaginary relief, calmness and occurs 11-12 hours after the first signs of the shock stage. During the period of the latent course of the pathological process, the pains become less intense and may even disappear. The pulse rate is slightly higher than normal. The patient calms down, thinks that the disease has receded and may fall into euphoria. But these favorable signs of a perforated stomach ulcer do not make the situation any less dangerous. The tongue still remains coated and dry, and on palpation of the abdomen, tension is felt in the anterior wall of the peritoneum. These signs cannot be missed, otherwise they will be followed by a worsening of the patient's condition.

1. Peritonitis. The disease passes into the stage of diffuse peritonitis after a day. The pain returns and becomes unbearable. The patient suffers from nausea and vomiting, which are sometimes accompanied by hiccups. Body temperature rises to 38 degrees. The abdomen swells, faint noises are heard in the peritoneum, which are replaced by silence. At this time, food flows into the abdominal cavity, and then infection occurs and dangerous infections develop.

Important! Usually, patients with peptic ulcer periodically experience pain that worsens in autumn and spring. This is a sign that the disease has become chronic. Recurrent attacks may result in perforation.

Treatment of perforated stomach ulcer

Perforated ulcers require surgery. This is reasonable even if there is the slightest suspicion of a perforated ulcer. Some patients underestimate the seriousness of the situation and refuse hospitalization and subsequent surgery. It is foolish to hope that the problem will disappear on its own, on the contrary, it will lead to complications, the consequences of which will be incompatible with life. Conservative treatment at the stage of perforation is not beneficial.

Surgical intervention

During the operation, which is vital for the patient, a small section of the stomach is cut off. This does not pose a danger to the future life and health of a person, and in the future will not affect his habits. At the same time, the surgeon cleans the abdominal cavity from the remnants of food, blood, etc.

Stomach before and after surgery

Conservative treatment

Conservative treatment in this situation is not applied, because it does not give a result. Sometimes patients categorically refuse the operation, although practice shows that, in the end, few manage to avoid getting on the surgeon's table.

As an alternative to surgery for symptoms of a perforated stomach ulcer, the patient is encouraged to constantly take large amounts of potent antibiotics. Not every organism can withstand such a “hit”, because both the gastrointestinal tract and other organs suffer from these unsafe medicines.

In addition to taking antibiotics, the patient will have to "swallow" a special probe. With its help, the food that enters the abdominal cavity is cleaned. Such a procedure is hardly pleasant, rather exhausting and taking away the last strength. For this reason, at the first sign of illness, doctors strongly recommend that you immediately agree to the services of a surgeon.

A special diet will help restore strength

Recovery after surgery

During the postoperative period, the main thing for a sick person is to follow the rules of a special balanced diet. The diet for a perforated stomach ulcer is based on the following rules:

• Avoid solid foods completely. It is impossible to remove it when it enters the peritoneum even with a probe. Therefore, the patient's diet should consist of liquid soups, kefir, juices and pureed dishes - mashed potatoes, minced meat, vegetables, baby food.
• Consume foods that soothe irritated mucosal walls of the gastrointestinal tract and reduce the risk of recurrence of the disease. These include milk and cream.
• Include in the drink decoctions that favorably affect the condition of the stomach. This effect has a drink from steamed rose hips in combination with honey.
• Eat often (5-6 times a day), but little by little. In order not to overdo it with a portion, make it a rule to use a small plate.
• Despite dietary requirements, the calorie content of meals should be high.
• Reduce your carbohydrate intake as much as possible, even high-fiber cereals. A large amount of energy is spent on the digestion of such food, and this is not necessary for a sick body at all.
• Avoid fried, fatty, pickled, smoked foods and products. Such nutrition is considered the worst enemy in diseases of the gastrointestinal tract. It is advisable to follow the diet menu after perforated ulcer surgery for a long time and put a ban on such products forever.

The formation of a through hole in the wall of the stomach is dangerous for human health and life. With timely surgery and further adherence to the diet, you can continue to enjoy life. We wish you to be healthy as long as possible!

By secret

Have you ever tried to lose excess weight? Judging by the fact that you are reading these lines, the victory was not on your side.

In case of peptic ulcer of the stomach and duodenum, perforation is a dangerous complication for human life and health. When the first symptoms appear, hospitalization and surgical care are necessary. During treatment in a hospital after surgical interventions on a perforated ulcer of the stomach and duodenum, diet therapy is indicated. Following the prescriptions of the attending physician on the menu in the postoperative period helps to reduce the rehabilitation period and the rapid normalization of digestive functions.

Symptoms of an exacerbation of an ulcer by perforation

Perforation in peptic ulcer is an acute condition in the destruction of the walls of the stomach and duodenum. Occurs in patients with a chronic course or in the acute stage, in 60% of those infected with Helicobacter pylori. A trial ulcer is diagnosed in 2-10% of patients.

Clinical picture:

• acute and sharp and epigastric mesogastric region;
• "board-shaped" hard stomach;
• pallor;
• dry mouth;
• frequent breathing;
• slow pulse.

Medical care for perforation

The patient spends the acute stage with a complication in the form of perforation in a hospital. If the operation is not performed on time, perforation is fraught with peritonitis and death. When the surgeon confirms the diagnosis, the patient is urgently prepared for surgical intervention.

There are three types of surgery:

• suturing;
• excision followed by pyloroplasty and vagotomy;
• laser cauterization;
• resection.

A separate item - laser cauterization is more often used as a preventive measure in case of a threat of perforation. In rare cases, a laser is used for perforation. After cauterization of a stomach ulcer, patients begin to fully eat earlier than after surgical procedures, but you can only eat what is shown on a therapeutic diet.

In the postoperative period, antiulcer drug therapy is carried out. After excision of a perforated gastric ulcer, a patient is shown a special diet according to the varieties of the zero and first table. In addition, doctors recommend undergoing a course of physiotherapy. After the operation, the patient must observe bed rest for at least the first two weeks, half-bed rest for another month.

Nutrition after perforated ulcer surgery

The first 24 hours after surgery shows absolute hunger. Nutrition with vitamins after gastric surgery to remove perforated areas is administered through a dropper. Unloading and sparing attitude to the digestive organs is the basis of recovery. The functions of the gastrointestinal tract are restored gradually, so they start with the lightest surgical diets with a low calorie content and a minimum salt content. Starting from the second day to the fourth, the patient is given tea with moderate temperature sugar and a rosehip broth. Drinks give one teaspoon every half hour. If the peristalsis has recovered, dietary nutrition is introduced in stages, gradually expanding the diet and introducing new products.

Diet after perforated gastric ulcer surgery is an important element in the complex of restoration and normalization of the gastrointestinal tract.

The rules of therapeutic diet therapy

The first two weeks after surgery on the stomach with a complication of an ulcer in the form of perforation is an especially important period, the diet is strictly adhered to, without overeating and not exceeding the norm of permitted foods. Excessive stress on the weakened digestive organs will cause a protracted recovery period. The damaged epithelium is weak at first, so the food should be neutral, non-aggressive, so that the mucous membranes begin to recover.

Products are selected according to the diet table number and their tolerance. The main principle is that they do not cause excessive release of hydrogen chloride, are easily digestible. The temperature regime for serving hot first and second courses is 50 degrees, cold - 30-40 degrees.

Food is consumed in small portions, in accordance with the number of the recommended dietary table, from six to eight times a day.

The diet after surgery for gastric ulcer complicated by perforation depends on the patient's well-being and the dietary table prescribed by the doctor.

The menu, depending on the number of the table, contains the following food and dishes:

• weak vegetable and meat (chicken, turkey, beef) broths;
• soups vegetable, meat, with the addition of butter or cream;
• wheat bread crackers;
• boiled, stewed, baked meat (turkey, chicken, veal) in the form of cutlets, soufflé, mashed potatoes, finely chopped cutlets;
• low-fat varieties of fish (pollock, hake) in a steamed, stewed form without skin;
• milk, cream are added to dishes during cooking;
• cottage cheese;
• kefir;
• yogurt;
• porridge is boiled to a mucus-like liquid consistency (semolina, oatmeal, rice, buckwheat);
• butter, olive, sunflower oils;
• coarse vegetables (potatoes, beets, carrots, broccoli, cauliflower) in steamed, boiled, baked form;
• green and black tea, loosely brewed;
• milk and fruit kissels;
• fruits in baked form, in compotes.

The diet after surgery and during any stage of gastric and duodenal ulcers should be made in accordance with this list of products.

Table No. 0 A

This diet therapy is prescribed on the fifth day after surgical manipulations on a perforated gastric ulcer, provided that the peristalsis has returned to normal. If the functions of the gastrointestinal tract have not recovered, continue the course of droppers. The duration of the diet of table No. 0 A after the operation of a perforated gastric and duodenal ulcer is from two to five days, depending on the patient's health. Doctors recommend bed rest, the exclusion of stressful situations.

Nutritional value of the dietary table:

• ten grams of proteins;
• fifteen grams of fat;
• no more than two hundred grams of carbohydrates.

Main Products of Table No. 0A:

• oatmeal, semolina, rice porridge boiled to a slimy form with the addition of cream;
• weak, not rich chicken or turkey broth;
• jelly from pears, pumpkins;
• rosehip decoction.

Sample menu for the period of Table No. 0A

In the first days of eating, it is important to follow the doctor's instructions and diet. If you eat forbidden foods, inflammation may develop, the walls of the gastrointestinal tract will be irritated, and complications are possible.

It is allowed to eat only liquid dishes in small portions from six to eight times a day, two hundred grams per meal. They are guided by an approximate menu after surgery for a perforated ulcer, but they look at the patient's well-being. If any of the products causes pain, bloating or discomfort, they are temporarily canceled.

Menu for the first day

For breakfast, oatmeal is boiled in water or with the addition of a teaspoon of cream. It is allowed to drink a decoction of wild rose. The porridge is boiled to a mucus-like liquid state, the cereal is ground before cooking.

For the second breakfast, a weak pear jelly is prepared. Wash down with weak sweet tea (half a glass).

Snack before dinner - dried fruit compote.

For lunch, they cook a weak broth on a chicken breast. Supplement with a decoction of wild rose (no more than half a glass).

For the second dinner, berry jelly is prepared.

For an afternoon snack, rice porridge is boiled to a liquid state (white rice is ground before cooking). Drink half a glass of sweet weak tea.

For dinner, a weak veal broth is prepared.

Second day diet

For the first breakfast, liquid semolina porridge is boiled without milk. As a drink - weak sweet tea.

For the second breakfast, veal broth is prepared. Wash down with half a glass of rosehip broth.

For a snack, cook liquid pumpkin jelly.

Before dinner, you can make a second snack with turkey fillet broth.

For lunch, pear jelly is prepared.

For the second dinner, a very liquid jelly is brewed. As a drink - sweet tea.

For an afternoon snack, they cook liquid dairy-free oatmeal porridge.

For dinner, a weak turkey breast broth is suitable.

third day

For breakfast, cook very thin dairy-free rice porridge. As a drink - dried fruit compote.

For the second meal, pear jelly is prepared.

Have a snack with chicken breast broth, drink weak sweet black tea.

Before lunch, they cook jelly-like oatmeal porridge on the water. From drinks - half a glass of rosehip broth.

For lunch, veal broth is cooked.

For an afternoon snack, liquid pumpkin jelly is suitable.

As a snack, drink rosehip compote.

For dinner, pear jelly is cooked.

Sample menu for the period of Table No. 0B

The nutritional value of the dietary table for fats and proteins is increased to fifty grams per day. It is allowed to enter salt up to four grams and carbohydrates no more than 300 grams. At this stage of diet therapy, when restoring the work of the stomach after surgery on an ulcer, you can eat mashed food, lean meats and fish, and eggs are introduced. The duration of diet therapy at the discretion of the doctor is from two to four days, depending on the patient's state of health. During the period of rehabilitation and recovery of mucous membranes after surgery with complications of stomach ulcers according to Table No. 0B, the serving size is not more than 250 grams. Milk is rarely included during this period due to the risk of bloating and flatulence.

Meal plan for the first day

For breakfast, a steam omelet is cooked without milk. The drink is dried fruit compote.

For a snack, a liquid dairy-free rice porridge is prepared.

Before dinner, pear jelly is boiled.

For lunch, boiled chicken breast is mashed to a puree state. Sweet tea for dessert.

For the second dinner, boil one soft-boiled egg. Drink - rosehip broth.

For an afternoon snack, milk-free liquid oatmeal is brewed.

For dinner, boiled pollock is ground to a puree state. From drinks - tea.

Second day menu

For breakfast, they cook semolina porridge without milk, pear compote.

For a snack, pear jelly is prepared.

For the second snack, you can boil one soft-boiled egg, drink sweet tea.

For lunch, turkey breast broth is boiled, which is then mashed. You can drink dried fruit compote.

For an afternoon snack, an omelet is prepared from one steamed egg.

For dinner, they cook jelly from apples.

Diet Table No. 0

At the next stage of dietary nutrition after surgery on a perforated stomach ulcer, the nutritional value of proteins is adjusted to one hundred grams per day, carbohydrates - up to three hundred grams, fats - up to seventy grams. Follow this table from two to four, depending on the patient's well-being.

First day menu

For breakfast, cottage cheese is rubbed with cream, and tea is used for drinks.

A baked apple is prepared for a snack, washed down with pear compote.

Before dinner, boil the cauliflower and rub it to a puree state.

For lunch - boiled chicken breast in a puree form. The drink is tea.

For an afternoon snack, a steam omelette is cooked, washed down with a fruit drink of berries.

For dinner, pollock is crushed with a side dish of pumpkin puree.

Diet of the second day

For the first breakfast, they cook oatmeal with cream. For dessert pear jelly.

Applesauce is prepared for a second breakfast, and tea is made from drinks.

For lunch, turkey breast cream soup is cooked, mashed potatoes are served as a side dish.

For an afternoon snack, yogurt with a baked apple.

For dinner, boiled veal is ground with vegetable puree.

Menu of the third day

For tomorrow, boil a soft-boiled egg. For dessert, pumpkin jelly is made.

For a snack - kefir and one white cracker.

For lunch, boil the chicken breast, rub it and mix it with boiled broccoli puree. Drink - rosehip broth.

For an afternoon snack, they grind cottage cheese with a baked apple.

For dinner, pollock is steamed with mashed potatoes. Drink - pear jelly.

Sample menu for the period of Table No. 1 B

Diet according to Table No. 1 B after surgery for a perforated gastric ulcer begins in a hospital and continues at home for two to four months. With good health and normal functioning of the digestive organs, the diet is changed to table number 1. All food at this stage is served pureed, steamed, stewed, baked.

First day menu

For breakfast, rice porridge is boiled in milk, washed down with rosehip juice.

For a second breakfast, they cook pear kissel, one white bread cracker.

For lunch, soup-puree is cooked from chicken breast, potatoes, carrots. For dessert, tea with honey.

For an afternoon snack, an apple is baked in the oven, a drink is a rosehip infusion.

For dinner, steamed cutlets are made from halibut, and milk jelly for dessert.

For the second dinner, a glass of kefir.

Second day menu

For the first morning meal, a steam omelet is prepared from two eggs and milk, for dessert - pear jelly.

For a snack, yogurt is mixed with a baked apple and a teaspoon of honey.

For a lunch meal, a turkey soufflé is prepared, boiled beetroot puree is served as a side dish, and half a glass of rosehip broth is served for dessert.

For the second snack, milk buckwheat porridge is cooked with one white cracker.

For an evening meal, a steamed veal cutlet is prepared, a side dish is stewed mashed carrots, a glass of tea.

Menu of the third day

For the first breakfast, they cook milk semolina porridge with butter, for dessert, dried fruit compote.

Second breakfast 1 baked apple and cottage cheese mashed with cream.

For lunch, turkey, carrot, and potato soup is cooked. Milk pudding for dessert.

For an afternoon snack, kefir and one white cracker, one soft-boiled egg are served.

For dinner, pollock is baked in the oven and served with steamed cauliflower. Morse.

For a snack before bed, you can have a glass of yogurt.

Diet table number 1

The diet at this stage of the patient's recovery after surgery is expanding, fruits, vegetables, and cheeses are added.

In the forbidden menu remains:

• seasonings;
• acute;
• fried or baked to a crust;
• any alcoholic drinks;
• sour fruits;
• marinades;
• sweet pastries;
• carbonated drinks;
• coarse vegetables (white cabbage, radish, onion, sorrel);
• smoked and canned;
• fatty;
• coarse cereals (barley, corn);
• coarse meat with fibers;
• ice cream;
• chocolate products;
• fried or hard boiled eggs.

List of dishes of the first day of the diet

For breakfast, they make a curd casserole with pears, sweet tea, a piece of mild cheese.

For a snack, fruit jelly is cooked from apples.

For lunch, chicken breast soup with potatoes and carrots, rosehip infusion and white cracker are allowed.

For an afternoon snack, a steam omelet with milk is prepared.

For dinner, steamed pollock cutlet, stewed zucchini.

Diet for the second day

Milk soup with noodles, dried fruit compote.

For a second breakfast, boil a soft-boiled egg, yogurt.

For lunch, buckwheat porridge, steamed turkey cutlet, tea.

For an afternoon snack, a glass of kefir with one cracker is suitable.

For dinner, cook milk soup from cereals, a baked apple.

After discharge from the hospital, the patient continues to adhere to the prescribed diet. If prohibited foods are not excluded, the organs of the gastrointestinal tract (gastrointestinal tract) after surgery on a perforated stomach ulcer will heal more slowly or an inflammatory process will begin. To prevent the recurrence of the disease, it is worth adhering to the correct healthy diet after recovery.

Marina asks:

How is rehabilitation after a stomach ulcer carried out?

Currently, rehabilitation after a stomach ulcer is carried out using the following methods:

• Physiotherapy;
• Acupuncture;
• Acupressure;
• Sanatorium-resort treatment with the use of mineral waters (balneotherapy);
• Mud treatment;
• Diet therapy;

The following exercises have an excellent rehabilitation effect:

• Rhythmic walking in place;
• Breathing exercises in a sitting position;
• Exercises for hands in a sitting position;
• Throwing and catching a sword in a standing position;
• Exercises on the hands in the supine position.

Acupressure is an impact on various biologically active points with your fingers. The principle of acupressure is the same as that of acupuncture. Massage of active points should be carried out daily. Moreover, it is better to find out the necessary points from an acupuncturist, and ask him to teach him how to massage them correctly.

Physiotherapy has a positive effect in rehabilitation after stomach ulcers. For rehabilitation, the following methods are used:

• Electricity;
• Ultrasound;
• Infrared, ultraviolet radiation;
• polarized light;
• Electrophoresis on the epigastric region with Novocaine, Platifillin, Zinc, Dalargin, Solcoseryl.

Mud treatment indicated during the period of attenuation of exacerbation of gastric ulcers. For treatment, silt mud is used at a temperature of 38-40 o C. The procedure is carried out at the beginning of 10 minutes, then extended to 20 minutes. The course of therapy consists of 10 - 12 procedures.

diet therapy based on the observance of table number 1. Food should be fractional (5 - 6 times a day) and in small portions. The diet must be based on lean meat and fish, from which cutlets, meatballs, soufflés, dumplings and steamed zrazy are prepared. Boiled sausages and sausages are also acceptable. In addition, the diet includes cottage cheese dishes (casseroles, soufflés, cheesecakes, lazy dumplings) and other dairy products. Soups should be vegetarian, slimy, with a dressing of boiled pureed vegetables and well-boiled cereals. Porridge should be semi-liquid. Eggs are allowed boiled soft-boiled or in the form of a steam omelette. Fruits and berries are used in the form of purees, kissels, mousses, jellies, compotes, jams, etc. You should eat yesterday's white flour bread. Dry biscuits, biscuit, savory buns are also allowed.

Mushrooms, broths, fatty meat and fish, poorly boiled lean meat, all fried, strong tea, coffee, carbonated water, spicy seasonings (mustard, horseradish, onion, garlic) and raw vegetables with coarse fiber (cabbage, turnip, radish, bell pepper, etc.). Also, you can not eat anything smoked, canned, spicy, fatty, soaked and pickled.

Phytotherapy helps to accelerate the onset of remission or prevent exacerbation of stomach ulcers. Cabbage and potato juice has an excellent effect. Cabbage juice is taken 1 glass 3 times a day, before meals. Potato juice is taken in half a glass 20 minutes before meals.

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