Nutrition For Exacerbation Of Gastritis: General Recommendations And An Example Of A Diet

Gastritis is an inflammation of the gastric mucosa, accompanied by a violation of secretion and motility, and often also by atrophy and further replacement of epithelial cells with connective tissue. One of the main signs characteristic of this pathology is dyspepsia - a feeling of heaviness, a literal overflow of the stomach after eating.

This disease requires not only timely diagnosis and treatment, but also compliance with fairly strict nutritional rules aimed at healing the mucosa and, if necessary, increasing the acidity of gastric juice. In this article, we will give general recommendations regarding the diet and some dietary supplements that contribute to a speedy recovery and relief of the course.

Types of gastritis

There is a so-called Correa cascade - the sequence of development of a stomach tumor, the initial stage of which is chronic gastritis. In other words, only endoscopic manipulation and further determination of the pathology stage will allow starting treatment with nutritional correction.

normal gastric mucosa

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Chronic active gastritis

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Atrophic gastritis is a chronic disease characterized by a decrease in the number of those stomach cells that are responsible for the production of hydrochloric acid and proteolytic (cleaving bonds in protein components) enzymes.

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Metaplasia is the formation of local areas similar in structure to the mucous membrane of the small or large intestine.

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Dysplasia - manifested by excessive division of mucosal cells, as well as their atypia.

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Stomach cancer

Causes of damage to the gastric mucosa

1. Autoimmune gastritis - the formation of antibodies against their own body structures - in this case, parietal cells of the gastric mucosa that produce hydrochloric acid, which leads to their atrophy. Such abnormal activity on the part of the immune system, which is normally obliged to clearly distinguish between “self” and “alien”, is considered to have a certain genetic predisposition: this is confirmed by statistics regarding family cases of the disease.

   It is also important to emphasize that, as a rule, autoimmune pathologies are combined with each other: in particular, a similar disease of the gastrointestinal tract is a common occurrence for patients with type 1 diabetes: it occurs 5 times more often in them than among healthy groups. population.

   In addition to an increased risk of developing both benign and malignant tumors of the stomach, autoimmune gastritis causes hypovitaminosis B12: in conditions of reduced acidity, which occurs due to a decrease in the number of functioning cells, the production of the internal factor of Castle by the mucous membrane, a specific protein that binds cobalamin and provides its absorption in the small intestine. Pernicious anemia develops, accompanied by the formation of large immature erythrocyte precursors and a shortening of their life - the time of circulation in the systemic circulation.

    

2. Infection with pathogenic strains of H. pylori - the infection occurs in the pyloric (output section) of the organ, and then spreads to other parts. Such dissemination leads to the development of inflammation, followed by the formation of ulcers and erosions.

   Infection, as a rule, is observed in childhood (usually intrafamilial transmission - when using common household items) and does not always require medical intervention: only aggressive strains of bacteria are subject to antibiotic treatment in order to destroy the pathogen.

    

   In general, the diagnosis of Helicobacter pylori infection is:

   • Carrying out breath tests with urea.

   • Taking a biopsy during FGDS.

   • Determination of antigens to Helicobacter in feces (while taking antibiotics or proton pump inhibitors to reduce stomach acidity, the results will be distorted).

   • Determination of IgM and IgG - signs of past and acute infections, respectively.

    

3. Reverse reflux of bile - occurs when the corresponding sphincter muscle is weak, limiting two different environments: alkaline in the duodenum and acidic in the stomach.

4. Abuse of alcohol and non-steroidal anti-inflammatory drugs (NSAIDs) - the latter is associated with the blocking of a specific enzyme (cyclooxygenase) by this group of pharmaceuticals, which is responsible for the formation of protective prostaglandin molecules that regulate the production of protective mucus. In addition, these drugs also have a direct toxic effect on the epithelial lining of the stomach even before entering the systemic circulation.

5. Estrogen deficiency, physiologically occurring in menopause, is associated with an increased risk of developing atherosclerosis (one of the forms of these sex hormones, estrone, exhibits a pronounced anti-atherogenic effect), leading to a deterioration in blood supply processes.

   Experiments on animals were also interesting. For example, it has been shown that the mitochondria, the small energy-producing power plants where organic substrates are sent as firewood, in female rats have been shown to oxidize cholesterol to a much greater extent than those obtained from male hepatocytes.

   Study: Autoimmune markers of gastrointestinal disease in patients with type 1 diabetes

    

6. Violation of methylation processes that ensure the inactivation of histamine - an inflammatory mediator and a stimulator of hydrochloric acid secretion. This can be observed both with deficiencies of vitamins B6, B9 and B12, and with mutations in the main genes that regulate this process: MTHFR, MTRR, MTR.

   In laboratory tests, we recommend paying attention to the following indicators:

   • Serum homocysteine ​​concentration.

   • The average volume of erythrocytes in the general blood test (increased with a deficiency of B6, B9, B12).

   • Organic acids in urine: methylmalonic and forminoglutamic acid.

    

7. Exposure to stress factors - leads to the secretion of cortisol - a hormone produced by the adrenal cortex, and promotes vasospasm, which leads to a decrease in blood supply to the gastric mucosa.

Signs of gastritis

Although the final diagnosis is made on the basis of a biopsy, the signs of gastric pathology will also be important, or rather their timely recognition, which largely determines the severity of the course and further treatment tactics.

The clinical picture is quite specific and in most cases is characterized by:

1. Pain (often cutting) in the left hypochondrium - especially after eating.

2. Manifestations of low acidity:

   • swelling;

   • gas formation;

   • indigestion - especially proteins;

   • parasitic infestations due to a decrease in the release of hydrochloric acid with antimicrobial properties.

    

3. Signs that accompany a decrease in gastric motility (which is stimulated by hydrochloric acid):

   • belching;

   • nausea;

   • a feeling of fullness in the stomach;

   • rapid onset of saturation;

   • decrease in appetite.

    

4. Vitamin and mineral deficiencies:

   • folic acid;

   • vitamin B12;

   • gland.

    

Nutrition for gastritis

It is necessary to chew and grind the incoming components with your teeth: this will not only facilitate the grinding of food by the muscular layer of the stomach, but also contribute to the initial stage of enzymatic breakdown of carbohydrate molecules by saliva amylase and maltase.

In addition, it is necessary to minimize or completely eliminate products containing lectins associated with increased permeability from the walls of the gastrointestinal tract. So, for example, gluten contained in wheat and a number of related grain crops, even in the absence of such an autoimmune and genetically mediated disease as celiac disease, can cause direct damage to the epithelial lining of the intestine, disrupting the density of intercellular connections and stimulating the restructuring of their supporting framework in the form of protein structures. By inhibiting the formation of RNA and DNA, gluten inhibits the growth of enterocytes, and also enhances their apoptosis (programmed cell death) and free radical damage as a result of activation of oxidative stress.

Such mechanisms, leading to disruption of absorption processes on the intestinal villi, create ideal conditions for the reproduction of bacteria and fungi - SIBO and SIGR develop (syndrome of excessive bacterial and, accordingly, fungal growth). This manifests itself in the form of bloating; diarrhea; gas formation, as well as an increase in intra-intestinal pressure, which, in turn, inhibits the release of pancreatic enzymes and bile, thereby creating a vicious circle.

Interestingly, about 60% of patients suffering from non-celiac gluten sensitivity (relative to a new pathology that is neither an autoimmune nor an allergic disease) complain of heaviness, a feeling of fullness in the stomach and rapid satiety - this allows us to draw appropriate conclusions about the effect of gluten and on motor skills. stomach, or rather on its reduction.

You should also carefully use, and it is better to completely limit foods that irritate the already injured gastric mucosa, in particular, this applies to food components containing sulfur:

• garlic;

• onion;

• turnip;

• horseradish;

• mustard.

It is necessary to exclude alcoholic beverages, as well as give preference to baked rather than raw vegetables and fruits. Considering that a decrease in stomach acidity creates ideal conditions for the active reproduction of pathogenic microflora, one should also refuse (at least for the duration of treatment) the use of refined sugars, sugary drinks and other sources of empty calories.

List of foods to limit

• Confectionery: candy, marshmallows, chocolate, and other sources of refined sugar.

• Packaged juices.

• Ready sauces.

• Canned food and semi-finished products.

• Fast food.

• Alcoholic drinks.

• Nuts and seeds - especially in unsoaked form.

• Hot spices.

• Raw vegetables and fruits.

• Baking and pastry.

• Products containing “hidden” gluten: yoghurts, sweets, canned food.

• Smoothies and fresh juices.

• Fatty varieties of fish and meat.

• Pickles.

• Ginger.

• Sour berries.

• Strong coffee.

• Sausages.

• Dried and salted fish.

• Legumes.

• Onion and garlic.

• Smoked products.

Featured Products List

1. Baked or mashed vegetables:

   • sweet potato;

   • carrot;

   • potato;

   • zucchini;

   • cauliflower;

   • broccoli.

    

2. Lean meats and fish.

3. Baked fruits:

   • apples;

   • pears.

    

4. Bananas in moderation.

5. Dairy products.

6. Eggs.

7. Long cooking cereals:

   • buckwheat;

   • quinoa;

   • Brown rice;

   • oatmeal (gluten free).

    

8. Low-fat broths and vegetable soups.

9. Compotes and jellies from unsweetened fruits without added sugar (it is better to make it yourself using agar).

General recommendations for chronic gastritis

1. Elimination of stress factors - we have previously written about the adverse effects of cortisol on the blood supply to the gastric mucosa.

2. Increased vagal tone: the parasympathetic system is responsible for rest, recovery and digestion - it helps to increase the motility of the gastrointestinal tract, increases the secretion of enzymes and digestive juices in general. Its activation is facilitated by:

   • yoga and Pilates;

   • breathing practices;

   • relaxing massages;

   • warm baths - especially in tandem with magnesium salts.

1. Eight-hour sleep and compliance with circadian biorhythms. Evening and night is not only the kingdom of the vagus, but also the time of increased production of melatonin by the pineal gland - a powerful antioxidant, a hormone of youth and a direct antagonist of cortisol.

2. Working with the folate cycle - when detecting breakdowns in one of the three genes that regulate methylation reactions (MTHFR, MTR, MTRR), high-quality support is needed in the form of active forms of vitamins involved in this process, as well as donors of methyl groups:

   • Vitamin B9 as methylfolate.

   • B12 in sublingual form.

   • S-adenosylmethionine.

   • Betaine (in the absence of damage from the gastric mucosa)

      

    

3. Taking antioxidants to relieve oxidative stress and reduce the oxidation of cell membrane phospholipids:

   • Vitamin E.

   • Vitamin A.

   • Vitamin C.

   • Selenium.

      

    

Dietary supplements for the treatment of gastritis

1. Preparations containing fatty acids (in particular, gamma-linolenic, eicosapentaenoic and arachidonic), from which prostaglandin E1 is formed, which increases the division of mucosal epithelial cells, enhances the secretion of protective mucus, and also improves blood circulation:

   • Evening primrose oil.

   • Borage oil.

   • Eicosapentaenoic acid (EPA) is an omega-3 polyunsaturated fatty acid.

    

2. Reducing the level of cortisol, and, consequently, improving blood supply contribute to:

   • dried basil;

   • motherwort;

   • rhodiola rosea.

    

1. Normalization of gastric motility - an increase in the stimulation of acetylcholine - one of the main mediators of the parasympathetic nervous system:

   • Lecithin.

   • Black cumin.

   • Fennel.

   • Rosemary.

    

2. Treatment of H.pylori (for dissemination):

   • Black cumin oil.

   • Grapefruit seed extract.

   • Oregano.

   • Colloidal silver.

   • N-acetylcysteine.

      

    

3. Work with hypochlorhydria - only after the healing of the gastric mucosa:

   • trimethylglycine;

   • iodine and chlorine.

    

An example of a diet for gastritis

The diet is scheduled for 3 meals a day, the most physiological for most groups of the population, but suitable, provided there is no exacerbation of the disease from the gastrointestinal tract. Otherwise, the frequency of doses is determined by the doctor or nutritionist on an individual basis.

Then, as a rule, fractional meals are prescribed, however, in order to develop minimal complications from carbohydrate metabolism, we recommend using foods with low insulin and glycemic indices as snacks between main meals. So, for example, baked or steamed vegetables are perfect.