What dietary recommendations are suitable for a patient with a gastric (peptic) ulcer?

From the Guidelines

For stomach ulcers, it is crucial to focus on eating a diet that's gentle on your stomach while avoiding foods that increase stomach acid or irritate the ulcer, as this approach can significantly reduce morbidity, mortality, and improve quality of life. When considering the best dietary approach for managing stomach ulcers, it's essential to prioritize foods that are bland, non-spicy, and easy to digest. Examples of recommended foods include oatmeal, bananas, apples, lean proteins like chicken and fish, yogurt, honey, and green vegetables.

Key Dietary Recommendations

• Eat smaller, more frequent meals rather than large ones to reduce stomach acid production, as suggested by 1.
• Avoid irritants such as alcohol, coffee, black tea, acidic foods (citrus, tomatoes), spicy foods, chocolate, and fatty or fried foods, which can exacerbate symptoms and hinder the healing process.
• Drinking plenty of water helps dilute stomach acid and is beneficial for overall health. While managing your diet, it's also important to take prescribed medications as directed by your doctor. If your ulcer is caused by H. pylori bacteria, you'll need antibiotics like amoxicillin and clarithromycin combined with acid reducers for 10-14 days, as discussed in 1.

Importance of H. pylori Eradication

• The eradication of H. pylori infection is crucial for preventing ulcer recurrences and reducing the risk of gastric cancer, as highlighted in 1.
• Recent studies, such as 1, emphasize the importance of diagnosing and treating H. pylori infection to prevent long-term complications. By following these dietary recommendations and adhering to prescribed treatment plans, individuals with stomach ulcers can effectively manage their condition, reduce symptoms, and improve their overall quality of life.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Diet Recommendations for Stomach Ulcer

• The available evidence does not support the need to place peptic ulcer disease patients on restrictive diets 2
• The major goal of diet is to avoid extreme elevations of gastric acid secretion and the direct irritation of gastric mucosa 2
• Only slight modifications in the patient's usual diet are recommended 2
• Frequent milk ingestion is not encouraged due to its transient buffering effect and significant gastric acid secretion effect 2
• Spices, such as black pepper, red pepper, and chili powder, may produce dyspepsia, but some studies suggest that daily pepper ingestion may have a beneficial adaptive cytoprotective response 2
• Patients should avoid any spice that causes discomfort, especially during exacerbation of peptic disease 2

Foods to Avoid

• Alcohol, especially concentrated forms, should be avoided 2
• Coffee should be avoided due to its strong acid secretagogue property 2
• Decaffeinated coffee and all caffeine-containing beverages should be restricted 2
• Citric acid juices may induce reflux and cause discomfort in selective patients 2
• Stomach distention with large quantities of food should be discouraged 2

Treatment and Management

• Acid blockers, such as omeprazole, can heal peptic ulcers in approximately 80% to 100% of patients within 4 weeks 3
• Eradication of H pylori decreases peptic ulcer recurrence rates from approximately 50% to 60% to 0% to 2% 3
• Discontinuing NSAIDs heals 95% of ulcers identified on endoscopy and reduces recurrence from 40% to 9% 3
• Lansoprazole and omeprazole are effective in the treatment of duodenal ulcers, gastric ulcers, peptic ulcer disease involving Helicobacter pylori infection, and other acid peptic disorders 4, 5, 6