Tuesday, 26 November 2013

Duodenal ulcers: The do and do not’s list

Duodenal ulcers, a type of peptic ulcer is defined as a condition of a localized tissue erosion in the lining  the duodenum as a result of bacteria Helicobacter pylori (H pylori) in most cases. According to the study by Department of Research, University Hospital, Basel, fasting gastrin and pepsinogen-I and -II concentrations were significantly higher in H pylori positive compared with H pylori negative subjects. Neither age nor sex affected basal gastrin and pepsinogen concentrations in H pylori negative subjects. Fasting gastrin, pepsinogen-I and -II concentrations in serum samples were similar in H pylori positive persons with no symptoms and those with duodenal ulcers suggesting that similar mechanisms are involved in increasing plasma concentrations of these variables in both populations. Hypergastrinaemia and hyperpepsinogenaemia are therefore probably secondary to active H pylori.
D. Preventions
D.1. The do and do not’s list
1. Dietary phytosterols and phospholipids
Experiments using animal peptic ulcer models showed that the lipid fraction in foods from the staple diets of low prevalence areas gave protection against both gastric and duodenal ulceration, including ulceration due to non-steroidal anti-inflammatory drugs (NSAIDs), and also promoted healing of ulceration. The protective activity was found to lie in the phospholipid, sterol and sterol ester fractions of the lipid. Amongst individual phospholipids present in the phospholipid fraction, phosphatidyl ethanolamine (cephalin) and phosphatidyl choline (Lecithin) predominated. The sterol fraction showing activity contained β-sitosterol, stigmasterol and an unidentified isomer of β-sitosterol. The evidence shows that dietary phytosterols and phospholipids, both individually and in combination, have a protective effect on gastroduodenal mucosa. These findings may prove to be important in the prevention and management of duodenal and gastric ulceration including ulceration due to NSAIDs(16).
2. Reduce stress
In t5he study to investigate Peptic ulcers after the Great East Japan earthquake and tsunami: possible existence of psychosocial stress ulcers in humans, showed that the incidence of all types of peptic ulcers was 1.5-fold increased after the earthquake, and in particular, the incidence of hemorrhagic ulcers was 2.2-fold increased; the gastric ulcer/duodenal ulcer ratio in hemorrhagic ulcers was also significantly increased (p < 0.05). Regarding the etiology of the peptic ulcers, the proportion of non-H. pylori and non-NSAID ulcers was significantly increased, from 13 % in 2010 to 24 % in 2011 after the earthquake (p < 0.05)(17).
3. Quit smoking and reduced intake of alcohol
As cigarette smoking and excessive alcohol drinking can cause damage to the stomach lining of that can lead peptic ulcer.
4.  Others, According to the article of Good Foods / Bad Foods For Peptic Ulcers By Sharon Gillson, she suggested the below
  • Restrict or avoid those foods that may cause irritation to the digestive system
  • Reduce excessive acid production
  • Prevent unpleasant side effects, such as heartburn.
  • Eat 5 to 6 small meals a day instead of 3 larger meals. It is important that you avoid overeating. Frequent, smaller meals will be more comfortable and easier on the stomach than two or three large meals a day.
  • Eat a diet rich in fiber, especially from fruits and vegetables
  • Rest and relax a few minutes before and after each meal, as well as remaining relaxed during meals.
  • Eat slowly and chew you food well
  • Avoid eating within 3 hours before bedtime
  • Eat foods that are low fat
  • Avoid foods that are fried
  • Avoid foods that are spicy
  • Cut down on the following foods:
    • Coffee
    • Decaffeinated coffee
    • Tea
    • Cola drinks
    • Carbonated beverages
    • Citrus fruits
    • Tomato-based products
    • Chocolate(17)

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(1) http://www.ncbi.nlm.nih.gov/pubmed/8314506
(16) http://www.ncbi.nlm.nih.gov/pubmed/23097339
(17) http://www.ncbi.nlm.nih.gov/pubmed/23053423
(18) http://heartburn.about.com/od/pepticulcers/a/ulcer_diet.htm 

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