1. Gastro-esophageal reflux disease (GERD) in old age.
2. The incidence of gastric and duodenal ulcers and their bleeding complications is increasing in old-aged populations worldwide.
3. H. pylori infection in elderly patients with H. pylori-associated peptic ulcer disease and severe chronic gastritis
4. Almost 40% of GU and 25% of DU in the elderly patients are associated with the use of NSAID(1) and/or aspirin(2).(a)
II. Gastric ulcers
Gastric ulcer, a type of peptic ulcer is defined as a condition of a localized tissue erosion in the lining the stomach.
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(21).
2. Reduce intake of NSAID
As NSAID has been proven to cause gastric Ulcer(9), by by inhibiting the body’s production of prostaglandins, hormones that protect the stomach lining.
Cigarette smoking increases xanthine oxidase activity, leukotrienes, and nitric oxide production and also neutrophil infiltration in the gastric mucosa(13).
4. Don’t miss your dental appoinment
Study showed that a significantly higher proportion of subjects with peptic ulcer reported that they lost five or more teeth (35.3 vs. 17.4%, p<0.001) or that they were told they had periodontitis (33.5 vs. 20.7%, p<0.001)(8).
5. 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)(22).
6. Excessive hard liquor drinking can damage the lining of stomach and worsen ulcers and aggravate pain.
7. 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:
- Decaffeinated coffee
- Cola drinks
- Carbonated beverages
- Citrus fruits
- Tomato-based products
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