Dear Sue:

If I have an ulcer, what types of food should I avoid? Which ones should I eat? Thanks,
Sally

Dear Sally:

Throw away old-fashioned notions about what's good or bad for ulcers. Recent studies are coming up with surprising findings. It used to be that spices were a no-no and milk was recommended. But research indicates that milk may even make ulcers worse, and chili cannot cause you to develop ulcers.

Did you know there are different types of ulcers? The most common are duodenal ulcers, which form in the small intestine next to the stomach. Less common are the true stomach ulcers, also know as gastric ulcers.

The notion that ulcers are caused by stress or diet is gone. Replacing it is the fact that a type of bacteria called Helicobacter pylori is the most common culprit. It is thought that these bacteria somehow alter the tissue lining of the digestive tract, making it more likely that, in some people, an ulcer will develop. Although we all carry those bacteria around with us in our gut, only a few of us will get ulcers. It may be genetically predetermined.

Ulcers can also be caused by certain drugs; they are common among heavy users of aspirin and ibuprofen.

Ulcer treatment may consist of taking the drug Tagament, which will help reduce stomach acid, along with an antibiotic such as tetracycline or amoxicillin to eliminate the bacteria.

Since it seems to be bacteria and not diet that cause ulcers, a bland diet seems unnecessary. In fact, there was never really any evidence that a bland diet ever cured an ulcer, merely that it helped reduce the symptoms. Therefore, foods that you can tolerate and that make you feel the best are the ones that you should eat. By all means, eliminate the spicy salsa dip and fatty chips if they make you feel worse, but if they don't then there is no medical reason to. (Some foods may irritate the GI tract, black pepper and chili being two common ones, so you may wish to avoid those.)

The bottom line
Foods will not cause nor cure ulcers, but they may delay healing or contribute to ulcer discomfort. To help reduce the unpleasant symptoms and reduce further irritation to the stomach or intestinal lining:

1. Eat spices in moderation.
2. Stop taking aspirin or other non-steroidal, anti-inflammatory medications.
3. Stop smoking. Smoking can delay healing.
4. Eat regular, well-spaced meals and eliminate snacking to reduce the number of times stomach acid is produced, and don't eat just before bedtime to reduce nighttime secretion of stomach acid.
5. Eliminate coffee and alcohol.
6. Curb milk drinking, since milk stimulates acid secretion.

With the use of antibiotics and acid-reducing drugs, and by following the dietary advice, an ulcer can be cured in as little as two weeks.

Best wishes for a speedy recovery.

Sincerely,
Sue Gilbert, M.S., nutritionist

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