Diet for ulcers is now quite liberal

DEAR DR. DONOHUE: I have some ulcer questions. Mine is most likely from overuse of NSAIDs. How long does it take for an ulcer to heal? If certain foods bother me now, will they always? If I eat or drink something that causes symptoms, does it make the ulcer worse? I took acid reducers for the first two months, but I am trying to do without them now. I don’t think it’s healthy to take them for a long time. Does taking those medicines speed ulcer healing, or just relieve symptoms? I’d like to eat more protein, but I know protein increases acid production, so I’m sure that isn’t a good idea. — E.G.


ANSWER:
An ulcer is an open sore. In the digestive tract, ulcers (peptic ulcers) are found most often in the stomach (gastric ulcer) or the duodenum (duodenal ulcer). The duodenum is the first part of the small intestine and is attached to the stomach. Duodenal ulcers are the more-common ulcers.

Stomach acid, along with the H. pylori bacterium, is the cause of most ulcers. The other big ulcer cause is NSAIDs, nonsteroidal anti-inflammatory drugs aspirin, Motrin, Advil, Aleve, Voltaren, Indocin and many others. Ulcers can result when NSAIDs are used for prolonged periods and in high doses. NSAIDs destroy the protective barrier that keeps acid away from the stomach and duodenal linings.

The pain of an ulcer is felt in the upper, middle part of the abdomen. People describe it as gnawing or burning. It gets worse at night and wakens people from sleep.

For someone like you, whose ulcer was caused by NSAIDs, it is important to determine if you also carry the H. pylori bacterium. If you do, then treatment involves stopping acid production and taking antibiotics for the bacterium. If the bacterium isn’t eradicated, ulcers tend to come back. People who have ulcers that are not NSAID-caused take three drugs to effect acid reduction and H. pylori elimination. The medicines speed healing.

Duodenal ulcers heal in eight weeks; stomach ulcers, in 12 weeks. You should avoid foods that irritate your stomach, both now and forever. You can try them once healing has taken place, but eliminate them if they hurt you. The days of strict ulcer diets are gone. You can eat anything that doesn’t upset your stomach. Protein is not banned.

DEAR DR. DONOHUE: I take one of my three daily calcium tablets in the morning with coffee. A friend tells me that coffee interferes with calcium absorption. Does it? — K.P.


ANSWER:
Coffee doesn’t diminish calcium absorption. You can take your tablet before you drink coffee, while you drink it or after you drink it.

DEAR DR. DONOHUE: Is it true that not eating after 6 p.m. takes weight off you? I would like to believe this. If it is true, does it mean you can eat whatever you want in the amounts you want during the day? And is it bad to lie down right after eating? If so, why?  — R.B.


ANSWER:
The only way to lose weight is to eat fewer calories. It doesn’t matter when you eat them. I’ve heard the same advice of no eating after 6 p.m. for weight loss; it doesn’t work.

Lying down after a meal sets a person up for heartburn. Staying upright for at least half an hour keeps food in the stomach. Half an hour isn’t long enough for some people. It takes up to four hours for all food to leave the stomach.

TO READERS: Questions about varicose veins and their treatment are discussed in the booklet on that topic. Readers can obtain a copy by writing: Dr. Donohue No. 108, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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