Manual of Clinical Nutrition

Manual of Clinical Nutrition Management III- 103 Copyright © 2013 Compass Group, Inc.

PEPTIC ULCER
Discussion
Peptic ulcer disease includes esophageal, gastric and duodenual ulcers. Research identifies the Helicobacter
(H.) pylori bacteria as the primary cause in 95% of gastric and duodenal ulcers (1- 3 ). The remaining 5% is
caused by non-steroidal anti-inflammatory medication usage (eg, aspirin and ibuprofen) and excessive
production of stomach acid. The treatment for individuals infected with the H. pylori bacteria includes
healing the ulcer with acid suppressing medication and curing the infection by using antibiotics ( 3 - 6 ).

There is no evidence that food, beverages, or spices cause or reactivate ulcers (3,4).

Table III-27: Medical Approaches for Peptic Ulcer Disease
Medical Approaches Rationale
Avoid foods not tolerated.
(See Section ID: “Gastrointestional Soft Diet”)

Eliminate foods that cause pain or discomfort to the

patient during the acute phases

Antisecretory medication (histamine H 2 antagonist

blocker)

Cimetidine (Tagamet), Ranitidine (Zantac)

Famotidine (Pepcid), Nizatidine (Axid)

Reduces gastric acid and pepsin secretion

Antibiotics Inhibits growth and destroys microorganisms, ie, H.

pylori bacteria

Antacids Buffers acidity

Sucralfate (carafate) Forms protective coating over ulcer

References

1. National Institutes of Health Consensus Statement. Helicobacter Pylori in Peptic Ulcer Disease. Bethesda, Md: NIH Office of Medical
   Applications of Research. 1994;12(1):1-15.


2. Marshall B, Warren J. Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. Lancet.
   1984;1:1311-1315.


3. A breakthrough in ulcer treatment. Tufts University Diet and Nutrition Letter. 1996;13(11):4-6.


4. Rubin, R, Cascade, E, Peura D, et al. Diagnosis and eradication of helicobacter pylori in the management of peptic ulcer disease: a
   decision analysis model. Am J Man Care. 1996; 2(4):375-383.


5. Rubin R, Cascade E, Barker R, et al. Management of dyspepsia: a decision analysis model. Am J Man Care. 1996;2(6):145-153.


6. Sung J, Chung S, Ling T, et al. Antibacterial treatment of gastric ulcers associated with helicobacter pylori. N Engl J Med.
   1995;332:139-142.