Gastric Ulcers: Diet, Symptoms, and Healing Insights

Gastrointestinal issues related to diet in the context of gastric ulcers?

Hello, Doctor.
I would like to ask you some questions:
1.
I underwent an upper gastrointestinal endoscopy two years ago, and prior to the procedure, I requested to self-pay for ulcer medication for over a month.
The endoscopy results showed scabbed lesions and mild gastritis.
Could you please clarify if the healed scar tissue indicates a non-cancerous ulcer?
2.
This year, due to excessive academic pressure, I experienced gastrointestinal discomfort (such as bloating, stomach pain, and involuntary pressure on my chest).
After undergoing an endoscopy, the doctor diagnosed me with a gastric ulcer, but the report from the examining physician translated to "multiple gastric erosions, antrum." What is the difference between multiple gastric erosions and ulcers? Are they equally serious?
3.
Up until now, I have been taking Taike gastric medication for about a month and a half, but due to heavy academic pressure, my condition fluctuates.
If I eat regularly but do not manage my emotions well, will this delay the healing of the ulcer? After completing this three-month course of medication, if I still occasionally experience bloating or pain, should I return to the hospital for a follow-up endoscopy to check if the ulcer has healed? Or should I consider seeing a psychiatrist to address issues related to autonomic nervous system tension?
4.
Controlling my diet has been quite challenging.
During my last treatment, I strictly adhered to the dietary principles found online (avoiding cold, fried, and sweet foods) and did not touch them at all.
However, after completing the three-month course of chronic medication, the feeling of bloating has not significantly improved.
This time, I have adopted a principle of eating everything but in small amounts (for example, only one pudding or one-third of a cup of mung bean soup).
Is this dietary principle appropriate? The online advice suggests avoiding irritating foods (like fried, cold, and sweet foods) completely during the treatment period.
Is it acceptable to occasionally consume a little, or will this delay the healing of the ulcer? Should I strictly adhere to the dietary principles found online? When it says to avoid strong tea, does that refer to types like tea rice tea? Can I drink some commercially available beverages like red tea, green tea, or bubble tea at room temperature? Can I have homemade pancakes without leavening agents for breakfast?
5.
Occasionally, after consuming some cold or glutinous rice products, I do not experience significant discomfort.
In fact, sometimes I feel more discomfort when I haven't eaten irritating foods, with noticeable bloating and stomach pain, but this tends to alleviate after one or two meals or a short nap.
Is this situation indicative of gastric spasms, or is it caused by the gastric ulcer (or erosions)? If this occurs frequently, could it be a sign of gastric cancer? I would appreciate it if you could take the time to answer my questions when you have the opportunity.
Thank you, Doctor.

Xiao Shi, 10~19 year old female. Ask Date: 2020/06/29

Dr. Chen Shidian reply Gastroenterology and Hepatology

Mild gastric mucosal erosion (commonly known as gastric abrasion) is not serious and can be improved with medication, and it is not related to gastric cancer.
It is advisable to avoid excessive spicy foods.
Your symptoms may be caused by high levels of stress, so it is recommended to work with a psychiatrist to manage your stress.

Reply Date: 2020/06/29

More Info

Understanding gastric ulcers and their management is crucial for anyone experiencing gastrointestinal discomfort. Based on your questions, let's delve into the details regarding gastric ulcers, their symptoms, dietary considerations, and healing processes.

1. Healing Scars and Non-Cancerous Ulcers: The presence of healing scars from previous ulcers generally indicates that the ulcer has healed. However, it is essential to note that not all healed ulcers are non-cancerous. The term "non-cancerous" typically refers to benign conditions, while ulcers can be benign or malignant. A thorough evaluation by a gastroenterologist is necessary to confirm the nature of any gastric lesions.

2. Difference Between Gastric Erosions and Ulcers: Gastric erosions and ulcers are related but distinct conditions. Erosions are superficial lesions that affect only the mucosal layer of the stomach lining, while ulcers penetrate deeper into the stomach wall. Multiple gastric erosions can indicate a more extensive inflammatory process but are generally considered less severe than ulcers, which can lead to complications such as bleeding or perforation if left untreated.

3. Impact of Stress on Healing: Stress can significantly affect gastrointestinal health. While adhering to medication schedules is vital, emotional and psychological stress can impede healing. The symptoms you describe, such as gastric discomfort and pressure in the chest, may be exacerbated by stress. It is advisable to incorporate stress management techniques, such as mindfulness, relaxation exercises, or counseling, to support your overall treatment plan. If symptoms persist after completing your medication regimen, a follow-up endoscopy may be warranted to assess healing.

4. Dietary Management: Dietary restrictions can be challenging, but they play a crucial role in managing gastric ulcers. While it is essential to avoid irritants like spicy, fried, or excessively sweet foods, occasional indulgence in small amounts may not significantly hinder healing. The key is moderation. For instance, consuming a small portion of pudding or a limited amount of sweet drinks occasionally may be acceptable, but it is best to avoid them regularly. Regarding tea, it is advisable to limit strong teas and caffeinated beverages, as they can irritate the stomach lining. Homemade pancakes without leavening agents are generally safe, but always listen to your body’s responses.

5. Symptoms and Gastric Spasms: The symptoms you describe, such as intermittent gastric discomfort and bloating, could be attributed to gastric spasms or the underlying ulcer condition. If these symptoms are recurrent, it is crucial to monitor them closely. While gastric ulcers can cause discomfort, persistent symptoms should not be dismissed as they may warrant further investigation to rule out more serious conditions, including gastric cancer. Regular follow-ups with your healthcare provider are essential for monitoring your condition.

In conclusion, managing gastric ulcers involves a multifaceted approach that includes medication adherence, dietary modifications, and stress management. Regular consultations with your healthcare provider are vital for monitoring your condition and making necessary adjustments to your treatment plan. If you experience any alarming symptoms, such as severe pain, vomiting blood, or significant weight loss, seek medical attention promptly. Remember, your health is paramount, and proactive management can lead to better outcomes.

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