Duodenal Ulcers: Medication and Dietary Concerns - Gastroenterology and Hepatology

Q: Duodenal Ulcers: Medication and Dietary Concerns

Hello： (1) Both are proton pump inhibitors and belong to the same class of medications. <br>(2) During the acute phase of duodenal ulcers, it is advised to avoid tea, coffee, spicy, fatty, and fried foods, as well as smoking and betel nut, as they can stimulate gastric acid secre

Duodenal ulcer

Hello Doctor: Last month, I was diagnosed with a duodenal ulcer.
I have two questions I would like to ask you.

1.
I was previously taking "Nexium," but during the treatment, I experienced soreness in my right thigh, so after my recent follow-up, I asked the doctor to change my medication to "Pantoprazole." Can you tell me if the therapeutic effect of "Pantoprazole" will be inferior to that of "Nexium"?
2.
The doctor advised me to avoid irritants, as well as tea and coffee.
However, I found more information online suggesting that there are many other foods I should avoid, but there are so many things I want to eat! Could you please advise me if I can drink milk? Is it true that I should completely avoid tea (like bubble tea)? And can I eat fried foods (like stinky tofu)?

Weilian, 30~39 year old female. Ask Date: 2012/07/24

Dr. Cai Anshun reply Gastroenterology and Hepatology

Hello: (1) Both are proton pump inhibitors and belong to the same class of medications.
(2) During the acute phase of duodenal ulcers, it is advised to avoid tea, coffee, spicy, fatty, and fried foods, as well as smoking and betel nut, as they can stimulate gastric acid secretion and directly irritate the ulcer, hindering healing.
After treatment stabilizes, approximately one month later, these foods that may cause ulcers are not prohibited for life.
However, the principle is to consume them in small amounts, moderately, without overindulgence, and not to eat them frequently.
What constitutes a moderate amount can vary for each individual.
Milk is acceptable, and tea can be diluted with less sugar.
Changhua Hospital cares about your health.
Dr.
Tsai An-shun.

Reply Date: 2012/07/24

More Info

Duodenal ulcers, also known as peptic ulcers, are sores that develop on the lining of the duodenum, which is the first part of the small intestine. They can cause significant discomfort and require careful management, including medication and dietary adjustments. Based on your questions, let's delve into the medication options and dietary concerns associated with duodenal ulcers.

1. Medication Comparison: "耐適恩" (Nexium) vs. "盼胃優" (Pantoprazole)
"耐適恩" (Nexium) is a proton pump inhibitor (PPI) that works by reducing the amount of acid produced in the stomach, thereby promoting healing of the ulcer and alleviating symptoms. On the other hand, "盼胃優" (Pantoprazole) is also a PPI and functions similarly to Nexium. Both medications are effective in treating duodenal ulcers, but individual responses can vary. If you experienced thigh pain while taking Nexium, it’s essential to communicate this to your healthcare provider, as it may indicate a side effect or an unrelated issue. Pantoprazole may or may not cause the same side effects, but it is generally well-tolerated. The effectiveness of Pantoprazole compared to Nexium should be similar, but your comfort and any side effects should guide your treatment choice.

2. Dietary Concerns: What to Avoid and What to Include
Managing your diet is crucial when dealing with duodenal ulcers. The general advice is to avoid foods and beverages that can irritate the stomach lining or increase acid production. Here are some dietary considerations:
- Avoid Irritating Foods: Spicy foods, acidic foods (like citrus), and fried foods can exacerbate ulcer symptoms. This includes items like fried tofu, which may be problematic due to its high-fat content and potential for causing discomfort.

- Caffeine and Tea: Caffeinated beverages, including coffee and certain teas, can stimulate acid production and should generally be avoided. This includes bubble tea, which often contains high levels of sugar and may also irritate the stomach. Herbal teas may be a better alternative, but it's essential to check if they are caffeine-free and not overly acidic.

- Dairy Products: Milk was once thought to be soothing for ulcers, but it can actually stimulate acid production and may lead to discomfort. While some people tolerate dairy well, it’s advisable to monitor your symptoms closely. If you find that milk does not cause any discomfort, it may be acceptable in moderation, but it’s best to consult your healthcare provider for personalized advice.

- Fried Foods: As mentioned, fried foods can be irritating. It’s best to opt for healthier cooking methods, such as steaming, boiling, or baking, to minimize irritation.

- General Recommendations: Focus on a diet rich in fruits (non-citrus), vegetables, whole grains, and lean proteins. Foods like oatmeal, bananas, and yogurt (if tolerated) can be soothing. Staying hydrated is also important, but be cautious with carbonated beverages and alcohol, as they can irritate the stomach lining.

In conclusion, managing duodenal ulcers involves a combination of appropriate medication and careful dietary choices. While both Nexium and Pantoprazole are effective PPIs, your comfort and side effects should guide your choice. When it comes to diet, avoiding irritants and focusing on soothing foods can help alleviate symptoms and promote healing. Always consult with your healthcare provider for personalized advice tailored to your specific situation, especially if you have concerns about medications or dietary restrictions.

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