Who is a gastroenterologist

A gastroenterologist is a narrow-profile specialist who diagnoses and treats the organs of the digestive system. Doctors of this area of ​​medicine work in polyclinics and hospitals, as well as in specialized and multidisciplinary clinics.

Competence of a gastroenterologist

Gastroenterology is a branch of medicine that deals with the diagnosis and study of diseases of the gastrointestinal tract and the treatment of the digestive system. Gastroenterologist treats inflammatory bowel disease

What organs does a gastroenterologist treat?

The doctor of this branch of medicine treats the organs of the digestive system, namely:

• Esophagus, stomach.
• Duodenum.
• Large and small intestine.
• Liver, gallbladder.
• Pancreas, bile ducts.

What diseases does a gastroenterologist deal with?

The list of diseases that are included in the field of work of a gastroenterologist includes:

• Dysbacteriosis, toxoplasmosis.
• Hepatitis group A, B, C, D, E.
• Ulcers and pyelonephritis.
• Mononucleosis (infectious).
• Exchange nephropathy (dysmetabolic).
• Gastritis, reactive pancreatitis.
• Crystalluria, a focus of chronic infection in the gastrointestinal tract.
• Appendicitis, urolithiasis and cholelithiasis.
• Adnexitis (gynecological pain), peritonitis.
• Acute pancreatitis, perforated ulcer.
• Glomerulonephritis.

In what situations should you contact a gastroenterologist?

You should visit a gastroenterologist if:

• There are constant pains in the abdomen and stomach.
• Pain is accompanied by nausea and vomiting.
• If there is a decrease in appetite and a sharp weight loss.
• If aching pain interferes with work.
• In the case when a change in the work of the intestinal track is noticed.
• When you previously had problems with inflammation of the gastrointestinal tract, duodenal ulcer, gallstone disease, or your body has already undergone surgery.
• If you wake up in the morning due to pain in the abdomen.

Laboratory tests and diagnostics that a gastroenterologist can prescribe

To diagnose a disease of the pancreas and liver, it is necessary to undergo tests:

• Aspartate aminotransferase, alanine aminotransferase.
• Alpha-1 antitrypsin and acid glycoprotein.
• Alkaline photophase, gamma-glutamyltransferase.
• Lipase, amylase.
• Bilirubin direct and general.
• Protein is common.
• Proteinogram, cholinesterase.
• Prothrombin time, analysis of feces for dysbacteriosis.
• Markers of hepatitis AT and AG.
• Biochemical blood test (total and direct bilirubin, total protein, albumin, ALaT, ASAT, LDH, GGT, alkaline phosphatase, thymol test).
• Analysis for chlamydia, yersinia, trichomonas, carriage of salmonella and shigella.
• Analysis for helminthic infections, protozoa (giardia, amoeba).

Diagnostics:

• Gastroscopy, urography.
• DNA diagnostics.
• Ultrasound examination of the abdominal cavity.

The diet affects the functioning of the internal organs of a person, especially the gallbladder and liver. The cause of gallstones and steatohepatitis is the consumption of sugar, sweets, high-calorie foods, animal fats. By eliminating or reducing the amount of their use, many diseases can be prevented.

The digestive organs work in emergency mode, processing such foods as: citrus fruits, coffee, fatty and fried foods, carbonated drinks, spices, chocolate.

Dangerous for the stomach is heavy high-calorie food (fast food), which you can afford in exceptional cases.

You can not starve, because long breaks between meals lead to stagnation of bile and provoke the formation of sand in the gallbladder.

Alcohol and beer are the enemies of the digestive system. 80% of diseases of the liver and pancreas are associated with their intake. It is especially harmful to eat fatty foods with large doses of strong alcoholic beverages, which leads to alcoholic hepatitis, acute pancreatitis, or chronic exacerbation.

Regular intake of anti-inflammatory non-specific drugs (analgin, aspirin) can cause damage to the mucous membrane of the duodenum or stomach, as warned by the instructions for these drugs.

If there are no contraindications and side effects in the instructions for biologically food additives (BAA), they should not be taken. Caution should be taken in the treatment of folk remedies.

Prolonged fasting can lead to the formation of gallstones.

Travelers often experience irritable bowel syndrome caused by food poisoning. Unfamiliar and unfamiliar food can cause a malfunction in the digestive system. Enzyme preparations and intestinal antiseptics should be taken with you on a trip.

The structure of modern medicine is highly developed. A variety of medicines and open access in pharmacies is considered a clear plus, ensuring the speedy recovery of people.

There are diseases that are treated not at all by doctors and medicines, but, as they say, by folk healers who actively convince suffering people that nature has already created an unprecedented supply of medicines that can cure any disease. Such treatment is called self-medication.

We are talking about diseases of the digestive system. For example, with a duodenal ulcer, it is known that a person is ill with an extremely serious disease, the presence of the disease quite noticeably affects the state of health. Physicians can cite many examples of patients accusing drugs of uselessness. The patients seriously assured that only natural components could help the sufferers cope with the disease.

Of course, there are people who blindly believe in such methods and refute their action with simple laws of logic. The fashion for such trends is contagious, for a start it is necessary to study the topic, before the final answer to the question: are folk methods of treatment a myth.

As a rule, gastroenterologists are harsh in their search for an answer. People of science do not recognize the possibility of nature to give healing substances in their pure form. Suppose the pollen of a certain flower has become an element of a drug, this looks quite logical. But rarely a doctor will undertake to assert that without chemical treatment, the flowers themselves will become an effective remedy for the disease.

In matters relating to the treatment of peptic ulcers, doctors tend to believe a confirmed fact: medicines, and strong ones, will become a method of treatment that brings the affected organs to a normal or relatively healthy state. Physiotherapy intervention is often used to determine the need for further treatment. Gastroenterologists advise resorting to the use of antibiotics.

For example, the drug cardiomagnyl with an ulcer actively destroys the pathogenic environment, which becomes a source of development. This is a common type of dangerous disease. Accordingly, with proper and regular intake, antibiotics will be able to establish the production of the natural bacterial background of the body. Some doctors advise not to dwell on such drugs - the effective principles of treating ulcers are considered insufficient. It is also recommended to use anti-inflammatory drugs that help relieve irritation of the mucous membrane of the affected organ.

Some medical workers speak with particular warmth about new technologies. For example, the treatment of gastric ulcers with a laser is an attractive way out for a person. Unfortunately, the methods are not fully developed. The natural way out is to resort to proven methods.

A new method of treatment, known as eradication therapy, has been proposed. Represents a set of measures aimed at the destruction of the disease. This procedure has contraindications. For example, a neglected stomach ulcer is considered a dangerous use case: the treatment may not go according to plan, causing more harm to the body. But such an operation will help heal the wound, facilitating further treatment.

Also, any narrowing of the tubular organs, or stenosis, leads to the need for surgical procedures. We are talking about laparoscopy as a method of struggle, when the operation is performed through small punctures. This technique has been practiced for a long time and is recognized as effective. Important information is the rationale for laparoscopic surgery - every intervention in the body is dangerous for humans.

The patient may need endoscopy - a kind of medical examination conducted using special devices, including an endoscope. There are cases when two procedures are indicated: at the beginning of treatment and at the end. Comparison will help determine the effectiveness of applicable techniques.

Probiotic preparations are also effective - agents that help the body restore the mucous membrane. An important addition to the effect produced is the positive effect of these drugs on the microbial balance. A person living with a disease of this type gets a chance for recovery. Selected gastroenterologists advise using such drugs in liquid form: so, doctors say, the substance will reach the affected organ faster, coping with a stomach ulcer.

Traditional medicine: can it help in the fight against an ulcer?

It sounds strange, but some patients have lost faith in modern treatment. Unfortunately, this situation is a common occurrence, a normal human reaction to “ineffective” drugs and treatment methods. However, not every patient understands that any drug is used for a certain amount of time, only in such a case even a small positive effect is noticeable.

Disappointment often leads curious ulcers to folk methods, which become a kind of revelation. Official medicine rarely agrees to the complete refusal of the patient from the help of a doctor, it is difficult for him to survive the fact of transferring control of his own health to an uneducated doctor who is used to being treated, for example, with the help of honey.

Is this really wrong? Are there methods of real help of traditional medicine in the fight against ulcer?

The use of pomegranate

As a rule, the development of the disease is more often observed in women.

Sometimes people endow the gifts of nature with miraculous properties. For example, it is known that pomegranate peels for stomach ulcers are considered an extremely effective method of home treatment. Indeed, after a series of disappointments in the use of medicines, patients subconsciously gain faith in such things. People are known who actually tried recipes using pomegranate or part of the fruit.

Selected patients claim that after three doses of pomegranate tincture they felt comparatively better. For example, vomiting stops with peptic ulcer. To prepare the drug, you will need two ingredients: ten grams of dry fruit peels, two hundred milliliters of boiling water. Pour the crusts with liquid, cover the glass with a tight lid. This will allow the pomegranate to give useful substances to the water, turn the liquid into a syrup for the treatment of peptic ulcer.

• dysentery;
• ulcerative colitis of the intestine;
• typhoid fever;
• salmonellosis;
• cholera.

Traditional doctors say that if a person suffers from diarrhea, vomiting, or the body temperature constantly rises, the solution will be useful. The drink is used as a tea decoction.

Application of potato juice

Many have long known that potato juice has a beneficial effect on the state of the stomach in remission, when an acute ulcer is not in the active phase. The main property of the juice is to help the gastric mucosa in the fight against peptic ulcer. The liquid protects the mucosa from the harmful effects of aggressive factors of influence, helps to fight high acidity.

Patients talk about the anesthetic properties of the juice. It is a known fact that potato juice has an anti-inflammatory effect on the disease, reducing the likelihood of pain in case of an ulcer.

There are two rules that help a person to properly prepare a tincture.

1. You will need to peel the potatoes, pass through a special juicer. It is permissible to grate the product on a fine grater. It is better to use gauze, through which juice will drain into the dishes, then it is easy to collect unnecessary potato residues and throw them away. This completes the preparation. Juice is required to drink shortly before meals. Thirty minutes is considered sufficient time. Potato juice partially cicatrizes wounds, becomes an advanced element of treatment.
2. Add carrots to this. You will need 100 g of these products. It is prepared in the same way as described above. Natural medicine should be taken differently. The juice will be most effective if the patient drinks the drink on an empty stomach, preventing the development of vascular stenosis. It is worth continuing the course for at least two weeks. According to the assurances of folk doctors, taking juice will help reduce the size of stomach ulcers, reaching sizes over 2 cm.

This drug has obvious contraindications. Firstly, potato juice is not suitable for people with individual food intolerance. Secondly, if we are talking about the fight against high acidity, such a medicine should also not be taken. The use of a substance for treatment is not suitable if the products are purchased at the end of winter. The fact is that the tuber accumulates a substance harmful to the body - solanine. It turns out that treatment in adult sick people will have to be stopped, and this is sometimes impossible due to a rapidly progressing disease.

In the absence of an optimal treatment option associated with the use of potatoes, healers suggest replacing the product with plants:

• chamomile;
• blooming Sally.

An infusion of herbs should be cooked in a similar way. There is a kind of physiotherapy that allows the body to adequately respond to the further course of treatment.

The use of St. John's wort

Of course, every patient wants to get rid of a stomach ulcer, which is not always possible. The use of St. John's wort is considered a radical method of treatment.

Grass is usually compared with an antibiotic of natural origin. Differs in St. John's wort efficiency. Many patients who used the plant in the fight against diseases of the digestive system rejected modern methods of treatment, being sure that only St. John's wort helped, in the end, say goodbye to an annoying and dangerous disease. The plant contains various resins, acids, saponins, has healing, astringent, anti-inflammatory and bactericidal properties. A set of medicinal substances and characteristics makes the plant an almost universal remedy in the fight against even a giant stomach ulcer.

The recipe for the preparation of the drug is simple. It is required to pour 200 ml of boiling water fifteen grams of the dried plant. The solution is infused in a thermos overnight.

Tincture is drunk thirty minutes before the next meal. It is advisable to take an infusion of St. John's wort several times a day: from two to four. Then, according to the assurances of professionals in the field of folk methods of treatment, gastric ulcer will recede.

Application of honey

The method of treatment is considered popular. People believe that only honey is able to influence the disease, to provide the healing effect necessary for the stomach.

Patients claim that with the simultaneous use of alcohol and honey, one can really recover. Special methods for preparing such tinctures have not been found. It is enough to add a spoonful of alcohol to two tablespoons of honey.

This method is considered unsafe for the body. Alcohol, as patients believe, kills bacteria, disinfecting the body from the inside, but the substance burns the mucous membrane of the affected organs. Some "experts" argue that we are talking about the treatment of stenosis as a consequence of an ulcer. However, the information provided is unscientific.

Medicine, based on scientific facts and achievements obtained in the course of many years of research, speaks of such consequences. are varied. If the disease has already begun to develop, it is worth considering professional treatment. The dispensary period spent in the hospital may turn out to be a more useful event than these folk methods. Everyone should think about the choice so that the initial stage of the disease passes under the close supervision of doctors, and not healers.

Massage for stomach ulcers

Often, fans of natural healing methods believe that massage can save a person from suffering. No refutation of such a theory has been created. It happens that qualified doctors send patients for massage with stomach ulcers.

The technique is easy to learn. The whole body should be massaged. The doctor strokes the abdomen in the navel, allowing the muscles to relax more quickly. Then the doctor makes rubbing movements. In the technique, doctors include tools that help create vibration in the area of ​​​​the projection of the colon.

Similar manipulations are carried out on the back of the patient. Exercises should be performed extremely carefully, eliminating the risk of damage to the organ and fragile bones, in case of strong pressure on a weak area.

Myth or reality: which method of treatment is considered the most effective

Unfortunately, despite the variety of methods described, none of them is really able to cope with gastric ulcer even in the initial stage of development. Accordingly, in relation to peptic ulcer, folk methods of treatment are a myth. Such techniques can enhance the effect of the antibiotics used and are auxiliary.

I would like to believe that a spoonful of honey a day can fix problems. But the natural "medicine" is not capable of healing the healed tissue inside, it can help eliminate a small scratch on the arm, for example. Selected folk remedies in reality cannot be used by patients, being contraindicated in diabetes mellitus and other diseases. It turns out that it is much easier to resort to the help of modern medicine products, the list of contraindications for which is rare.

Such an approach will exclude the development of more terrible diseases, for example, oncology. Due to the lack of modern treatment, chemotherapy may be required. Moreover, the rehabilitation period increases, a person often has to spend in the hospital not two weeks, but months. The words will be a warning: follow the reason not to delay contacting a doctor.

When delayed, treatment with folk remedies can stretch for a long time lost for traditional medicine. An accidentally healed wound can "open", becoming a new impetus for the development of the disease.

Doctors warn that during the period of exacerbation, an ulcer attack is likely, leading to undesirable consequences. For example, the consequences are:

• stenosis;
• perforation;
• opening of wounds due to age (senile ulcers).

The consequences are classified as hazardous to health.

What should be the diet for stomach ulcers

A person suffering from a disease is obliged to exclude from the diet some of the products:

• alcohol;
• roast;
• caffeine;
• soy sauce.

Other products are also known, the use of which will cause a complication of the disease. It is important to remember what is recommended to eat. For example, it is necessary to increase the content of hemoglobin in the blood, helping the body to fight infection intensively, preventing the aggressive spread and development of the disease throughout the body.

Complications in the form of an ulcerative stage of gastric cancer or a silent gastric ulcer occur due to improper adherence to a diet prescribed by a professional.

Should the patient's lifestyle change?

Certain changes will affect the way of life of a person. What methods the patient will choose: folk or prefer modern treatment - the patient must understand that with an established diagnosis of an ulcer, one should live on. The first thought should be a sincere desire to give up bad habits. The smoker must give up the destructive "hobby", the alcoholic must give up alcohol. It is better to add mineral water to the diet.

The patient must be aware that the peripheral nature of the lesion often plays a negative role in the development of treatment. Untreated resulting stenosis leads to more deplorable consequences. For example, over time, a perforative wall is formed, which affects neighboring organs. The process of perforation will begin, gradually leading to damage to the gastrointestinal tract.

No method of treatment will help a patient who will not listen to the doctor's recommendations, follow the necessary diet and take prescribed medications regularly. Only when a person begins to take a responsible attitude to health will any chosen type of medicine help. Ultimately, even a healed ulcer will prove to be a better outcome than the harm caused by improper treatment. The choice must be taken seriously.

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| site collection
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| Mikhail Meerovich Gurvich
| Therapeutic nutrition: advice from a gastroenterologist
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During the course of forty years, my colleagues and I have accumulated extensive experience in the dietary treatment of diseases of the digestive system through the daily practice of healing in the clinical nutrition clinic and in a number of Moscow polyclinics for forty years.
We often have to answer the question: has the importance of therapeutic nutrition decreased due to the emergence of many new and sometimes quite effective medicines?
The answer can be unequivocal: the role of clinical nutrition in the treatment and, most importantly, the prevention of diseases of the digestive system has not only not decreased, but has increased significantly. The fact is that the use of therapeutic nutrition allows you to be content with a minimum amount of medicines, and therefore reduces the possibility of side complications from their use and allergic reactions. And compliance with the diet and diet recommended by the doctor contributes to the prevention of diseases.
At the same time, it must be recognized that in some diseases, modern medicines make it possible to reduce the time for the use of "strict" sparing diets, and make it possible to increasingly use more advanced and varied diets for therapeutic purposes.
Nutrition and diseases of the digestive system are closely related. Improper nutrition, overeating, eating disorders can be the cause of diseases. On the contrary, therapeutic nutrition is often the main remedy for various diseases of the digestive system. Thus, dietetics and gastroenterology are inseparable from one another. It is no coincidence that Professor M.I. Pevzner, creating a system of fifteen numbered dietary tables, the very first tables - No. 1, 2, 3, 4, 5 attributed to the dietary treatment of the digestive system.
The recipes for dietary meals given in this book are taken primarily from dietary and culinary practice. Some of the recipes are taken from various cookbooks and a card file of dishes developed by the Institute of Nutrition under the guidance of Professor M.A. Samsonov, who made a great contribution to the science of clinical nutrition. Many of the above dietary dishes are still used in the clinical nutrition of patients at the clinical nutrition clinic of the Russian Academy of Medical Sciences.
In the proposed book it is impossible to present all the problems of therapeutic nutrition for various diseases of the digestive system and answer many questions of my readers. I talked about diets for some diseases and answered only some of the questions.
The author will be grateful for critical comments and feedback from readers about this book, and will be happy to answer questions of interest.

Address for letters: 127299, Moscow

Moscow, st. Clara Zetkin, 18, bldg. 5.

“But don’t the sick and the healthy have something in common that they need to be reminded of? For example, so that they are not greedy in food ... "
Seneca "Letters to Lucilius"

Many people think this way: if there were food at hand, and we ourselves will figure out what to cook and how much to eat. This opinion is untenable. You can have enough food at your disposal, but eating is fundamentally wrong. Do you know people who prefer to eat what is fatter, sweeter and more expensive? I know.
A neglectful attitude to nutrition, to the interests of one's own health often ends sadly. In some cases, it leads to intractable obesity, in others - to gastritis, peptic ulcer of the stomach and duodenum, cholecystitis, pancreatitis, etc.
How should you eat? Is it possible to be guided only by your appetite? Of course, if you are young, you have good health and do not have a tendency to be overweight, then appetite is a good adviser. We will first of all consider the issues of therapeutic nutrition. And although in many situations it is impossible to draw a clear line between medical and rational nutrition, we will try to focus on the first, not forgetting the second.
What is a diet? Medical nutrition, or diet therapy, is, of course, a method of treatment in which much depends on the patient himself. In drug treatment, the patient, as a rule, exactly follows the advice of the doctor, and dietary recommendations are not always carried out so punctually.
The word "diet" refers to both the diet and the composition of the food. Some experts elevate this word to the Latin dies - "day", while others believe that it comes from a consonant ancient Greek word meaning a way of life, a way of life. In the dictionary of Brockhaus and Efron we read: “A diet means a food regimen established for healthy and sick people according to age, physique, profession, climate, seasons, etc.” This is a good definition.
When recommending this or that diet, the nutritionist uses not only the data of biochemistry, physiology, food hygiene, but also the centuries-old experience of practical medicine. Even Hippocrates wrote: "He who nourishes well, he heals well." However, the doctor is not able to regulate absolutely everything, down to the smallest details. The doctor will not stand next to you at the stove and stop your hand when you open the refrigerator once again.
How much, when, why? Science cannot yet give each of us firm instructions: eat this and that, in such and such quantity; I am not sure that she will be able to do this so categorically in the foreseeable future. And if you find peremptory advice in any popular publication, take it critically. However, the attending physician, who knows not only your age and body weight, but also the state of health, energy consumption, tolerance of certain foods, can specify general dietary advice in relation to you - if, of course, you need diet therapy.
The doctors of the famous Salerno school (XIV century) instructed:

The highest law of medicine is to follow a diet steadily: the treatment will be bad if you forget about the diet while treating. how much, when, why, where, how often and what is applicable - all this should be prescribed by the doctor when prescribing a diet.

Currently, many reference publications on nutrition, including medical ones, are being published. The reader, far from dietology, but for one reason or another who is interested in it, the numerous information contained in these reference books can only confuse. For example, there are 28 treatment tables (taking into account the options indicated by letter indices, more than 40).
Each table is for a specific ailment. But many people over the age of forty have several diseases at once. What diet should they follow?
Some authors of popular articles emphasize the harmfulness of some products; their colleagues, using similar arguments, strike others off the list.
Alas, the advice is sometimes contradictory. Let's try to find the truth in our conversations about diet.

Diet in real conditions. Few people have the time and patience to weigh products to the nearest gram at home, calculate the loss of vitamins during heat treatment, verify the amount of absorbed proteins, fats, carbohydrates ... And you don’t need all this.
Another thing is a laboratory experiment: then the diet of the experimental animal is weighed with all care, the chemical composition of the food is determined with an accuracy of tenths of a gram. But we live in real, not experimental conditions. And if you have gastritis, colitis, or another disease of the digestive system, and your body weight is normal, then measuring and weighing can be replaced with a reasonable attitude to your own appetite without harming your health. Finish your meal as soon as you feel full. Leave the table, knowing that you could eat another small piece of delicious food, but it is better to refrain from this by an effort of will. And one more thing: the feeling of satiety after dinner lasts longer when the menu is varied - appetizer, soup, meat, vegetables, porridge, bread, sweets. Food without whims saturates better, and delicacies, whether they are sweets or smoked meats, are not useful for everyone.
Please remember that the appetite that signals us to eat is not perfect and often fails us. In addition, saturation depends on the stereotype of nutrition, tastes and habits. So, if you usually eat a lot of bread, you will feel that your appetite is not satisfied if you ate without bread; do not rush to trust this feeling.
Standard or individual approach? Treatment tables were developed about half a century ago. Much has been improved during this time, diet options have become significantly larger, recommendations have become more accurate and specific. Nutritionists need to know all this. And the sick?
This question is rather delicate. A clear differentiation of treatment tables in clinics and therapeutic nutrition departments is apparently justified - at least from the standpoint of nutrition science. But already in sanatoriums and rest homes, such detail, in my opinion, is unnecessary. Here, basic diets for a certain group of diseases (for example, gastroenterological diseases) are more acceptable, so that the sick (or vacationers) themselves have the opportunity to choose dishes - of course, on the recommendation of a doctor.
Much has changed in the past half century; the structure of nutrition has become more rational. The current patient knows a lot about the causes and manifestations of his illness, he knows how to prevent exacerbations. Finally, he is literate enough to make his own diet - of course, guided by general guidelines for clinical nutrition. And who better than himself will take into account the peculiarities of his health, the tolerance of certain foods and dishes, and finally, taste habits, which must also be reckoned with, unless, of course, they are harmful to health.
In home dietology, we propose to be guided by the motto: not table number such and such, but an individual diet, your own, special menu, which takes into account the general principles of therapeutic nutrition recommended by the doctor for this disease: a set of products, culinary processing features, diet.
In other words, the doctor gives advice, you follow it, showing independence within the limits allotted to you.
Seven rules of home nutrition. Don't let the magic of numbers work on you; perhaps another doctor will choose six or eight principles - that's not the point. People who need to diet should be familiar with the basics of practical dietology, and everyone should be familiar with the first three positions. Here are the rules:
1) eat a varied diet;
2) observe the diet;
3) do not overeat;
4) prepare food properly;
5) know the calorie content and chemical composition of the daily diet in general;
6) know the characteristics of the chemical composition of the main products;
7) to understand that with the help of a diet, not a disease is treated, but a patient.
If I am asked what are the main provisions here, I will name the first and second without hesitation. But this is in a general, abstract case. Giving individual recommendations to a particular patient, the doctor will certainly single out the most important link in diet therapy, its quintessence. For example, in some diets it is necessary to pay primary attention to the culinary processing of products (say, a complete ban on all fried foods is introduced); in others, emphasis is placed on the composition of nutrients (increasing or decreasing the amount of proteins, limiting the use of table salt, etc.). But, I repeat, in all cases it is necessary to take care of the diversity of the diet and the observance of the diet.
First rule. In therapeutic nutrition clinics, doctors carefully calculate the caloric content of substances in the diet, taking care, first of all, of their balance. In everyday nutrition, these difficult calculations can be avoided (the exception is obesity, in which it is always useful to calculate the caloric content of the diet), if you follow the first rule of rational nutrition - a variety of diets. This rule applies to everyone - both healthy and those who are prescribed a diet for prevention or treatment.
If the food is varied, if it includes products of both animal (meat, fish, eggs, milk, cottage cheese) and vegetable origin (vegetables, fruits, cereals, bread), then you can be sure that the body will receive everything necessary for life without any special effort on your part.

Nutritionist advises
The most important thing in our diet is the diversity of the diet. If the food includes meat or fish, vegetables, fruits, cereals, bread, then the body will receive all the nutrients necessary for life.

It is possible to distinguish the main groups of food products that should be presented in everyday nutrition: milk and dairy products (kefir, curdled milk, cottage cheese, etc.); vegetables, fruits (fresh and sauerkraut, potatoes, carrots, beets, tomatoes, cucumbers, lettuce, pumpkin, radishes, apples, pears, etc.), berries; meat, poultry, fish, eggs (sources of animal protein); bakery and pasta, cereals; fats (butter and vegetable oil, lard, etc.); sweets (sugar, honey, confectionery).
Second rule. To follow a diet means to eat regularly, at the same hours. In this case, you develop a conditioned reflex: at the set time, gastric juice will be most actively secreted and the best conditions will arise for digesting food. This rule is universal.
Your body (especially if you are engaged in intense physical or mental work) is not at all indifferent - to receive food after 3-4 or after 10 hours. Such food is too expensive, in which systematically, for months and even years, breakfast is tea or coffee with a sandwich, at lunchtime - again sandwiches or pies, and dinner turns into lunch. This is how a considerable number of students earn during the years of study not only a diploma, but also gastritis, colitis, cholecystitis, obesity.
It is widely believed that an obese person, if he wants to lose weight, should eat less and less often, say, twice a day. This is not true! Infrequent meals cause a feeling of intense hunger, and such a regimen eventually leads to overeating. A person eats more in two meals than with 4-5 meals a day, because with a strong feeling of hunger it is difficult to control your appetite. If you started to gain weight, switch to frequent, fractional meals!
In any case, eat at least 3-4 times a day. For lunch, don't forget a bowl of soup. Eating dry food, "sandwich food" from day to day invariably leads to diseases of the stomach and intestines. Try to have dinner no later than an hour and a half before bedtime: a hearty meal before bedtime contributes to obesity and makes sleep restless. But don't go to extremes and go to bed hungry. A glass of kefir or curdled milk before going to bed is what you need.
By the way, would you like to be more productive? Reasonable coordination of work, rest and nutrition always contributes to this.

Properly selected products play a truly healing role, which, of course, does not exclude other forms of therapy.

Third rule. Body weight is one of the important indicators of health. Excess body weight increases the risk of diseases such as diabetes, coronary heart disease, gallstone disease. Finally, overeating significantly reduces performance.
Everyone knows that overeating is harmful, but statistics show that every year the number of people suffering from obesity and overweight is growing, and more and more obese among young people. Therefore, we remind you once again: do not be greedy for food.
Fourth rule. One French culinary specialist remarked that cooking is the key to health. It may be said too passionately, but there is some truth in this. Let us give just one example confirming the validity of this thesis. With exacerbation of peptic ulcer and chronic gastritis, accompanied by increased secretion of gastric juice, rich meat and fish broths are excluded from the diet: they contain too many extractives that irritate the gastric mucosa.
Patients are prescribed a diet that is as sparing as possible for the stomach; products are advised to either boil or steam, recommend milk, soft-boiled eggs (or steam omelet), semolina and rice porridge ...
It would seem nothing special. But very often the patient's state of health noticeably improves, heartburn and pain in the epigastric region disappear due to only an adjustment in nutrition - the exclusion of broths and fried foods.
Fifth rule. The calorie content and chemical composition of food are of paramount importance in many ailments, but above all in obesity and diabetes (which, by the way, are often combined). Properly selected products play a truly healing role, which, of course, does not exclude other forms of therapy. In mild forms of diabetes, you can often do without medication at all, you just need to strictly follow the prescribed diet. As with obesity, in diabetes, digestible carbohydrates are primarily limited, that is, sweets that increase blood sugar levels and form excess adipose tissue; they are replaced with xylitol, sorbitol, etc. When overweight, low-calorie foods such as cucumbers, cabbage, zucchini, pumpkin, low-fat cottage cheese are useful.
You can get an idea of ​​the calorie content of breakfasts, lunches and dinners using tables of the chemical composition of foods. But this is not enough! It often happens that the daily diet seems to be chosen correctly, the main nutrients - proteins, fats, carbohydrates, vitamins, mineral salts - are balanced. But the dishes are so monotonous, their taste is so inexpressive that you don’t want to eat ... There is no need to go to extremes and evaluate the diet only by its chemical composition. In many diseases, the chemical characteristics of therapeutic nutrition are not at all necessary to be put at the forefront. This applies, in particular, to most gastroenterological diseases - gastritis, colitis, cholecystitis, etc.
However, it is desirable for everyone to have a general idea of ​​\u200b\u200bthe calorie content of the diet. For example, it is useful to know that the calorie content of a chicken egg is about 60-70 kcal, 100 g of lean beef is about 150 kcal, 100 g of butter is about 750 kcal, etc. This will help prevent overweight.

Nutritionist advises
If you start to gain weight, switch to frequent, fractional meals. Eat at least 3-4 times a day, but little by little. For lunch, don't forget a bowl of soup.

Sixth rule. The abundance of foodstuffs and the multiplicity of their individual chemical characteristics force us to confine ourselves to illustrations.
Here are vegetable oils - sunflower, cottonseed, corn, olive. They are famous for their high calorie content and good digestibility, and in addition, they contain polyunsaturated fatty acids and vitamin E - healing agents for atherosclerosis. Polyunsaturated acids stimulate defense mechanisms, increase the body's resistance to infectious diseases; vitamin E inhibits the development of atherosclerosis and promotes muscle activity. And one more thing: vegetable oils have a pronounced choleretic effect, which means they prevent the development of cholecystitis. Heat treatment weakens these manifold useful properties; therefore, it is necessary to use vegetable oil more often not for frying, but for dressing salads, vinaigrettes, and in some cases first courses.
More examples. Rose hips are champions in the content of vitamin C, rosehip infusion is useful for increased fatigue. In addition, it is a choleretic and anti-sclerotic agent. Blueberries, due to the significant content of tannins, have an astringent and anti-inflammatory effect, reduce intestinal motility. Wheat and rye bran, containing many B vitamins, mineral salts and, most importantly, plant fibers, are often used to prevent and treat various intestinal diseases accompanied by constipation; vegetables with a high fiber content (cabbage, beets, carrots) are also good for this purpose.
Seventh rule. This rule is common to medicine: treat not the disease, but the patient. Perhaps more often than other specialists, it is useful for nutritionists to recall the statements of the outstanding Russian therapist M.Ya. Mudrova: "I intend to tell you a new truth, which many will not believe and which, perhaps, not all of you will comprehend ... Healing does not consist in treating the disease ... Healing consists in treating the patient himself."
In this case, the current “numbering” system is by no means an absolute recommendation, but only an indicative dietary treatment scheme. When it is applied in each case, significant adjustment is necessary. An experienced doctor will take into account the form and stage of the disease, the characteristics of metabolism, body weight, concomitant ailments, and, last but not least, the habits and tastes of the patient, if they are reasonable and not detrimental to health.
So, before forbidding coffee to a patient suffering from peptic ulcer in remission, it is necessary to weigh the pros and cons of such a ban. If coffee, consumed for decades, does not cause an exacerbation, then it is hardly worth prohibiting it, depriving the patient of one of the components of mental comfort: it is enough to give advice to drink coffee less often and not too strong.
It is necessary to take into account intolerance and food allergies to certain foods. It is not necessary to include in the diet even dishes that are very useful in terms of chemical composition, if the patient does not tolerate them well due to a variety of circumstances. And in case of infectious diseases, after surgical interventions, a balanced in composition, enriched with vitamins and certainly tasty, varied food always speeds up recovery.
Only one conclusion can be drawn from these examples: there is not and cannot be a standard medical diet.

It is necessary to take into account intolerance and food allergies to certain foods. It is not necessary to include in the diet even dishes that are very useful in terms of chemical composition, if they are poorly tolerated due to a variety of circumstances.

"Help the Doctor" Therapeutic nutrition is an integral part of complex therapy, it is applicable for all diseases. Sometimes it is an auxiliary method of treatment, against which medications act more effectively, sometimes it is almost the main therapeutic factor, and very often a reliable prophylactic that prevents exacerbations of peptic ulcer, gout, hypertension, etc.
Yes, it is not easy to use diet therapy at home - and not only because you need to be able to cook dietary meals, but also because following the dietary recommendations prescribed by your doctor requires an effort of will. However, taking care of your own health should not be left solely to the shoulders of the doctors who care for you.
Centuries ago, the great Hippocrates wrote: “Life is short, the path of art is long, opportunity is fleeting, experience is deceptive, judgment is difficult. Therefore, not only the doctor himself should use everything that is necessary, but also the patient, and those around him, and all external circumstances should contribute to the doctor and his activities.
So let's help...
Dietetics for patients with diseases of the digestive system. The rules of home dietetics for diseases of the digestive system are largely identical to the recommendations that we formulated in the section "Dietetics for All".
However, dietary requirements for diseases of the digestive system have their own characteristics.

Many are still convinced that one of the causes of gastritis is dry food. It is probably difficult to find a person who, in childhood, was not subjected to numerous verbal attacks by his mother and grandmother about the need to consume soups daily in order to avoid stomach problems. However, there are a huge number of cultures in the world whose national cuisines do not imply the daily use of broth with additives, and, oddly enough, the frequency of stomach problems among local residents does not exceed the standard rates. And the very concept of "soup" entered the Russian meal only 3 centuries ago. Moreover, with a number of diseases of the gastrointestinal tract, the use of rich soups and chicken broths can only bring harm.

What is really important is the observance of a sufficient water regime, on average at the rate of 30 ml of water per 1 kg of body weight per day. And it doesn't matter if you drink water with or without food. On gastric juice, contrary to established stereotypes, this will not have a significant effect. And the food will be digested, and the acidity of the stomach will not suffer from this.

#2: eat right

Gastritis is an inflammation of the gastric mucosa caused by various factors. One of these factors is food. What you eat is not only important for digestion, but can affect your overall health. Diets are not needed, just like eating every 2 hours. You just need to make your diet in accordance with the recommendations for a healthy and balanced diet. Namely: limit food with animal fats, especially fried ones, drink carbonated drinks less often, do not mix foods that are too different or difficult to digest in one meal. The classic of such an unfortunate combination is sandwiches with butter and red caviar. It is worth trying not to abuse industrial sauces (mayonnaise, ketchup) and preservation. Another unhealthy habit is to drink tea with muffins, sweets and chocolate, and do not treat this meal as a separate meal.

Equally important is how you eat or your diet, in particular, you should not go hungry, it is optimal to eat at least 4 times a day, try to avoid eating in a hurry and leave at least two hours of time to digest what you eat before going to bed .

#3: don't believe the rumors

Unfortunately, in the modern world, the source of medical information is not always a doctor or specialized literature, which, on the one hand, has led to an increase in medical literacy, but on the other hand, leads to a huge number of fables and myths, including those related to stomach diseases. One of them - gastritis is inherited. This is not true. Simply the most common cause of gastritis is Helicobacter pylori infection, the infection of which most often occurs in childhood in the family circle (usually through saliva). So it turns out that children whose parents suffer from this infection, especially beloved children who are often kissed, are literally doomed to get the same disease. The second common myth is why get treated if it is very easy to get infected again. This is not at all true! The frequency of re-infection after successful treatment in developed countries does not exceed 3%! But the recurrence of the disease, that is, the repeated detection of the same bacterium in ineffectively treated people, is indeed quite common. There are already questions both to the doctor (whether he prescribed a modern effective treatment regimen) and to the patient (whether he followed all the recommendations for taking the drugs). One of the ways to increase the effectiveness of treatment is to add Rebagita to the standard treatment regimen, which increases the protective forces of the gastric mucosa.

#4: Don't wait for symptoms to appear

The golden rule of medicine - "disease is easier to prevent than to cure" - works in relation to the stomach. Even if nothing bothers you, but, for example, in your family, your dad is an ulcer, and your grandmother died of stomach cancer, or maybe you realize that your diet is far from ideal, and even your work is very stressful, then you shouldn’t wait for pain, heartburn, or any other symptom. Don't delay your visit to the doctor.

Often the cause of damage to the mucosa of the gastrointestinal tract is the use of drugs, especially the painkiller group. With frequent headaches, problems with the spine and joints that require regular intake of anti-inflammatory and painkillers, as well as the use of hormonal drugs, it is worth at least once to see a gastroenterologist. In this group of patients, stomach problems often debut unexpectedly against the background of seemingly complete well-being, often already with a complicated form - peptic ulcer or bleeding.

#5: Check Your Stomach - It Doesn't Hurt!

A deterrent to going to a specialist is often the fear of the prescribed endoscopic examination of the stomach, often colloquially called "swallowing the tube." In fact, in the modern medical world, everything is done to make even invasive examinations as comfortable as possible. The devices used now, like heaven and earth, differ from those that were even 15 years ago, so the emotional stories of "experienced" patients should be treated as ancient history. Today's probes are an order of magnitude thinner, very flexible, which significantly facilitates and speeds up the examination, and, most importantly, the procedure, if desired, can be performed completely painlessly in a dream. Well, let's be honest, that endoscopy is, yes, unpleasant, but not painful at all! The main thing is the mood and strict implementation of the recommendations of the doctor and nurse during the procedure.

#6: It is not necessary to swallow the tube

In Europe, the “test and treat” strategy has now become widespread, when in patients without risk factors it is enough to determine the Helicobacter pylori microbe in the stomach in any non-invasive way, for example, using a blood test, exhaled air or stool tests, and immediately prescribe treatment. All those methods that are used abroad have been available in our country in the past few years. The main thing to understand is that this tactic works only when a person comes before the appearance of vivid symptoms, otherwise endoscopy still cannot be avoided.

#7: Say No! bad habits

Neither excessive desire for alcoholic beverages nor smoking contribute to the normal functioning of the digestive tract. Despite the fact that the effect of alcohol on the body is multifaceted, and in some situations, with moderate consumption, it can have a beneficial effect on certain organs and diseases, this effect is completely inapplicable to the stomach. In the classification of gastritis, alcoholic damage to the stomach is even singled out as a separate item.

Smoking also worsens the blood supply to the mucosa, disrupts the motility of the stomach and increases the secretion of gastric juice, which has a particularly negative effect on the body when smoking on an empty stomach. With additional risk factors, smoking is a direct path to peptic ulcer disease! If you can’t quit smoking abruptly, as a first step, it is recommended that you at least not smoke at night, on an empty stomach, as well as the first hour after eating, and also not drink hot coffee or strong tea with a cigarette.

#8: Forget the soda

Often we think that heartburn is something commonplace, “it happens to everyone” and is easy to deal with. Indeed, even a simple soda relieves us of this unpleasant symptom in a few minutes. Everything is explained very simply, soda is an alkaline substance that chemically binds hydrochloric acid in the stomach, a neutralization reaction occurs, and there is no complaint. However, for efficient digestion, nature provides that the stomach must have acidic contents, therefore, a short time after taking soda, the so-called “acid rebound” occurs, when a secondary release of hydrochloric acid occurs, even more, which negatively affects the mucous membrane of the stomach and esophagus . Thus, with regular use of soda, the patient himself maintains the inflammatory process in the stomach.

Often heartburn occurs when, contrary to the laws of nature, the contents of the stomach begin to move not down, but retrograde up into the esophagus. At the heart of this situation is a violation of motor skills, so just removing the acid is not enough, it is also necessary to establish normal peristalsis (wave-like contractions) of the upper digestive system. That is why, in addition to drugs that reduce acidity, for heartburn, the doctor prescribes prokinetics (itomed), which not only removes the symptom, but also establishes an effective coordinated work of the digestive organs.

It is important to remember that there are no harmless symptoms! Often, heartburn is the main symptom of the presence in the body of such diseases as reflux disease, gastritis, or even peptic ulcer, where complex and long-term treatment is required.

No. 8: down with self-medication

The widespread belief that everyone has gastritis, as well as the availability of most drugs for the treatment of the stomach, has led to the fact that often the advice of experienced friends and acquaintances is the first recommendation and guide to action in this pathology. Such self-treatment, as well as the use of so-called "folk" remedies often lead either to a chronic pathological process or to threatening complications. At the same time, few people know that with Helicobacter pylori gastritis, a short two-week course of treatment can completely get rid of this disease and successfully prevent peptic ulcer and stomach cancer.

An equally important rule is the full course of therapy. Always bring the treatment of gastritis to the end! Compliance with all medical recommendations, even during the period when acute pain and other symptoms stop, is a guarantee of reducing the risk of relapse, and also allows you to completely get rid of the disease.

Monitor your health, get examined regularly, get treated properly, and the stomach will be your reliable partner in any situation!

Tatyana Ilchishina - Candidate of Medical Sciences, gastroenterologist, hepatologist of the multidisciplinary medical holding "SM-clinic", a member of the Russian Gastroenterological Association, the Russian Society for the Study of the Liver.

As a rule, a gastroenterologist has to deal with the consequences of malnutrition, which is among the causes that lead to diseases of the gastrointestinal tract. However, the fact is known that preventing a disease is much easier and, most importantly, more useful than treating it. Prevention, and more prevention! Listen to the advice of an experienced specialist - a gastroenterologist - an osteopath.

• Not all diseases of the gastrointestinal tract are directly related to addiction to fast food, snacks on the run, unbalanced diet. For example, gastritis and ulcers are a consequence of the fact that the Helicobacter pylori bacterium has settled in the body, and you cannot get rid of the problem if you do not get rid of this bacterium (and this is only possible with the help of a course of medication). Another thing is that the bacterium does not attack just like that: it means that the prerequisites have appeared in the body for the harmful “guest” to get into the digestive tract, feel good there and begin its destructive effect. Weak immunity, dietary errors, factors such as stress, etc., created favorable conditions for the “invader”. And if a person also tries to contact doctors less often, then for many years the occupation of the stomach by bacteria has allowed the formation of gastritis or a stomach ulcer. Therefore, the first rule is to be examined by a gastroenterologist regularly, as part of an annual medical examination, and do not neglect treatment if it is prescribed to you. And do not self-medicate if the state of your digestive organs seems to you far from ideal!
• Violations of the diet and errors in nutrition hit the liver and gallbladder the hardest. If you want to prevent gallstones from appearing in the gallbladder, and liver cells to remain functional and not degenerate into adipose tissue, limit sugar, sweets, fatty and high-calorie foods in the diet. High-calorie nutrition is one of the main reasons not only for the appearance of excess weight, but also for violations of the liver and gallbladder.
• Foods that make our digestive tract work in an enhanced mode should be severely limited or, if possible, completely eliminated. This is all the same fat, citrus fruits, coffee and chocolate, sweet soda, an abundance of spicy and spicy. Alcohol is especially harmful to the liver and pancreas.
• The method of cooking is also important: fried foods have a bad effect on the digestive tract, where it is better to eat foods boiled, steamed or baked. The abundance of raw vegetables and fruits, by the way, is not such a healthy habit. Coarse fiber, which is contained in these products, can irritate the intestines, lead to increased gas formation, increased peristalsis, and digestive disorders. Therefore, it is very important to observe the measure: you need to eat from 400 to 800 g of vegetables and fruits per day, but not necessarily all this amount - in raw form.
• Long breaks between meals are harmful. It is better to eat fractionally, 4-6 times a day, with a mandatory break of 3 hours. And by the way, if you are hungry, and there are no options other than fast and “harmful” fast food, then a hamburger is better than bile stasis in the gallbladder. If you fast regularly, sand and stones will begin to form in the gallbladder against the background of stagnation of bile.
• Is it true that you can't eat after 6 pm? The question is moot. Rather, you should not eat up at night, it is just as harmful as going to bed hungry. Therefore, if you are used to going to bed late, for example, at midnight, then the last meal should be no later than 21.00 - 3 hours before bedtime. If you eat later, a tightly packed stomach will interfere with healthy sleep, and digestion processes will be disturbed.
• Before going on a diet, be sure to consult a gastroenterologist. Many diets make you feel hungry, and this, as mentioned above, leads to the formation of gallstones.
• If there is a load on the digestive tract (a wedding, birthday, alumni meeting or other celebration is ahead), adjust the diet and start taking enzymes in advance to reduce the load on the digestive tract and make it easier for him to work.
• If you are not on a diet for weight loss (you just don’t need it, for example), arrange weekly fasting days for yourself - on apples, cucumbers, cottage cheese. Do not forget to drink a lot, at least 2 liters of pure water without gas. Such respite will not only improve digestion, but, as a result, will have a positive effect on the condition of the skin, help to remove excess fluid from the body and the disappearance of edema.
• Many problems of the organs of the gastrointestinal tract of a functional nature - that is, associated with impaired work - can be solved by an osteopathic doctor using various treatment methods available in the arsenal of these specialists. Various techniques can influence the mobility of organs, their internal movements, improve mobility, remove congestion in the organs themselves and around them, relieve tension and spasms, normalize blood circulation and improve the function of the liver, kidneys, intestines, stomach, esophagus, pancreas.

So if you experience any troubling symptoms—for example, heartburn, a feeling of heaviness, pain, upset—do not try to solve the problem yourself. It is best to seek qualified help from a gastroenterologist-osteopath.