Nutritional care in peptic ulcer / Cuidados nutricionais na úlcera péptica

INTRODUCTION: Peptic ulcer is a lesion of the mucosal lining of the upper gastrointestinal tract characterized by an imbalance between aggressive and protective factors of the mucosa, having H. pylori as the main etiologic factor. Dietotherapy is important in the prevention and treatment of this disease. AIM: To update nutritional therapy in adults' peptic ulcer. METHODS: Exploratory review without restrictions with primary sources indexed in Scielo, PubMed, Medline, ISI, and Scopus databases. RESULTS: Dietotherapy, as well as caloric distribution, should be adjusted to the patient's needs aiming to normalize the nutritional status and promote healing. Recommended nutrients can be different in the acute phase and in the recovery phase, and there is a greater need of protein and some micronutrients, such as vitamin A, zinc, selenium, and vitamin C in the recovery phase. In addition, some studies have shown that vitamin C has a beneficial effect in eradication of H. pylori. Fibers and probiotics also play a important role in the treatment of peptic ulcer, because they reduce the side effects of antibiotics and help reduce treatment time. CONCLUSION: A balanced diet is vital in the treatment of peptic ulcer, once food can prevent, treat or even alleviate the symptoms involving this pathology. However, there are few papers that innovate dietotherapy; so additional studies addressing more specifically the dietotherapy for treatment of peptic ulcer are necessary. .

INTRODUÇÃO: A úlcera péptica é uma lesão que ocorre na mucosa do trato gastrointestinal, sendo caracterizada por um desequilíbrio entre fatores agressores e protetores da mucosa gástrica, tendo como principal fator etiológico o H. pylori. A dietoterapia é fundamental na prevenção e tratamento dessa patologia. OBJETIVO: Rever a terapia nutricional na úlcera péptica em adultos. MÉTODOS: A metodologia utilizada foi um estudo exploratório de revisão do conhecimento disponível na literatura científica. RESULTADOS: A dietoterapia bem como a distribuição calórica deve ser ajustada as necessidades do paciente com objetivo de normalizar o estado nutricional e promover a cicatrização. As recomendações de nutrientes podem ser diferenciadas nas fases aguda e de recuperação, havendo uma maior necessidade proteica e de alguns micronutrientes como vitamina A, zinco, selênio e vitamina C na fase de recuperação. Além disso, alguns estudos evidenciam que a vitamina C tem efeito benéfico na erradicação do H. pylori. As fibras e probióticos também possuem um importante papel no tratamento da úlcera péptica, reduzindo os efeitos colaterais dos antibióticos e auxiliando na redução do tempo de tratamento. CONCLUSÃO: Percebe-se que poucos são os trabalhos que evidenciam a terapia nutricional da úlcera e não há consenso sobre o tema. Com isso, mais estudos são necessários para abordar com maior especificidade o tratamento dietoterápico da úlcera péptica. Dieta equilibrada é fundamental no tratamento da úlcera péptica, uma vez que o alimento pode prevenir, tratar ou mesmo aliviar os sintomas que envolvem esta doença. No entanto, existem poucos trabalhos que inovam dietoterapia; assim, são necessários estudos adicionais abordando mais especificamente a dietoterapia para o tratamento de úlcera péptica. .

Body mass index and per capita income influence duodenal ulcer healing and H. pylori eradication whilst dietary factors play no part.

BACKGROUND: The role of dietary and sociodemographic factors in the healing of duodenal ulcer following H. pylori eradication remains undefined. AIM: To assess the role of diet, sociodemography and body mass index in the healing of duodenal ulcer and eradication of H. pylori. METHODS: A cross-sectional study consisting of 67 consecutive duodenal ulcer patients was undertaken. Sociodemographic factors studied included age, sex, occupation, educational status, religion, type of family, number of family members, per capita income and residence (urban vs. rural). Personal habits studied included alcohol consumption and smoking. Regular dietary intake over a two-month period was assessed using the food frequency questionnaire. All patients had documented H. pylori infection at the time of inclusion and received standard triple eradication therapy. Follow-up endoscopy and testing for H. pylori were done 4 weeks after completion of eradication therapy. RESULTS: The mean age of the 67 patients (60 male, 7 female) was 39.9+/-13.6 years. Healing of duodenal ulcer was documented in 51 patients. H. pylori infection was successfully eradicated in 31 patients but not in the other 36. There was no difference between the groups (Group A1: H. pylori eradicated, Group B1: H. pylori not eradicated) with regard to dietary and socio-demographic variables, except for BMI, which was significantly higher in patients in whom H. pylori had been eradicated. Per capita income was significantly higher in Group A2 (healed duodenal ulcer) as compared to Group B2 (duodenal ulcer not healed) while there was no difference in dietary and socio-demographic variables in these two groups. CONCLUSION: We found that higher body mass index and higher per capita income were associated with successful H. pylori eradication and duodenal ulcer healing, respectively, and that diet had no role to play in either. Further epidemiological studies from different parts of India and studies that control for Helicobacter pylori are required to establish predictive factors.

Cómo convivir con su úlcera / How to live with your ulcer

El artículo presenta un plan básico de educación para pacientes que sufren de úlcera péptica. Describe características, síntomas, tratamiento, complicaciones y prevención de las lesiones ulcerosas

Nuevos conceptos sobre la dieta en el tratamiento dela úlcera péptica / New concepts on the treatment of peptic ulcer

Gracias a los nuevos conocimientos en esta última década acerca de la úlcera péptica, tanto la patogenia como el tratamiento han variado. El descubrimiento del helicobacter pylori y su hallazgo en la superficie de las células epiteliales gástricas sitúan a la úlcera péptica como una enfermedad infecciosa. También han variado las concepciones que hacían que la dieta del ulceroso fuera una de las más restrictivas y se ha podido minimizar la larga lista de alimentos prohibidos en la dieta terapéutica de esta enfermedad