What are the best foods to eat
if I have a stomach ulcer?

A natural approach to helping yourself through your diet

Ulcers are sores that can happen in your digestive tract, including your lower throat (oesophagus), stomach and intestines. Ulcers are usually caused by the bacteria Helicobacter pylori that many of us have in our bodies already. The symptoms can be made worse by your stomach acid. 

It is not entirely clear why ulcers start but stress and diet, especially a fatty diet, are big contributing factors. A higher intake of fat can greatly increase your chance of getting an ulcer in the first place and cause other gastrointestinal problems. High salt intake is also implicated. 

STOMACH ULCER TREATMENT 

You can treat ulcers. A doctor will recommend antibiotics to kill the bacteria, a medical herbalist will recommend herbal antibiotics such as goldenseal.

Carefully controlling your diet is crucial to successful treatment. This is to make sure that your stomach produces less acid when digesting your food. Eating large meals requires the stomach to produce large amounts of stomach acid. So it is best to eat small meals. Ideally, you should be having 5 to 6 small meals a day and not 2 or 3 large ones. 

Your meals should be low in fat and sugar and high in fibre. A diet based on fruits, vegetables and whole grains is just that. The reason for avoiding fatty foods, is that they are harder for you to digest, so your body then produces more stomach acid and aggravates your condition. Foods that are low in fat can speed up your recovery. 

Herbal teas will also help you to feel more comfortable and support the body's healing process, especially herbs such as marshmallow root, liquorice, chamomile and peppermint.

CUTTING DOWN ON RED MEAT 

Red meat can be fatty, which will make your ulcer worse. Meat also contains a lot of protein and, even if you don’t have an ulcer, it takes longer to digest. Because it takes longer, it stays in the stomach for longer - therefore more acid is released to digest it. 

Most red meat is higher in fat content than white meat. You can’t always see this as the fat is marbled right through the meat, giving it its flavour. So just trimming off visible fat is not enough. Ideally avoid red meat until your ulcer has healed. 

If you do eat meat, stick to very lean cuts and eat tiny portion sizes (4 oz or less) to make it easier for your body to digest. Cut off any visible fat before eating. Eat the meat at least three hours before bedtime to give your body a chance to digest it. If you eat meat too close to bedtime, you may feel worse when you lie down. 

TASTY ALTERNATIVES 

You need protein in your diet. Eat white meats such as chicken or turkey and fish. Remember to remove the fatty skin from chicken. 

Oily fish, like salmon, mackerel, sardines and herring contain omega-3 fatty acids. They help to reduce the risk of ulcers by producing compounds called prostaglandins, that help to protect the lining of the stomach and intestines (Mori et al, 2006).  

Omega oils contain EPA and DHA which are the active compounds in this case, so if you are not eating a lot of fish take a krill oil, cod liver oil or seed oil supplement that is high in EPA and DFA. Prostaglandins appear to have a similar effect as the drug omeprazole prescribed for excess stomach acid, but without the drug’s side effects that trouble so many people. 

You can also use low-fat cheese, yogurt and peanut butter, as well as tofu and other soy products. 

FRUIT AND VEGETABLES 

Eat more vegetables and fruit, such as carrots, kale, broccoli, red/green peppers, cabbage juice, grapes, apricots and kiwi fruit, for their beta-carotene and vitamin C content, in order to help protect the lining of the stomach and intestine. 

Many fruits such as berries contain high levels of antioxidants which lower the risk of ulcers and ease symptoms when an ulcer has already developed. 

There is a lot of scientific evidence that seaweeds have an antiulcer effect (Mori et al, 2006). This is because, like oily fish, they release prostaglandins. If seaweed is hard to incorporate you can take seaweed as capsules but ideally the powder from the food should be added to your food as a seasoning. 

Vitamin E from foods like wheatgerm, hazelnuts, cold-pressed sunflower seed oil, soybean oil, will help along with zinc, found in seafood and whole grains. 

Amino acids also have a healing action. Good food sources include: seaweed, wheatgerm, cheddar cheese, almonds, sunflower seeds and sesame seeds. Alternatively, L-Glutamine can be taken to help an ulcer improve. 

SLIPPERY ELM FOODS 

Slippery elm has antioxidant and anti-inflammatory properties. It has been clinically proven to improve IBS symptoms (Hawrelak & Myers, 2010), is also used to treat stomach ulcers (Langmead et al, 2002) and is a key ingredient in the Essaic Formula used to support people with stomach cancer (Seely et al, 2007). It works by making a viscous mucilage that lines the stomach and intestines, calming inflammation, absorbing toxins (Choi et al, 2002) and destroying free radicals. 

Slippery elm foods are mixed low fat and soy milk powders, with other herbs or antioxidants that benefit and protect the stomach lining. They can be made into a drink, milkshake, added to yoghurt or smoothies. Slippery elm should be taken before every meal in order to protect the gut.

CAFFEINATED FOODS 

Foods and drinks that contain, like chocolate, coffee and soft drinks, can make your ulcer worse. Avoid them. Some people even find decaf coffee is irritating. 

DAIRY PRODUCTS 

Many dairy products are high in fat. Avoid them or use low-fat alternatives. Spicy foods and seasonings Avoid chili peppers, black pepper, mustard, curry and other strong spices. 

SALT AND SALTY FOODS 

There is evidence that people with a Helicobacter pylori infection who have a high salt intake are at greater risk of developing stomach cancer (Kuriki et al, 2007). Reduce your salt intake. Try using seaweed instead of salt to provide flavour. 

Foods commonly high in sodium include: canned soup, tortilla chips, potato/corn chips, salted nuts, salted meats (eg. bacon), blue cheese, cornflakes. There can also be a lot of hidden salt in soy sauce, pickled vegetables some preserved or canned vegetables, packaged and processed foods, and pre-prepared meals. Read the labels and choose low sodium varieties. 

OTHER IRRITANTS 

Cut out smoking and alcohol. They interfere with your stomach lining and increase production of stomach acid. 

EXAMPLE MENU

Breakfast
Slippery elm food mixed into low-fat yoghurt
A bowl of oatmeal with berries 
Or scrambled egg on wholemeal toast
Marshmallow herb tea 

Snack
Oatcake with hummus
Liquorice herb tea

Lunch
Cold turkey
Whole grain bread
Low-fat cheese
Carrot sticks
Bottled or filtered water 

Snack
Fresh fruit such as grapes or kiwi  

Dinner
Steamed fish or baked chicken seasoned with seaweed
Mashed potato mixed with chopped kale
Lightly steamed broccoli or french beans
Peppermint tea

Snack
Dry roasted sunflower and pumpkin seeds (unsalted)
Chamomile herb tea 

Slippery elm bark is a soothing and nutritional food supplement that helps to calm and protect an irritated gut lining.

Health worries?

If you have health concerns or over the counter remedies do not help as much as you would like, we advise you to see a medical herbalist.

You can find a qualified herbalist at Napiers,  NIMH or the CPP or email us for advice

by Monica Wilde
10 Nov 2012.

References

Abbreviations used:
EPA eicosapentaenoic acid
DHA docosahexaenoic acid
IBS inflammatory bowel syndrome 

Bhattacharya A., Ghosal S. and Bhattacharya S.K. (2006) Effect of fish oil on offensive and defensive factors in gastric ulceration in rats. Prostaglandins Leukot Essent Fatty Acids. 74(2):109-16. PMID:16352428

C Choi HR, Choi JS, Han YN, et al. (2002) Peroxynitrite scavenging activity of herb extracts. Phytother Res. 16(4):364-7.

H Hawrelak J.A. and Myers S.P. (2010) Effects of two natural medicine formulations on irritable bowel syndrome symptoms: a pilot study. J Altern Complement Med. 16(10):1065-71. 

Kuriki K, Wakai K, Matsuo K, Hiraki A, Suzuki T, Yamamura Y, Yamao K, Nakamura T, Tatematsu M, Tajima K. (2007) Gastric cancer risk and erythrocyte composition of docosahexaenoic acid with anti-inflammatory effects. Cancer Epidemiol Biomarkers Prev. 16(11):2406-15 PMID:18006930 

L Langmead L, Dawson C., Hawkins C, et al. (2002) Antioxidant effects of herbal therapies used by patients with inflammatory bowel disease: an in vitro study. Aliment Pharmacol Ther. 16(2):197-205. 

M Mori J, Hayashi T, Iwashima M, Matsunaga T, Saito H. (2006) Effects of plastoquinones from the brown alga Sargassum micracanthum. Biol Pharm Bull. 29(6):1197-201. PMID:16755016 

S Seely D, Kennedy DA, Myers SP, Cheras PA, Lin D, Li R, Cattley T, Brent PA, Mills E, Leonard BJ. (2007) In vitro analysis of the herbal compound Essiac. Anticancer Research. 27(6B):3875-82. PMID:18225545