The right diet can lower your risk of an ulcer, relieve pain and possibly help you heal faster, while the wrong one can make symptoms worse
By: Michelle Crouch
For decades, the scientific community thought certain foods could cause peptic ulcers. Now, we know better.
Ulcers, painful sores that develop in the lining of your stomach and small intestines, are almost always caused by one of two things:
Bacteria called Helicobacter pylori (H. pylori) that live in the stomach.
The use of pain medications (nonsteroidal anti-inflammatory drugs) that erode the lining of the stomach.
That doesn’t mean what you eat doesn’t matter. Some foods are linked to a lower risk of ulcers because they are anti-inflammatory, coat the lining of the stomach or strengthen its microbiome. Others can cause discomfort if you have an ulcer.
“There’s no specific diet for peptic ulcer disease, but in general, we tell patients to avoid things that hurt or cause pain,” says Reid Ness, M.D., associate professor of medicine in the division of Gastroenterology, Hepatology and Nutrition at Vanderbilt University Medical Center.
Here are foods to eat if you have an ulcer or are prone to them, and some things you may want to avoid:
1. Broccoli and other high-fiber foods
Research reveals that eating a diet rich in fiber can lower your risk of developing an ulcer. In one study, Harvard researchers followed male participants for six years and found that the risk of an ulcer was 45 percent lower for those with the highest fiber intake, compared with the lowest.
Foods with fiber “coat the lining of the stomach and reduce the damage that gastric acid would have on the stomach lining, thereby reducing the formation of ulcer or preventing ulcer formation,” says Devika Kapuria, M.D., a gastroenterologist and assistant professor at the Washington University School of Medicine in St. Louis.
Top choices: Broccoli, as well as other cruciferous vegetables, leafy greens, berries, oatmeal, high-fiber cereals and whole-grain breads
2. Sweet potatoes and other foods high in vitamin A
Sweet potatoes are one of the richest sources of vitamin A, and a few small studies indicate the root vegetable appears to have anti-ulcer properties. The same Harvard study described above found that diets high in vitamin A were associated with a 54 percent lower risk of ulcers.
Top choices: Besides sweet potatoes, other good sources of vitamin A include carrots, squash, kale, spinach, broccoli, tomatoes, red bell peppers, cantaloupe and mango. Many breakfast cereals, juices and dairy products are fortified with vitamin A.
3. Yogurt with live active cultures and other foods with probiotics
Probiotics, the living organisms found in yogurt and other fermented foods, are good for your gut.
Early studies indicate that probiotics can help counteract the H. pylori bacteria that cause ulcers. A small, double-blind, randomized trial in 2015 found that pairing probiotics with the standard antibiotic treatment for ulcers improves effectiveness.
4. Cranberries and other colorful fruits and vegetables
There is some evidence that berries rich in flavonoids, or polyphenols, can help combat peptic ulcer disease. Flavonoids are known as “gastroprotective” because they increase mucus to protect the lining of the stomach.
Flavonoids, particularly those in cranberry juice, have been shown to slow or suppress H. pylori growth in research studies. In one double-blind, randomized trial published in 2021 in the Journal of Gastroenterology and Hepatology, people who drank cranberry juice twice a day for eight weeks had a 20 percent drop in their H. pylori infection rates compared with those who consumed lower amounts of juice or a placebo. Even those who drank the juice once a day saw improvement.
Top choices: In addition to cranberries, try blueberries, blackberries, cherries, red grapes, red cabbage and leafy greens.
6 substances you may want to avoid if you have a stomach ulcer
1. Alcohol
Alcohol is “a toxin that damages the lining of your stomach and causes inflammation,” Kapuria says. Research indicates that alcohol consumption may increase your risk of getting an ulcer, and one study found that heavy drinking increases the risk of a bleeding ulcer fourfold.
If you have an ulcer, alcohol will make it more painful and can interfere with healing. “If you drink enough, you can worsen preexisting ulcers,” Kapuria says.
2. Coffee and soda
Coffee, in both its caffeinated and decaffeinated forms, stimulates the production of stomach acid, Kapuria said. The same goes for soft drinks, which irritate the stomach because of their carbonation.
Some ulcer patients report that the increased acid causes irritation, pain or heartburn. If coffee bothers you, you might want to try a darker roast, which produces less acid, or skip your java fix altogether.
A few studies have shown people who drink three or more cups of coffee a day may have an increased risk of ulcers. However, a large study published in PLoS ONE found no link between coffee consumption and ulcer formation.
Fried foods take longer to digest and can aggravate stomach ulcers.
3. Tomatoes and tomato products
When you have an ulcer, your doctor prescribes acid-reducing medications to create an environment in your stomach for healing, Ness says. If you then eat acidic foods with tomato sauce, “it somewhat negates what we’re trying to do with the medication,” he says.
Some patients who have ulcers find that acidic foods cause a burning sensation.
4. Lemons and other citrus fruits (but only if they cause pain)
Like tomatoes, citrus fruits such as lemons, oranges and grapefruits are acidic, and they can cause pain if you have an ulcer.
However, citrus fruits are high in vitamin C and flavonoids, and some studies show they reduce inflammation and inhibit the spread of H. pylori, so they can be beneficial. Keep them in your diet if they don’t cause discomfort, Kapuria says.
5. Fried and fatty foods
These foods take longer to digest and can cause abdominal discomfort and bloating, aggravating stomach ulcers. “People who already have peptic ulcers may feel worse when they eat those foods,” Kapuria says.
6. Hot peppers and other spicy foods
Scientists used to think spicy foods caused ulcers, but the latest research finds that’s not the case. They can cause discomfort for those who already have an ulcer. Capsaicin — the compound in hot peppers and hot sauce — is a “direct chemical irritant,” Ness says. Exposing what is essentially an open sore in your stomach (an ulcer) to capsaicin can cause pain and burning.
How H. Pylori Causes Ulcers
Thirty to 40 percent of people in the United States have these bacteria living in their stomach, often without obvious symptoms. When allowed to grow unchecked, H. pylori can break down the protective lining in the stomach, leading to an ulcer. The Cleveland Clinic estimates 40 percent of stomach ulcers are linked to H. pylori. Although scientists no longer think stress directly causes ulcers, some speculate that chronic stress on the immune system may allow the bacteria to thrive. Read more about what causes them and the five warning signs of ulcers.
Michelle Crouch is a contributing writer who has covered health and personal finance for some of the nation’s top consumer publications.
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