Foods to Eat and Avoid With a Peptic Ulcer

November 25, 2019AGNES JOSEPHNews

Peptic ulcers are painful, open sores that develop on the inside lining of the stomach (gastric ulcers) and the upper portion of the small intestine (duodenal ulcers). Given that they’re located along the path that food and beverages travel during digestion, it’s not surprising that certain things a person with ulcers eats and drinks could irritate these lesions.

One of the best ways to manage peptic ulcers, then, is by steering clear of foods and beverages that are known to aggravate them. Here’s a quick overview of the causes and symptoms of peptic ulcers, plus comprehensives lists of foods that are good and bad to eat if you have them.

Causes and Symptoms

Most peptic ulcers are caused by a bacterium called Helicobacter pylori (H. pylori) that takes up residence in the stomachs of more than half the people in the world, usually during childhood.

H. pylori can damage the mucosal lining of the gastrointestinal (GI) tract, making it easier for acidic digestive juices to cause damage and inflammation.

Another cause of peptic ulcers is long-term use of aspirin and certain other painkillers—specifically non-steroidal anti-inflammatory medications including Advil and Motrin (ibuprofen) and Aleve and Anaprox (naproxen). Smoking also may play a role in the development of ulcers, and there’s some indication that certain people are genetically predisposed to them.

Contrary to long-standing myths about what causes ulcers, neither spicy foods nor excessive stress plays a role. However, both of these can make the following symptoms of peptic ulcers worse:

• Stomach pain
• Bloating
• Belching
• Heartburn
• Nausea
• Fatty food intolerance

Dietary Goals

Acids produced by the stomach when certain foods are eaten can bring on the classic burning pain of peptic ulcers, so avoiding those foods is key to preventing flare-ups.

It’s also important to know that having an empty stomach can worsen pain, and so choosing foods that help to buffer stomach acid can be a helpful strategy for managing ulcers. Medications that reduce stomach acid also can help.

As much as food plays a role in the appearance of peptic ulcer symptoms, how you eat also factors in. By focusing on better eating habits, you can significantly reduce the impact and severity of a peptic ulcer.

Eating Tips

• Eat five or six small meals a day rather than three large ones.
• Sit upright in a chair while eating rather than slouching on the sofa, lying in bed, or eating on the run.
• Rest and relax a few minutes before and after each meal.
• Eat slowly and chew each bite thoroughly.
• Have your last meal or snack at least three hours before bedtime.

Foods to Eat

There are certain foods that are easier on the stomach when nursing a peptic ulcer. They include foods that are lower in fat, acidity, and spiciness, including:

• Most fresh, frozen, or canned vegetables and fruits
• Milk and dairy products, including low-fat and non-fat yogurt and cottage cheese, and plain mild cheese with fewer than 5 grams of fat per ounce
• Whole-grain or enriched seedless bread and grains, including bagels, tortillas, English muffins, pita bread, buns, dinner rolls, low-fat crackers, cereals, barley, rice, and pasta
• French toast, muffins, pancakes, and waffles made with low-fat ingredients
• Lean meats, including beef, pork, lamb, veal, skinless poultry, crisp bacon, lean ham, fresh or frozen fish, or water-packed canned fish
• Eggs
• Smooth peanut butter and other nut butters
• Tofu and other meat substitutes
• Beans and peas cooked without fat
• Soups and mildly seasoned meat stock
• Fats (used sparingly), including non-fat or low-fat mayonnaise and salad dressings and light or low-fat margarine
• Sweets, including sugar, syrup, honey, jelly, seedless jam, marshmallows, hard candy, sherbet, fruit ices, gelatin, angel food cake, graham crackers
• Low-fat snacks such as pretzels and rice cakes
• Salt, pepper, mild spices and seasonings, most herbs, ketchup, mustard, and vinegar (in moderation)
• All beverages as tolerated

Foods to Avoid

On the flip side, to avoid symptoms of a peptic ulcer, you need to lower your fat intake and avoid foods that trigger stomach acid and irritate open sores. These include:

• Fried foods
• Spicy foods
• Coffee (including decaf), tea, and cola
• Carbonated beverages
• Citrus fruits and juices (pineapples, berries, figs)
• Chocolate
• Alcohol
• High-fat carbs, such as croissants, biscuits, muffins, granola and bran cereals, bread that contain nuts or seeds, wild rice, and crackers
• Raw vegetables, as well as corn, broccoli, Brussels sprouts, cabbage, onions, cauliflower, cucumbers, green peppers, rutabagas, turnips, sauerkraut, tomatoes, and vegetables prepared with added fat
• Tomato-based products, like soups and sauces
• Whole milk, chocolate milk, buttermilk made with whole milk, evaporated whole milk, cream, and strong cheeses
• Highly seasoned meats, poultry, and fish, including corned beef, luncheon meats, frankfurters, other sausages, sardines, and anchovies
• Fatty meats
• Dried beans and peas cooked with fat
• Chunky peanut butter
• Nuts and seeds
• Gravy
• Cream soup
• Highly seasoned salad dressings
• High-fat snacks, such as chips and buttered popcorn
• Desserts, including cake, cookies, pie, pastries, doughnuts, chocolate, creamy candies, and any sweets and desserts containing nuts, coconut, or fruit
• Strongly flavored seasonings and condiments, such as garlic oil, barbecue sauce, chili sauce, chili pepper, chili powder, horseradish, and black pepper
• Pickles

In addition to avoiding certain foods, make an effort to stop smoking while nursing a peptic ulcer and avoid nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, Advil and Motrin (ibuprofen) and Aleve (naproxen) until you are fully healed.

Article Sources

1. Ramakrishnan K, Salinas RC. Peptic ulcer disease. Am Fam Physician. 2007;76(7):1005-12.
2. Vomero ND, Colpo E. Nutritional care in peptic ulcer. Arq Bras Cir Dig. 2014;27(4):298-302. doi:10.1590/S0102-67202014000400017016

Additional Reading

• Canadian Society of Intestinal Research. Diet for Ulcer Disease.
• Mayo Clinic. Helicobacter Pylori (H. Pylori) Infection.