What to Eat When You Have an Ulcer

Dietary Recommendations for Better Management

An ulcer diet is intended to help reduce the pain and irritation that comes from a peptic ulcer—a painful sore that develops on the lining of your stomach, esophagus, or small intestine. Your doctor may put you on medication for your condition, but following an ulcer diet is an essential part of your overall care plan to manage symptoms and help your ulcer heal.

Foods or beverages don't cause ulcers, nor can they cure them. However, certain foods (e.g., fermented dairy foods) can help repair damaged tissue, and those that perpetuate acid build-up and inflammation (e.g., fried choices) may further aggravate your ulcer and threaten your digestive tract's natural layer of protection.

An ulcer diet is appropriate for anyone with an ulcer. It can also help those with gastritis or general stomach irritation.

Your doctor is far more likely to treat your ulcer with medications instead of diet alone, but adding an ulcer diet to your treatment can definitely help you feel better faster and possibly prevent another ulcer in the future.

Benefits

Following an ulcer diet along with other treatment recommendations your doctor suggests can be beneficial because it can:

  • Correct any nutritional deficiencies that may be contributing to your symptoms
  • Provide the protein and other nutrients your body needs to heal
  • Help you eliminate foods that aggravate the lining of your stomach or small intestine
  • Help to control related conditions like Crohn's, celiac disease, or bacterial infections, which might be contributing to your ulcer

Most peptic ulcers are caused by long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), which can erode gastrointestinal lining, or by a bacterial infection known as Helicobacter pylori (H. pylori). An ulcer diet addresses both of these by including certain foods that have antibacterial properties and compounds that help promote healing.

A 2015 review published in The World Journal of Gastroenterology looked at the use of polyphenols, a type of antioxidant compound in many plant foods, to manage peptic ulcers. The authors identified a wide range of polyphenols from foods like apples, grapes, green tea, pomegranates, turmeric, berries, and peanuts that can be beneficial in ulcer management.

Some of the polyphenols helped to heal the stomach erosions faster, and others had antibacterial effects and helped kill H. pylori. The polyphenols in green tea suppressed some of the compounds that trigger inflammation and helped to strengthen the mucosal lining of the stomach.

While spices that add heat to foods are not typically advised on an ulcer diet, a review of studies on diet and H. pylori found that some spices that simply add flavor also help kill the bacteria. Other foods that showed an antibacterial effect include fermented dairy foods like kefir or yogurt. There's also evidence that honey, especially manuka honey, can kill H. pylori and other bacteria.

Of course, there are other possible causes of peptic ulcers as well, and an ulcer diet targets two additional ones in particular—poor nutrition and excessive alcohol use.

How It Works

An ulcer diet works by helping to promote healing, avoiding irritation to the lining of your stomach or duodenum, and limiting excess acid production.

There are no strict rules about which foods to eat, but try to add as many foods as you can from the best choices list, and definitely avoid foods that make you feel worse or trigger excess acid production and reflux.

According to an update on nutritional management of stomach ulcers published in Environmental Disease, it's important to eat a balanced diet with about 30% of your calories coming from healthy and omega-3 rich fats like olive oil, fatty fish, and walnuts. A diet that's too high in fat can aggravate symptoms of an ulcer.

Eating enough protein is also important. While your ulcer is healing, aim for about 1.2 grams of protein per kilogram of your ideal body weight. The remainder of your calories should come from high fiber carbs like legumes, whole grains, fruits, and vegetables. A higher-fiber diet is associated with a lower risk of peptic ulcers. The report also advises adding some zinc and selenium to help with healing.

Duration

You should stay on an ulcer diet until your doctor tells you your ulcer is completely healed. Afterward, you can resume your normal way of eating. However, if you feel better while on the diet or you are have risk factors for ulcers, like smoking, this way of eating may be worth continuing—even if in a modified way.

What to Eat

Compliant Foods

  • Fruits (any, fresh or frozen)

  • Vegetables

  • Legumes

  • Lean meats (e.g.,skinless poultry, lean beef)

  • Fish and seafood

  • Eggs

  • Whole soy foods (e.g., tofu or tempeh)

  • Fermented dairy foods (e.g., kefir or yogurt)

  • Healthy fats like olive oil, avocados, and nuts

  • Whole and cracked grains

  • Green tea

  • Herbs and spices (mild; fresh or dried)

Non-Compliant Foods

  • Alcohol

  • Coffee (regular, decaf)

  • Caffeinated foods and drinks

  • Milk or cream

  • Fatty meats

  • Fried foods/high-fat foods

  • Heavily spiced foods

  • Salty foods

  • Citrus fruits and juices

  • Tomatoes/tomato products

  • Chocolate

Best Choices

Fruits: Any fresh or frozen fruits are good and contribute beneficial fiber and antioxidants. Berries, apples, grapes, and pomegranates are among the best choices for ulcer healing polyphenols. If citrus fruits or juices like orange or grapefruit trigger reflux, avoid those.

Vegetables: Leafy greens, bright red and orange vegetables, and cruciferous vegetables like broccoli, cauliflower, and kale are packed with vitamins and antioxidants that are especially good for your overall health and healing. Avoid spicy peppers and tomatoes/tomato products if they cause reflux. Limit raw vegetables, as they can be harder to digest.

Lean proteins: Skinless poultry, lean beef like sirloin or tenderloin, fish, eggs, tofu, tempeh, dry beans, and peas are excellent sources of low-fat protein. Fatty fish like salmon, mackerel, and sardines provide omega-3 fats, which can reduce inflammation and may be helpful in preventing another ulcer.

Fermented dairy: Products like kefir and Greek yogurt provide probiotics along with protein, so they're good choices.

Breads and grains: 100% whole grain breads and whole or cracked grains like oats, quinoa, farro, millet, or sorghum are good sources of fiber to include in your diet.

Herbs and spices: You can use most mild herbs and spices liberally. They're all concentrated sources of health-promoting antioxidants. Best bets include turmeric, cinnamon, ginger, and garlic, which have antimicrobial and anti-inflammatory properties. For a sweetener, try to use honey instead of sugar.

Foods to Limit

Alcohol: All alcohol is a stomach irritant and will delay healing. Avoid wine, beer, and spirits.

Caffeine: You should cut back or eliminate coffee, tea, and caffeinated sodas, as these can increase stomach acid production.

Milk: Milk used to be recommended as a treatment for ulcers, but the latest research has found that it increases stomach acid, so it's best to avoid it.

Certain meats: Avoid highly-seasoned meats, lunch meats, sausages, and any fried or fatty meats and proteins.

High-fat foods: Try to avoid large amounts of added fats, which can increase stomach acid and trigger reflux. You may need to avoid gravy, cream soups, and highly-seasoned salad dressings. (Healthy fats are OK.)

Spicy foods: You may want to skip anything that is "hot" such as chili peppers, horseradish, black pepper, and sauces and condiments that contain them, especially if they bother you or cause any pain or reflux.

Salty foods: Researchers have found that highly salted foods may promote the growth of H. pylori. Be aware that pickles, olives, and other brined or fermented vegetables are high in salt and are associated with an increased risk of H. pylori ulcers.

Chocolate: Chocolate can increase stomach acid production, and some people find that it triggers reflux symptoms.

Recommended Timing

Try to eat five or six small meals each day, rather than three large ones. Stomach acid is produced every time you eat, but large meals require much more of it for digestion, which can be irritating.

Finish up eating at least three hours before bedtime, and try to stay upright for a few hours after your last bite for improved digestion and less acid reflux.

Take Your Time

Be gentle on your system while your ulcer is healing by chewing your food well and eating slowly.

Cooking Tips

Stick to lower fat cooking methods like roasting, braising, and grilling instead of frying. Also, limit your use of butter and oils when you cook, as these can be harder to digest.

Modifications

In some cases, celiac disease or inflammatory bowel diseases can be associated with ulcers. If you have another health condition that affects your stomach or intestinal tract, it's important that you adhere to those diet recommendations as well as an ulcer diet.

For celiac disease, that means eating only gluten-free grains like quinoa, millet, sorghum, or rice, and taking care to read food labels for sources of hidden gluten.

For inflammatory bowel diseases, this might mean limiting lactose-containing foods, choosing lower-fiber foods, and avoiding things like carbonated beverages.

Considerations

General Nutrition

An ulcer diet should not have a negative impact on your nutrition status. As long as you maintain good variety in your diet, any nutrients the foods you are limiting contain will be provided by other foods.

If you're trying to add more polyphenol-rich foods and fiber to your diet, and cutting back on fatty foods, an ulcer diet may be even more nutritious than your regular diet.

Practicality

It should be fairly easy to stick with an ulcer diet when you're preparing your own meals at home. However, it might be challenging to stay on track when you're traveling, attending parties, or celebrating holidays. If you can't pass up that glass of wine or piece of chocolate cake, make it a small one.

Energy and Health

With fast food, chips, and alcohol off limits, you might find that you're eating healthier, feeling better, and maybe even dropping some weight.

A Word From Verywell

If you have any type of stomach pain, nausea, vomiting or any other gastrointestinal symptoms that last longer than a few days, always consult your doctor. Ulcers can be serious if they cause internal bleeding. An ulcer diet is meant to help, but your doctor should be aware of your efforts and recommend a comprehensive treatment plan.

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Article Sources

  1. Vomero ND, Colpo E. Nutritional care in peptic ulcer. Arq Bras Cir Dig. 2014;27(4):298-302. doi:10.1590/S0102-67202014000400017

  2. Zaidi SF, Ahmed K, Saeed SA, Khan U, Sugiyama T. Can Diet Modulate Helicobacter pylori-associated Gastric Pathogenesis? An Evidence-Based Analysis. Nutr Cancer. 2017;69(7):979-989. doi:10.1080/01635581.2017.1359310

  3. Farzaei MH, Abdollahi M, Rahimi R. Role of dietary polyphenols in the management of peptic ulcer. World J Gastroenterol. 2015;21(21):6499-517. doi:10.3748/wjg.v21.i21.6499

  4. Mandal MD, Mandal S. Honey: its medicinal property and antibacterial activity. Asian Pac J Trop Biomed. 2011;1(2):154-60.

  5. Kulshreshtha M, Srivastava G, Singh MP. Pathophysiological status and nutritional therapy of peptic ulcer: An update. Environmental Disease. 2017 Jul 1;2(3):76.

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