Diet taboos for atrophic gastritis

There is no "absolute fasting list" that everyone must abide by. There is only one core taboo - avoid foods that will directly damage the gastric mucosa and disrupt the rhythm of gastric acid secretion. As long as you eat the rest without discomfort, there is no need to overeat.

I met 52-year-old Aunt Zhang in the outpatient clinic before. She was diagnosed with the mildest type of C1 atrophy. She was so frightened by the report that she ate white porridge and steamed buns for three months and stopped eating all meat, eggs and milk. When she was reexamined, not only did her acid reflux become more severe, she was also found to have hypoalbuminemia, and her face was swollen. In fact, she just avoided the misunderstanding that many people make: she thinks that for atrophic gastritis, the softer and lighter the food, the better, regardless of her body's reaction.

Speaking of this, someone must ask, is it true that pickled foods must not be touched as mentioned on the Internet? In fact, academic circles have always had different views on this point. Traditional gastroenterology advice is that pickled foods high in salt and nitrite will aggravate oxidative damage to the mucosa and increase the risk of intestinal metaplasia and dysplasia. If you can avoid it, don’t eat it. ； However, in recent years, clinical observations have also found that patients with atrophy who have insufficient gastric acid secretion, occasionally eating less than 10g of fresh and refreshing kimchi (the kind that has only been pickled for 1-2 days and has a low salt content) can stimulate gastric acid secretion and improve the problems of bloating and indigestion after meals. The key point is not to eat the salty old pickles that have been pickled for more than half a month, and don't eat them every now and then, just once a week at most to satisfy your cravings.

And the most frequently asked question is "can I eat spicy food?" There is really no one-size-fits-all approach. If you grew up in Xianggui, Sichuan, Chongqing, and Hunan, you won’t feel uncomfortable eating spicy food every time. If you are diagnosed with atrophy, you don’t have to say goodbye to peppers directly. Eating a small amount of slightly spicy fresh peppers can promote blood circulation in the mucous membrane, which is good for repair. ； But if you have symptoms of acid reflux, heartburn, or stomach pain whenever you eat spicy food, especially spicy strips and spicy hot pot with industrial chili essence, you really should not touch them. The atrophic gastric mucosa is like thinned soil. If you splash irritating things on it, it will definitely be more likely to cause problems.

Oh, by the way, there are two categories that you should try to avoid no matter what type of atrophy you have or whether you have symptoms: one is food with a temperature exceeding 65°C, such as freshly boiled soup, freshly grilled skewers, and freshly cooked hot pot shabu-shabu, which you blow twice before stuffing it into your mouth. The WHO has long classified hot drinks above 65°C as Class 2A carcinogens. The atrophic mucosa itself has poor repair ability. If you are repeatedly burned, the risk of cancer will increase several times.； The other type is processed meat products, such as vacuum-packed ham, bacon, roadside sausages, and bacon. The nitrite and preservative contents in them are very high. Statistics from the 2022 "Chinese Journal of Gastroenterology" show that patients with atrophy who eat processed meat products more than three times a week have a 47% higher risk of intestinal metaplasia progression than those who do not eat them. They really should eat less.

What many people think is good for the stomach may actually be a scam. For example, high-alcohol liquor will directly damage the mucosal barrier regardless of whether you drink it for a small amount. Friends who have atrophy are really recommended to quit. ； There is also strong tea and strong coffee drank on an empty stomach. The caffeine in them will stimulate the excessive secretion of gastric acid. If you have atrophy and erosion, you will most likely be in pain for a long time after drinking it. By the way, there is also milk. Some doctors say that drinking milk can neutralize gastric acid and protect the stomach. Some say that people with lactose intolerance will become bloated after drinking it. Whether you want to drink it or not is completely up to you. Drink it if you feel comfortable. If you feel bloated, switch to sugar-free yogurt. There is no need to force it.

In fact, over the years, the problem for many patients with atrophy is not that they have no dietary taboos, but that they have too many taboos. There was a patient who didn't even dare to eat apples, saying they were too hard. In fact, if you cut them into small pieces and chew them, or steam them until soft and eat them, supplementing with vitamins will actually be good for mucosal repair. You really don’t need to check the fasting lists on the Internet one by one. Your stomach is more accurate than all the lists: you can eat if you feel comfortable after eating, there is no pain, no bloating, and no acid reflux. ； If you feel uncomfortable after eating it, don’t touch it even if others say it will nourish your stomach.

One final word, the core of disease control for atrophic gastritis is never taboos, but regular gastroscopy review, and dietary adjustment is only a supplement. Don’t reverse the priorities.