Gettyimages 165658956 Stomach Pud Resized

Peptic ulcer disease is very common among older adults.  It is a condition in which open sores develop on the inside lining of your stomach and the upper portion of your small intestine (the duodenum). Research suggests the main causes of peptic ulcers are Helicobacter pylori (H. pylori) infection, prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs), and unhealthy lifestyle factors, such as smoking, excessive alcohol use, and eating an unhealthy diet.

The elderly are more at risk for peptic ulcer disease because of frequent NSAID usage, age, and the presence of H. pylori. Research suggests that up to 40% of elderly patients take an NSAID daily. Also, the incidence of H. pylori ranges from 53-73% in the elderly population, contributing to an increased risk of ulcers. Peptic ulcer disease can cause burning stomach pain, difficulty swallowing food, feeling uncomfortable after eating, weight loss, poor appetite, and diarrhea. Pain tends to be worse 1-3 hours after eating and at night.  Medical treatment should take place to avoid severe complications such as internal bleeding, perforations, obstructions, and gastric cancer. Evidence suggests that certain dietary interventions may help prevent and treat stomach ulcers. Making some dietary changes can help alleviate symptoms, help keep the body healthy, and help reduce the risk of developing stomach ulcers.

There are certain foods that buffer stomach acid and can help decrease discomfort and pain. A diet high in fiber is advised because fiber acts as a buffer, reducing concentrations of bile acids in the stomach and the intestinal transit time. This results in less abdominal bloating and pain.  Milk may temporarily soothe ulcer pain because it coats the stomach lining. However, milk also causes your stomach to produce more acid and digestive juices, which can actually make ulcers worse. Limiting foods such as this that increase acid production can help relieve symptoms. It is recommended to eat 5-6 smaller meals throughout the day, rather than 3 large meals to help reduce the production of stomach acid.

Try following these nutrition tips below to help with peptic ulcer disease:

Foods to Avoid:

  • Alcohol: Alcoholic beverages can erode the protective mucosal lining along the gastrointestinal tract and lead to further inflammation and bleeding.
  • Spicy foods
  • Fried foods
  • Acidic foods
    • tomatoes
    • citrus fruits, such as lemons, oranges, and grapefruits
    • refined carbohydrates, such as white bread, white rice, and processed cereals
    • soda
  • Coffee (even decaffeinated coffee): Coffee can increase acid production and exacerbate symptoms.
  • Soft drinks: along with increasing acid production, soft drinks are gaseous and cause gastric distension and indigestion.

Foods Recommended:

  • Low fat or non-fat dairy
  • Tender well-cooked lean meat, poultry, fish, and eggs
  • Whole grains prepared without added fat — aim for a minimum of five servings of whole grains daily. Research shows that a high fiber diet decreases the risk of developing ulcer disease.
  • All varieties of fruits and vegetables
  • Limit to <8 teaspoons of oils and fats daily. Chose olive or canola oil and low-fat salad dressings and mayonnaise.

Make sure to follow your medical providers advice and take all medications as prescribed. Stomach acid makes the pain worse, as does having an empty stomach.  If there is an excess of stomach acid your medical provider may prescribe proton pump inhibitors (PPIs) to help reduce the amount of acid the stomach produces. If prescribed a proton pump inhibitor (PPI) make sure they are taken correctly. PPIs require a meal to activate them. A meal should be eaten within 30 minutes to 1 hour after taking a PPI for the acid suppression therapy to work most effectively. Waiting longer than this can decrease the effectiveness of this medication.

There is some research that suggests alternative medications may be helpful to relieve signs and symptoms of peptic ulcer disease. As with all treatments, speak with your doctor before trying these or other supplements, as they may interfere with treatments for other issues. See the list below for some alternative treatments.

  • Bismuth containing products- may help with symptoms of a peptic ulcer.
  • Zinc- There is some evidence that zinc can help heal ulcers.
  • Probiotics such as Lactobacillus, which is naturally present in the gut, could help restore the natural balance of bacteria. H. pylori infection can upset the balance of bacteria in the gut.
  • Omega-3 fatty acids may lessen the impact of gastritis.

Preventing stomach ulcers may be possible by following a balanced, nutritious diet and cutting back on processed foods, smoking, and alcohol consumption. Making some dietary changes has proven to decrease discomfort and symptoms in peptic ulcer disease. Along with dietary changes, make sure to also seek a physician’s advice about medications to reduce symptoms and prevent complications.


Nutrition Care Manual: