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胃酸反流与低碳饮食(中英)

胃酸反流与低碳饮食(中英)

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Helicobacter pylori is a microaerophilic bacterium commonly found in the stomach.. It wasestmated H plori was present in over 50% of the world's population. H. pylori infection can cause chronic gastritis and gastric ulcers, and has been linked to the development of stomach cancer. However, whil H plori infection can be treated with antibiotics, over 80% of individuals infected with the bacterium are asymptomatic, and it may play an important role in the natural stomach ecology.

Gastroesophageal reflux disease, or GERD, is another digestive disorder that affects many people. In GERD, the lower esophageal sphincter (LES), the ring of muscle between the esophagus and stomach, has lost control of back flow of stomach contents into esophageal tube, causing heartburn or acid indigestion. The relationship of H. pylori and gastroesophageal reflux disease has been one of controversy. Some early studies suggested that eradication of H. pylori infection would result in an increase in erosive esophagitis and GERD symptoms. Although there are several studies to support this, the weight of the evidence suggests strongly that eradication of H. pylori has no effect on the development of heartburn and in fact does not exacerbate GERD symptoms. There are also several studies that suggest that that H. pylori infection might be protective against severe end organ damage in patients with GERD. While GERD cannot be prevented by elimination of H plori infection, in most cases, it can be relieved through diet and lifestyle changes.

In this case, a middle aged male had been suffering GERD for over 10 years, with various symptoms. H plori infection had been positively identified and was introduced with combiened antibiotics treament. While the infection was gone after treatment, for about three years, there was no reliefe on GERD. At the time, he was relatively healthy with typical Chiese diet, normal blood sugar, normal blood fat, and normal blood pressure levels. He was weighted at175, maybe a lille bite high in body fat ratio . He was very disciplined in his lifestyle with a very balanced diet, no smoking, no spicy fppd, no after meal snakes, and only1ocassionly drinking little bite alcohale and coffee. At the beginning, we had no idear that a low carb diet would have a benefial effect on his acid reflux, and never even thought about it. Just one day, it happened came to our attension, that he had not experienced heatburn for almost two months! With time, we had become more and more confident that his GERD had gone for good.

It has been five years since then, there has been no recurent of any acid reflux symptomes, and we believe the key for his success is low carb diet. Based on my own limited research, this is not an isolated case, and scientifists have strong evidence that low carb diet is effective in treament of GERD. Please refer to the following publication: "Dietary carbohydrate intake, insulin resistance and gastro-oesophageal reflux disease: a pilot study in European- and African-American obese women". If you are interested, you can also get more information by reading :Heartburn Cured: The Low Carb Miracle "by Norm Robillard (2005). " 

幽门螺杆菌是一种常见需氧微生物,是寄生于胃中最常见细菌。据估计,世界上有超过50%以上人有不同程度的幽门螺旋感染。幽门螺杆菌感染常见的危害是慢性胃炎和胃溃疡,是引发胃癌的危险因素。幽门螺旋杆菌感染可以通过抗菌素进行治疗。但是,80%以上的细菌感染者无症状,而且幽门螺旋杆菌本身可能在维系胃生态中起重要作用。胃食管反流病或GERD是另一种影响许多人的消化系统疾病。在GERD中,食管下括约肌(LES)连接食道和胃之间的肌肉环,不能正常工作导致胃内容物回流到食管,引起烧心等一系列不适。幽门螺杆菌感染与胃食管反流病的关系一直是争议的问题之一。一些早期研究表明,根除幽门螺杆菌感染会导致糜烂性食管炎和GERD症状增加。但是,大量研究证据表明,根除幽门螺杆菌对胃酸返流导致的烧心的发展没有影响,并没有加剧GERD症状。也有一些研究表明,幽门螺杆菌感染可能对GERD患者的严重终末器官损害具有保护作用。所以,虽然阻止幽门螺旋杆菌感染有重要意义,但是消除细菌感染通常不能预防或治疗GERD带来的问题。在大多数情况下,可以通过饮食和生活方式的改变来缓解GERD。

这个病例资料来源于文学城“虎嗅蔷薇”网友,承蒙她允许翻译引用有关资料,非常感谢。

“我先生受胃酸反流的种种不适困扰长达10年以上。专科医生确诊有幽门螺杆菌。在三联疗法治愈幽门螺杆菌感染之后的两三年,GERD症状并无缓解。采纳低碳饮食法之前,他并无肥胖症,最高体重在175磅。但我觉得他内肥是有的。当时的饮食是相当标准的均衡饮食。而且他饮食习惯定时定量,非常规律,可以说和时钟一般刻板。没有吃点心和暴饮暴食的习惯。不抽烟,不吃辣,少喝酒。喝咖啡。血脂血糖血压指标全部正常。 我们起初并不知道低碳饮食会有治疗GERD的效果,所以一开始根本没有注意这方面的反应。大约一两个月后才忽然意识到......他许久没有烧灼感了! 后来随着时间的推移,开始越来越确定他的GERD是真的好了。至今已有5+年的历史。

由于熟悉他的病史和他的症状消失得彻底,我确信这是减少碳水量所带来的变化。随着对低碳饮食的了解越来越多,发现原来这种效果根本不是我先生独此一家的个例,而是在low carbers里相当普遍的现象”。 “有没有对这个问题的科学研究?有的。大家可以看看这个,算是一个低碳饮食治疗胃酸反流的代表: Dietary carbohydrate intake, insulin resistance and gastro-oesophageal reflux disease: a pilot study in European- and African-American obese women 这个研究的对象是肥胖GERD女病人,采用高脂低碳饮食10周后,毫无例外的所有病人的胃酸反流症状全部消失,所有的药物都不需要了,全停: “By the end of diet week 10, all GERD symptoms and medication usage had resolved in all women.” 也有一些其他的研究,我就不贴了。 如果真对这个方法感兴趣,还可以看这本书,"Heartburn Cured", 作者是个microbiology博士。此人是个资深GERD受害者,20多年的病史,原以为要一辈子吃PPI药了。他的经验是开始控制碳水后第二天,折磨了他20多年的不适症状就消失了。Too good to be true? You be the judge. 若不是我lg的亲身经历,我肯定也会怀疑。 我对lg经历的感想是:他以前符合标准饮食指南的均衡饮食对他来说非常不适合,可以说是一种致病饮食。我怀疑世界上有某一种特定饮食结构是适合所有人的。对许多人适合的饮食,不见得适合其他人。标准指南要参考,但不宜盲目硬套,否则可能变成以自己的体质去适应不适合自己的指南,削足适履。胃酸反流非常普遍, 不知道有多少比例是由于碳水量过高引起的。我们的家庭医生和专科医生从来没有提及这个问题,估计大部分病人自己想也想不到。一边吃着伤害自己的饮食,一边以为自己的饮食很健康,很均衡,没有需要改的地方。同时一边困惑, 一边长久吃药来缓解不适”。

关于低碳饮食的作用和需要考虑的问题,下面谈谈个人的体会,供桃花网友参考。

低碳饮食的宗旨,是通过生活方式,特别是饮食结构的改变,改善消化系统功能。所以,不是为了治病,不是为了替代治疗,大家应该区分两者差别;低碳的标准是什么,要根据每个人年龄,性别,工作生活环境,以及特殊需求来确定;注意征求医生的意见,并随时进行必要调整。我遇到过的问题有两个:体重下降过快和贫血,体检发现问题后根据医生意见进行了调整。

饮食结构:

  1. 主食,燕麦片,,全麦面包(黑面包),有机整玉米(不是商店那种甜玉米,一般的玉米,比较硬,我这里farmers market 买的)。。我彻底断绝大米饭,包子馒头面条等。
  2. 副食:雨柔,鸡胸肉,牛肉,猪肉,鸡蛋,豆制品(豆腐,豆腐干,豆腐丝,豆腐泡等)。因为我的血脂,胆固醇,血压均没有问题,不用考虑太多鸡蛋问题;
  3. 蔬菜:尽量多样。我有一段时间血钾稍高,医生给了一个卡片,上面有各种蔬菜含钾多少,贴在冰箱上很方便。不过后来再也没有过问题,提醒你注意体检测量一下所有指标
  4. 水果:排除瓜果类,柑橘类(含糖高),其它不限,但是以苹果,蓝莓,草莓,猕猴桃,葡萄为多
  5. 零食:黑巧克力,坚果,从不例外。现在看见满桌子糕点糖果什么的,一点诱惑力也没有了
  6. 饮料:只喝水,有时候泡泡茶,偶尔一杯红酒,不沾任何含糖饮料汽水什么的。不喝牛奶,中医不喜欢牛奶。

我个人和一些朋友的体会是,低碳饮食与适当锻炼结合,可以有效改善消化系统功能,对于高血糖高血脂高血压以及消化不良都有很大帮助,减肥就更不用说了。这个饮食结构不需要额外投资,简单易行,难就难在意志力,很多人尝试,但是总会找借口放纵自己,最后三天打鱼两天晒网,然会就不了了之了。无论拟采用那种饮食结构,维持一个有规律的生活习惯都很重要。人体内脏器官的功能经常是一种自主性条件反馈,而不受意识控制。

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来源: 文学城-doldentate1
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