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Does irregular meal pattern cause stomach ulcer?


Certainly, it is important to maintain a schedule for eating. In this report by SADE OGUNTOLA, experts say that irregular meal patterns over a prolonged period can be associated with increased risk of developing an infection that puts one at risk of stomach problems, including stomach ulcer.

These days, people lead a hectic and stressful life, obviously noticed by not eating regular meals; hence stomach problems have become common over the years. The most common symptoms include nausea, burping and dull pain right below the heart. Some people might lose their appetite, while others are inclined to feel an acute hunger, along with an upset, hollow, fiery feel, although they might have eaten a meal shortly before. Some might even experience recurrent, acute pangs, indigestion or heartburn.

Doubtless, skipping meals can veer individuals towards poor snacking behaviour, low energy levels and decrease in muscles, evidence suggests that irregularity in meal timing over a prolonged period can be associated with increased risk of developing Helicobacter pylori (HP)  infection and gastritis.

In a study, researchers found that deviating from regular meal timing by two hours or more was associated with a 13-fold increase in risk of developing HP with gastritis, and a six-fold increase in risk of developing gastritis.

This study to determine whether a prolonged irregular meal pattern is associated with increased risk of gastritis and HP involved 323 subjects. They were divided into three groups: subjects with HP infection and gastritis, subjects with gastritis, and a control group.

Each participant was interviewed on eating habits and meal timing. The duration of meal timing deviation is about eight years as compared to four and half years in the control group.

Irregular meal is taken as a deviation from regular meal timing for one hour or more at least once per week. Factors like probiotic consumption, the presence of stress or any major stressful event prior to diagnosis were addressed as confounders.

After controlling for the potential confounders of gender, age, stress, and consumption of probiotics, they found that deviating from regular meal timing by two hours or more was associated with a 13-fold increase in risk of developing HP with gastritis, and a six-fold increase in risk of developing gastritis. It was in the 2013 edition of the journal, Nutrition.

Dr Temitope Oke, a consultant gastroenterologist, stated that H. pylori infection occurs when H. pylori bacteria colonises and grows in the stomach, with most people not realising they have the infection. This is because they never get sick from it or experience any sign or symptom from the infection.

He said that the few individuals with H. pylori infection that have signs or symptoms experience aches or burning pain in their abdomen, an abdominal pain that worsens with an empty stomach, nausea, loss of appetite, frequent burping, bloating and unintentional weight loss.

Dr Oke, however, said that irregular meal pattern or the quantity of food taken cannot cause H. pylori infection but that individuals get infected with H. pylori from contaminated food and water as well as through direct contact with saliva, vomit or fecal matter where there is poor hand hygiene.

He added, “You get infected with an organism that is present in your meal and if you take a large quantity enough to propagate the infection, it can lead to gastritis.”

Ulcer, gastritis and stomach cancer are all complications of H. pylori infection.  The germ can damage the protective lining of the stomach and small intestine, causing ulcer. About 10 per cent of people with H. pylori will develop an ulcer. In addition, H. pylori infection can irritate the stomach, causing inflammation or gastritis, and much less commonly, stomach cancer.

But not everyone who is exposed to H. pylori germ will become infected. Before a person can be infected with H pylori, the bacteria must penetrate the lining covering of the intestine. The lining of the intestine acts as a natural protective barrier, which limits the penetration of microorganisms.

In the study, the researchers suggested that people who have irregular meal patterns are at higher risk of HP infection or gastritis probably because during the usual meal timing the stomach and intestines produce secretions, free radical scavengers or perhaps some other yet to be discovered chemical, that cause the lining of the stomach to be susceptible to HP infection and gastritis if food is not ingested during this time

According to them, for the infection to cause harm, the HP must efficiently adapt to the gastric niche, a process that takes place over many years and involves regulation of bacterial genes in response to environmental factors. These environmental factors may include, but are not limited to, cigarette smoking, stress, irregularity in meal timing and other dietary factors. Stress has been shown to increase permeability of germs into the linings of the intestine by disease-causing germs as HP.

Experts, in a cross sectional study on the dietary habits and H. pylori infection at a Lebanese hospital, said that socio-demographic and clinical variables were more associated with H. pylori, but not with dietary factors.

This cross-sectional study conducted on 294 patients at a tertiary healthcare center in northern Lebanon in 2016, showed that H. pylori infection risk was higher among participants with a university education or above, those with a history of peptic ulcers, gastric adenocarcinoma and vitamin D level below normal.

The study in the journal, BMC Gastroenterology, stated that none of the food items studied was associated with H. pylori infection. The foods included milk, yogurt, salty cheese, red meat, salami or ham, sausages, hot dogs, hamburgers, chicken, fish, green vegetables, tuberous vegetables, and grains.

Previous studies worldwide have investigated the relationship between dietary patterns and H. pylori, with many being published over 20 years ago. Some studies have found that salty, pickled, fermented, or smoked foods increased the risk of H. pylori infection, while another found no association between H. pylori and pickled food.

Moreover, lower consumption of raw vegetables was significantly associated with higher risk of H. pylori infection in a group of Iranian students. A recent case-control study of patients with peptic ulcer in Pune, India found that meat consumption as well as the consumption of restaurant meals increased the risk for H. pylori infection, while chili peppers intake was protective against it.

Similarly, a previous study demonstrated that some types of raw ready-to-eat foods, such as fruit salad, maybe the sources of resistant and virulent strains of H. pylori. The results suggested that raw food products may serve as one route of transmission of H. pylori.



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