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Complications, such as obstruction, perforation, and hemorrhage are infrequent, but normally require surgery as described in Chapter 12. Most cases, however, can be handled by strict attention to dietary wisdom and more effective stress coping mechanisms. Many physicians refuse to treat a person with peptic ulcer who continues to use cigarettes. It is essential to abstain from all tobacco and alcohol. Alcohol stimulates acid secretion, while tobacco interferes with acid neutralization. Coffee and other forms of caffeine also increase acid production, aggravating the tendency to ulcer disease. Spices and condiments gradually erode the mucous protective lining of the stomach and increase the susceptibility to damage by the acid and pepsin present in the gastric glands. Emotional tension must be relieved with periods of meditation, exercise, adequate rest, and the cultivation of a tranquil, accepting personality. Spiritual renewal and prayer are all essentials in achieving this state of peaceful digestion essential to health. Antacids, although popularly used, do not possess curative powers. Neutralization of the acid can be done in alternate more physiologic ways. Small amounts of food, particularly those high in fat content, such as avocados and olives, are helpful to the digestion. They retard acid production, as well as gastric emptying. High protein diets and acid fruits are usually avoided in the acute stages. Vegetable juices are preferable. Liquids on the cool side tend to reduce gastric secretions more than do hot drinks. On the other hand, because of reflex connection to the autonomic nervous system, moist hot packs over the stomach can reduce acid secretion, as well as give a splendid pain relief. These should not be prolonged, but may be used frequently through the day. Within a few weeks, in all but the complicated cases, symptoms will subside. Healing is usually complete. Malabsorption Selectivity in absorbing nutrients is one of the most important characteristics of the human intestine. A newborn baby has the ability to absorb many large protein molecules. This is one of the reasons why antibody protection is secured from the mother’s colostrum, the early form of milk. For this reason, the early introduction of solid foods should be discouraged. Absorption of too many complex proteins can set the stage for food allergies that last a lifetime. Once digestive integrity has been established in infancy the intestinal absorption is quite specific. Proteins must be broken down to amino acids, fats to fatty acids, and carbohydrates to the simple six-carbon sugars— glucose, fructose, and galactose. Absorption of these end-products of digestion requires adequate amounts of specific enzymes. Please refer to