Sucralfate Diet: Foods To Eat And Avoid

Sucralfate is a medication used to treat duodenal ulcers, which are sores that form in the lining of your small intestine. 

Common brand names for sucralfate include Orafate, ProThelial, and Carafate.

Sucralfate comes in both liquid and tablet forms and is taken orally (by mouth). Typical doses of sucralfate are usually around one gram (1,000 milligrams) twice to four times daily. 

It’s used in adults and can also be used in children, though its safety hasn’t been established in children younger than 14.

Sucralfate is in a class of drugs called protectants, which work to heal duodenal ulcers by coating and protecting the ulcer from stomach acid.

Peptic ulcers are estimated to impact up to 6% of the United States population. 

Contrary to the previous belief that stress causes ulcers, there are known risk factors, like using common over-the-counter medications and getting certain bacterial infections.

If you are one of the 6%, your healthcare provider might prescribe sucralfate to help you heal from your ulcer. 

What is sucralfate, and how does it work? We’ll answer those questions as well as suggest foods to eat and avoid while taking sucralfate in this article.

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What is Sucralfate used for?

Sucralfate is most commonly used to treat duodenal ulcers but can also be used for:

  • Epithelial wounds (wounds in the thin lining of your skin or internally)
  • Chemotherapy-induced mucositis (inflammation of your mouth or gut from chemotherapy)
  • Radiation proctitis (inflammation of the skin of the rectum)
  • Ulcers in a condition called Behcet disease
  • Burn wounds

Sucralfate allows duodenal ulcers to heal by coating them in a protective barrier, protecting the exposed inner lining of the intestine from highly acidic stomach acid, which can further erode duodenal ulcers.

Duodenal ulcers cause symptoms like:

  • Feeling very full and bloated after eating
  • Indigestion
  • Nausea
  • Stomach/abdominal pain
  • Weight loss

How quickly does Sucralfate work?

Sucralfate begins to work 1-2 hours after you take it, with one dose lasting around six hours.

The medication also helps neutralize stomach acid, meaning it becomes less acidic (the acidity is what can break down an open ulcer).

Sucralfate should heal an ulcer within eight weeks of taking it. You might respond more quickly than this, but it depends on the severity of your ulcer, your dose, and other factors.

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Foods to avoid while taking Sucralfate

Citrus fruits/acidic foods

One of the groups of foods most commonly recommended to avoid if you have ulcers is acidic foods, such as citrus fruits and tomatoes.

Your stomach acid is more acidic than these foods, but eating a diet high in acidic foods can worsen ulcer symptoms in some people. 

However, there isn’t strong evidence to avoid acidic foods, so only do so if they worsen your symptoms.

Some foods that are considered acidic to (potentially) avoid while taking Sucralfate include:

  • Blueberries
  • Grapefruit
  • Grapes
  • Lemons
  • Limes
  • Oranges
  • Peaches
  • Pineapples
  • Plums
  • Tomatoes

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Spicy foods

Certain spices might aggravate duodenal ulcers being treated by sucralfate, which could potentially hinder your healing and make sucralfate less effective.

If you notice that spicy foods worsen your symptoms, you should avoid them while taking sucralfate. 

Some examples of spices that might worsen ulcer pain include:

  • Chili powder
  • Nutmeg
  • Mustard powder
  • All types of pepper (cayenne pepper, black pepper, etc.)

High-fat foods

Greasy and fried foods take longer to digest, so they might worsen ulcer symptoms like nausea and stomach pain when eaten

Eating these foods can also trigger your stomach to produce more stomach acid and digestive enzymes, which can worsen ulcer pain and hinder sucralfate’s ability to heal ulcers.

Besides the obvious greasy and fried foods like fast food and other convenience foods (pizza, hot dogs, French fries, etc.), some high-fat foods to avoid while taking sucralfate can include:

  • Beef (especially non-lean cuts)
  • Butter
  • Cheese
  • Coconut (including coconut oil)
  • Ice cream
  • Lamb
  • Lard and cream
  • Palm oil and palm kernel oil
  • Pork
  • Poultry with the skin on
  • Some baked and fried foods that use high-fat ingredients like butter, lard, etc.

Dairy products (for some people)

Dairy products can worsen the symptoms of stomach issues for some people, including ulcers. If dairy products seem to worsen your ulcer symptoms, then you should avoid them while you take sucralfate.

However, some dairy products might offer some benefits for ulcers (such as fermented dairy products – more on that in the ‘foods to eat’ section), so you shouldn’t necessarily avoid all dairy products unless it’s a culprit for worsening ulcer pain.

Some dairy products to (potentially) avoid on sucralfate include:

  • Milk
  • Cream
  • Cheese
  • Yogurt
  • Ice cream
  • Dishes made with any of these ingredients (puddings, custards, cream pies, etc.)

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Gas-forming foods (if they worsen symptoms)

If you’re experiencing stomach pain or a feeling of fullness due to your ulcers, you’ll want to avoid foods that can cause excess gas formation. 

These foods are healthy and nutritious, so if they don’t cause excess gas formation, then you don’t need to avoid them in your diet while taking sucralfate.

Foods that can cause gas formation include:

  • Apples
  • Artichokes
  • Asparagus
  • Beans and lentils
  • Bran
  • Broccoli
  • Brussels sprouts
  • Cabbage
  • Cauliflower
  • Onions
  • Peaches
  • Pears
  • Prunes
  • Whole wheat products

Foods to eat while taking Sucralfate

Probiotic-rich foods

Fermented foods are a good source of probiotics, which are beneficial bacteria that can help support healthy digestion. Probiotics might also help prevent and heal ulcers, according to a study!

In addition, probiotics can be recommended if you’re taking antibiotics to treat an H. pylori infection, a common cause of duodenal ulcers.

You can take probiotic capsules for a more concentrated dose of probiotics, but they’re also naturally found in foods like:

  • Yogurt
  • Kefir
  • Sauerkraut
  • Tempeh
  • Kimchi
  • Kombucha

Lean protein and healthy fats

Since high-fat foods (often sources of protein) might worsen ulcer symptoms, you might be wondering what types of protein you should be eating while taking sucralfate.

Protein can help rebuild damaged tissue and promote the formation of new, healthy tissue. This is important for ulcer healing while taking sucralfate.

Lean protein and foods rich in anti-inflammatory fats (omega-3 fats) are recommended over high-fat/greasy/fried foods while taking sucralfate. 

Some lean proteins or foods rich in healthy fats include:

  • Eggs
  • Lean meat (lean beef, skinless poultry, white meat fish, etc.)
  • Low-fat dairy products (if tolerated/not a trigger) such as yogurt, cheese, and milk
  • Nuts and seeds
  • Salmon
  • Vegetable oils (olive oil, canola oil, etc.)

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Fruits and vegetables

Fruits and vegetables are a good source of fiber, a nutrient that is important for promoting healthy bacteria in your digestive system. 

Eating fiber is especially important if you’re also taking antibiotics to treat your duodenal ulcer, such as in the case of an H. pylori infection.

Not only are fruits and vegetables rich in fiber, but they’re a natural source of antioxidants, which help fight inflammation and promote healing.

Aim to get a variety of fruits and vegetables, preferably in a variety of colors such as blue, green, purple, and orange. 

Getting a variety of colors ensures you’re getting the different antioxidants that are unique to differently pigmented produce.

Summary of foods to eat and avoid on sucralfate

Foods to eatFoods to avoid
Probiotic-rich foodsCitrus/acidic foods
Lean proteinSpicy foods
Healthy fatsHigh-fat foods
FruitsDairy products 
VegetablesGas-forming foods

Can you drink alcohol while taking Sucralfate?

Alcohol is damaging to the lining of your digestive tract and can cause ulcers. You should avoid drinking alcohol while treating an active ulcer since drinking might inhibit ulcer healing.

All forms of alcohol have the potential to be problematic, including:

  • Hard alcohol
  • Beer
  • Wine
  • Cocktails

How long after taking sucralfate can I drink alcohol?

Once you have stopped taking Sucralfate and have recovered from your ulcer, ask your doctor or pharmacist if it’s safe to start drinking alcohol again.

Can I drink coffee with Sucralfate?

The evidence that caffeine worsens ulcers is inconsistent. 

Caffeine isn’t directly linked to the formation of ulcers, but it might irritate active ulcers in some people (caffeine is considered a gastric irritant). 

It also stimulates your digestive tract, which might worsen symptoms like stomach pain and nausea from duodenal ulcers.

Consuming some caffeine may be perfectly tolerated while taking sucralfate, but if caffeine seems to be a trigger for you, you should aim to limit or avoid it.

Caffeine is found in the highest amounts in foods and drinks like:

  • Black teas
  • Caffeinated sodas
  • Coffee (especially strong coffee like espresso shots)
  • Energy drinks
  • Dark chocolate (caffeine is in cocoa solids)

Can you take Sucralfate with NSAIDs?

It might be best to avoid using NSAIDs while taking Sucralfate. Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most well-known causes of ulcers. These drugs reduce your digestive tract’s ability to protect itself from stomach acid, which increases the risk of developing an injury (ulcer) to the mucosal lining.

Some examples of commonly-used over the counter NSAIDs include:

  • Ibuprofen (Advil)
  • Naproxen
  • Aspirin (in higher doses)

However, certain prescription pain relievers are also considered NSAIDs, which is why it’s important to review your medication list with your healthcare provider if you’re prescribed sucralfate.

If you need to use over-the-counter pain relievers while you’re being treated for a duodenal ulcer, you should consult your healthcare provider to determine which medication will be best suited for you.

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Should you take Sucralfate with food?

No. Sucralfate must be taken on an empty stomach for it to be effective. The medication needs time to reach your stomach and intestines and coat the ulcers without the presence of food. 

Therefore, you also cannot eat right after taking Sucralfate. It should be taken two hours after or one hour before meals.

What happens if you take Sucralfate with food?

If you take sucralfate with food, its efficacy will be reduced, and you might not heal from your duodenal ulcer as quickly as if you take it on an empty stomach.

Rest assured that taking sucralfate with food isn’t necessarily dangerous, but it does reduce its effectiveness. 

Can you drink liquids after taking Sucralfate?

It’s fine to take sucralfate with water, but you should avoid drinking large amounts of liquids for around an hour after taking your dose. 

Drinking large amounts of liquid after taking sucralfate might interfere with its ability to coat your intestinal lining, so it’s better to avoid liquids right before and after you administer your dose.

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Conclusion

Sucralfate is a medication used to protect the lining of your intestine to allow duodenal (intestinal) ulcers to heal. It can be used for other things as well, but this is its primary function.

You should avoid eating and drinking things that could potentially inhibit the healing of duodenal ulcers or worsen symptoms from the ulcer. Some foods to avoid while taking sucralfate can include acidic foods, spicy foods, high-fat foods, dairy products, and gas-forming foods.

Foods to eat while taking sucralfate (to support healing) include probiotic-rich foods, lean proteins, healthy fats, fruits, and vegetables.

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Sources

  1. Kudaravalli P, John S. Sucralfate. [Updated 2022 Feb 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan.
  2. Khoder G, Al-Menhali AA, Al-Yassir F, Karam SM. Potential role of probiotics in the management of gastric ulcer. Exp Ther Med. 2016.

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