1. since you are giving a long history of ulcer, thus apart from scarring 'pyloric stenosis' is also possible, thus analysis of gastric aspiration and Barium meal
X-ray of stomach and duodenum is essential.
2. since Pernicious Anemia
[PA] is an AUTOimmune disorder i.e. the body’s immune system attacks and destroys the stomach’s mucosal cells: as a result Intrinsic Factor
[IF] can no longer be made, and vitamin B-12 cannot be absorbed, so scarring at most will cause gastric outlet obstruction
[which can narrow or close the intestinal opening and can prevent food from leaving the stomach and entering the small intestine
,resulting in vomiting the contents of the stomach]
3. In old age , as there is atrophy of the glandular mucosa of the fundus of the stomach which is same etiology of pernicious anemia, thus AGE is a contributory factor for the progress of the disease.
.Take: bland diet,rice with plain dal,boiled vegetables,sweet biscuits,sweet fruits,plain idli.
.avoid sour fruits like citrus fruits,imli,grapes,instead take sweet/dry fruits.
.avoid all chillies.
.avoid period of starvation:take small meals every 2 hrs.
.do not keep the stomach empty,also don’t take heavy meals.
.avoid tea and coffee.milk is good (cold)
.for breakfast and snacks:bread/toast jam,cheese or butter,cornflakes
.avoid deep fried and hot foods.
.eat food which are low in fats.
.eat at a leisurely pace.chew your food well.
.avoid eating 3 hrs prior to retiring to bed.may cause secretion of gastric acid
if meals taken during bed time.
.include protein in each meal and snacks.
.antacids are the drug of choice.
.avoid gastric irritant drugs like aspirin,all NSAID’S,steroids.
. complication of PA is severe neurological deficit, thus regular Neurologist
Opinion is must.
. diet rich in vitamin B12 are: liver, beef/mutton;chicken,fish,whole egg, milk, cheese, yogurt.