The term pancreatitis defines an inflammatory process localized in the tissue of the pancreas (pancreas). The acute or chronic course of the disease of varying severity leads to a violation of the functional state of the organ, which affects the digestive process. Treatment of pancreatitis, regardless of the severity of the course, the nature and origin of the pathological process, necessarily includes the use of dietary recommendations. According to the classification of diets, the table for pancreatitis is marked 5p.
The main feature of the diet
The main goal of the diet in acute or chronic pancreatitis is a significant decrease in the functional load on the pancreas, which contributes to the rapid decrease in the severity of the inflammatory process. The diet has several of the following distinguishing features:
- In the diet, the amount of carbohydrates (mainly sugar and other easily digestible double sugars) and fats is reduced.
- Increasing the protein content in the diet.
- A severe restriction of the intake of extractive organic compounds, purine bases, refractory fats, essential oils, cholesterol and coarse fiber, which significantly increase the load on the organs of the digestive system.
- Increasing the content of lipotropic compounds and vitamins.
- Dishes should be steamed or boiled. Braising food is limited. Avoid fried foods.
- The number of cold and hot dishes is limited.
The chemical composition, daily content of the main organic compounds, as well as the energy value of the diet in pancreatitis include the following indicators:
- Proteins - 110-120 g, 60-65% of which should be of animal origin.
- Carbohydrates - 350-400 g, of which 30-40 g sugar is allowed. It is recommended to consume 20-30g of xylitol sweetener.
- Fats - 80 g, of which 15-20% are of vegetable origin.
- Table salt (sodium chloride) - 10 g.
- Free liquid - 1. 5 liters.
- Energy value - 2600-2700 kcal.
The recommended food intake is 5-6 times a day, with individual servings being small. As a result, the entire digestive system in general and the pancreas in particular can be relieved.
Mechanism of therapeutic action
The pancreas is a functionally important organ of the digestive system. It produces a number of digestive enzymes (protease, lipase, amylase) responsible for breaking down proteins, fats and carbohydrates in the lumen of the small intestine. With the development of an inflammatory reaction, which is provoked for various reasons, there is damage to the cells of the gland, as well as tissue edema. At the same time, compression of the excretory ducts of the pancreas develops, the outflow of its contents is disturbed, which can subsequently lead to tissue death provoked by the release of digestive enzymes (pancreonercosis). To avoid complications of inflammation, it is important to reduce the load on the pancreas, which is what the 5p diet was designed to do.
The essence of nutritional recommendations is to significantly reduce the amount of carbohydrates and fats that accompany food. At the regulatory level, this leads to a decrease in the functional activity of the pancreas, the production of digestive enzymes and the likelihood of developing pancreatic necrosis. Fractional frequent meals in small portions can relieve the load on all organs of the digestive system, which will help to quickly reduce the severity of the inflammatory process in the pancreas. By increasing the amount of lipotropic compounds and vitamins, it is possible to improve the course of metabolic processes in the tissues of the liver and other parenchymal organs of the digestive system.
Hints
The implementation of nutritional recommendations is indicated in the development of chronic pancreatitis in remission (improvement in the functional state) or the acute course of the inflammatory process during the period of convalescence (recovery). The diet can also be used for combined inflammation of the pancreas, gallbladder and liver.
contraindications
With a pronounced acute course of the inflammatory process, the use of a diet for pancreatitis is not recommended, since in this case Table 0 (complete lack of nutrition) is prescribed for a period of up to several days. The main organic nutrient compounds in the form of monomers are administered parenterally by intravenous infusion (amino acids, glucose). If necessary, intensive treatment with drugs of various pharmacological groups is also prescribed.
Allowed Products
The use of a diet for pancreatitis involves taking permissible foods, the list of which is very diverse and includes:
- The first courses are soups boiled in water with the addition of vegetables (carrots, potatoes, pumpkin, zucchini), cereals (semolina, rice, buckwheat), vermicelli, a small amount of butter is allowed.
- Meat - Lean meats, including chicken, rabbit, veal, beef, skinless turkey. Before cooking, the skin (poultry) and sinews are removed from the meat. It is recommended to boil or steam it.
- Vegetables - potatoes, cauliflower, zucchini, green peas, carrots, beets, squash boiled, baked or steamed.
- Cereals - cereals from oats, buckwheat, semolina, rice, which are boiled on water or with a little milk. They can also be added to soufflés and puddings.
- Ripe, sweet fruit or berries that can be eaten fresh or baked.
- Dairy products - low-fat whole milk in limited quantities, subject to their normal tolerance, yogurt, cottage cheese, cream.
- Sweets - mousse, jelly, jelly, jam, which are prepared with xylitol (a sweetener).
- Chicken eggs - limited, 2 pieces per day in the form of omelettes.
- Flour products - yesterday's bread from wheat or rye flour, lean products.
- Fats - butter, vegetable oil.
- Drinks - green, weak black tea, fruit juices, compotes, rosehip broth.
Prohibited Products
Against the background of the implementation of nutritional recommendations for pancreatitis, the use of the following foods is excluded:
- Soups, cabbage soup, borscht on meat, fish broth, beetroot, okroshka.
- Fatty meat (duck, goose, pork, lamb), fried, stewed dishes from it, smoked meat, sausages.
- Fatty, fried, stewed, salted fish, caviar, canned food.
- All dairy products high in fat and sugar, including lactose (milk sugar).
- Legumes, limited use of barley, maize, pearl barley and crumbly cereals.
- Cabbage, turnip, sorrel, pepper, eggplant, radish, onion, garlic, spinach, mushrooms, radish.
- Spices, spicy, fatty sauces, especially those cooked in meat broth.
- Coffee, cocoa, carbonated and cold drinks.
- Cream confectionery, chocolate, ice cream, sweets with a significant sugar content.
- Animal fat.
nutritional characteristics
Proper use of the diet for pancreatitis involves following several of the following recommendations and dietary habits:
- The menu for acute pancreatitis or exacerbation of a chronic process includes a mandatory sparing regimen. The amount of food is severely limited until temporary healing hunger (diet 0). As the severity of the inflammatory process subsides, the menu is gradually expanded, but the food is served in crushed form.
- With chronic pancreatitis, a 5p diet is used without rest. It includes the usual temperature regime with the obligatory exception of very hot and very cold dishes.
- The acute course of the inflammatory process in the tissues of the pancreas requires hospitalization of a person in a medical hospital, where the doctor establishes nutritional recommendations. If in the first few days there is a high probability of developing pancreatic necrosis, a diet 0 is prescribed under close medical supervision.
- It is recommended to eat food in small portions at least 5 times a day, which can significantly reduce the load on the pancreas.
- It is recommended to have the last meal no later than 2 hours before the intended sleep. In modern recommendations, the period between dinner and bedtime is increased to 3-4 hours.
- With chronic pancreatitis, a diet is prescribed for a long period of time, which is necessary primarily to prevent the exacerbation of the inflammatory process in the tissues of the pancreas.
Sample menu for the week
Monday
- Breakfast - buckwheat porridge boiled in milk, bread and butter, weak black tea.
- Lunch - fresh pear.
- Lunch - soup with vegetables boiled in water, pasta casserole with chicken, apple jelly.
- Snack - biscuit biscuits, rosehip broth.
- Dinner - boiled boneless fish, mashed potatoes with a little butter, green tea.
Tuesday
- Breakfast - cooked vegetable vinaigrette, cheese sandwich, green tea.
- Lunch - cottage cheese casserole with the addition of plums.
- Lunch - milk soup with rice, stewed carrots with boiled chicken, fruit compote.
- Afternoon snack - lean biscuits with freshly squeezed fruit juice.
- Dinner - pasta with cottage cheese, boiled in water, jelly.
Wednesday
- Breakfast - apple and carrot salad, chopped steamed cutlets, fruit juice.
- Lunch is a baked pear.
- Lunch - vegetable soup boiled in milk, boiled boneless fish with rice porridge, fresh fruit.
- Snack - biscuit cookies, dried fruit compote.
- Dinner - rice porridge cooked in milk, cheese sandwich, apple compote.
Thursday
- Breakfast - semolina porridge boiled in milk with the addition of prunes, weak black tea.
- Lunch - mashed carrots with apple jam.
- Lunch - vegetable soup cooked on a decoction of dried fruits, cottage cheese pudding, baked apple.
- Snack - fruit jelly.
- Dinner - buckwheat porridge boiled in water with steamed beef chops, still mineral water.
Friday
- Breakfast - cheesecake with carrots, black tea.
- Lunch - cottage cheese with low-fat sour cream.
- Lunch - soup with barley and carrots boiled in water, stuffed cabbage with rice and boiled chicken, fruit jelly.
- Snack - sweet fresh apple.
- Dinner - potatoes boiled in water, boiled boneless fish, kefir, a piece of bread.
Saturday
- Breakfast - cheesecake with fruit jam, green tea.
- Lunch is a fresh banana.
- Lunch - borscht cooked in vegetable broth, vegetable and chicken casserole, fruit compote.
- Snack - dry biscuit, compote of dried fruits.
- Dinner - casserole with pasta and boiled beef, kefir.
Sunday
- Breakfast - soup with potato dumplings boiled in milk, weak black tea.
- Lunch is a fresh sweet apple.
- Lunch - cabbage soup cooked in vegetable broth, boiled noodles with steamed cutlets, compote.
- Snack - biscuit biscuits, rosehip broth.
- Dinner - an omelette from chicken eggs, lazy dumplings with cottage cheese, kefir.
doctor's opinion
The diet for pancreatitis is biologically healthy. Reducing the functional load on the pancreas significantly reduces the risk of complications, including pancreatic necrosis, and the inflammatory process in the tissues of the organ is also accelerated. At the same time, the severity of edema decreases, the outflow of pancreatic juice and bile improves, which contributes to the normalization of the functional activity of all organs of the digestive system. Diet recommendations are intended to reduce the functional load on the pancreas during the abatement of an acute inflammation or against the background of the chronic course of the disease. In the case of acute pancreatitis, due to the high risk of developing pancreatic necrosis in a medical hospital, Diet 0, which is a therapeutic starvation diet, can be prescribed.