The term pancreatitis describes an inflammatory process localized in the tissues 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 that affects the digestive process. Treatment of pancreatitis, regardless of the severity of the course, the nature and origin of the pathological process, necessarily involves the use of dietary recommendations. According to the classification of diets, the pancreatitis table is marked 5p.
The main feature of the diet
The main goal of the diet in acute or chronic pancreatitis is a significant reduction in the functional load on the pancreas, which contributes to a rapid decrease in the severity of the inflammatory process. The diet has several of the following distinguishing features:
- The amount of carbohydrates (mainly due to sugar and other easily digestible disaccharides) and fats are reduced in the diet.
- Increasing the protein content in the diet.
- A sharp restriction in the intake of extractive organic compounds, purine bases, refractory oils, essential oils, cholesterol, coarse fiber, which significantly increases the load on the organs of the digestive system.
- Increasing the content of lipotropic compounds and vitamins.
- Meals should be steamed or boiled. Cooking is limited. Avoid fried foods.
- The number of cold and very hot dishes is limited.
The chemical composition, the daily content of the main organic compounds, as well as the energy value of the diet for pancreatitis include the following indicators:
- Proteins - 110-120 g, of which 60-65% must be of animal origin.
- Carbohydrates - 350-400 g, 30-40 g of sugar are allowed. It is recommended to take 20-30 g of xylitol sweetener.
- Fats - 80 g, 15-20% of which are of vegetable origin.
- Table salt (sodium chloride) - 10 gr.
- Free liquid - 1. 5 liters.
- Energy value - 2600-2700 kcal.
Recommended food intake 5-6 times a day, single portions should be small. This makes it possible to reduce the load on the entire digestive system in general and on the pancreas in particular.
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 the breakdown of proteins, fats and carbohydrates in the lumen of the small intestine. With the development of an inflammatory reaction, triggered by various causes, damage to glandular cells occurs, as well as tissue edema. At the same time, compression of the excretory ducts of the pancreas develops, the outflow of contents is disturbed, which can provoke tissue death, which is subsequently triggered by the release of digestive enzymes (pancreonercosis). To prevent complications of inflammation, it is important to reduce the load on the pancreas, for which the 5p diet was developed.
The essence of dietary recommendations is to significantly reduce the amount of carbohydrates and fats that come with food. This regulatory situation causes a decrease in the functional activity of the pancreas, a decrease in the production of digestive enzymes, and a decrease in the likelihood of pancreatic necrosis. Fractional frequent meals in small portions make it possible to reduce the load on all organs of the digestive tract, which helps 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 tract.
tokens
The implementation of dietary recommendations is indicated in the development of chronic pancreatitis in remission (improvement of functional state) or in the acute course of the inflammatory process in the recovery period (recovery). Also, the diet can be used for combined inflammation of the pancreas, gallbladder, liver.
Contraindications
With a pronounced acute course of the inflammatory process, it is not recommended to use a diet for pancreatitis, since in this case table 0 (lack of complete nutrition) is prescribed for a period of up to several days. The main nutritional organic compounds in the form of monomers are administered parenterally by intravenous drip (amino acids, glucose). Also, if necessary, intensive therapy is prescribed using drugs of various pharmacological groups.
Allowed Products
Using a diet for pancreatitis involves taking allowed foods, the list of which is quite diverse, including:
- The first dishes are vegetables (carrots, potatoes, pumpkin, zucchini), cereals (semolina, rice, buckwheat), noodles, soups boiled in water, in which a small amount of butter is allowed.
- Meat - lean meats, including chicken, rabbit, veal, beef, skinless turkey. Before cooking, the meat is cleaned of skin (poultry), tendons. It is recommended to boil or steam.
- Vegetables - potatoes, cauliflower, zucchini, green peas, carrots, beets, pumpkin boiled, baked or steamed.
- Cereals - cereals from oats, buckwheat, semolina, rice, cooked with water or a little milk. They can also be added to soufflés and puddings.
- Ripe, sweet fruit or berries that can be eaten fresh or cooked.
- Dairy products - low-fat whole milk in limited quantities, subject to its normal tolerance, yogurt, cottage cheese, cream.
- Desserts - mousse, jelly, jelly, marmalade, prepared using xylitol (a sweetener).
- Chicken eggs - limited, in the form of omelettes, 2 per day.
- Flour products - bread made from yesterday's wheat or rye flour, lean products.
- oils - butter, vegetable oil.
- Drinks - green, weak black tea, juices, compotes, rosehip juice.
Forbidden Products
Against the background of the implementation of dietary recommendations for pancreatitis, the use of the following foods is excluded:
- Soups, cabbage soup, borsch with meat, fish broth, beetroot, okroshka.
- Fatty meats (duck, goose, pork, lamb), fried, stewed dishes from it, smoked meats, sausages.
- Oily, fried, boiled, salted fish, caviar, canned food.
- Any dairy product high in fat and sugar, including lactose (milk sugar).
- The use of legumes, barley, maize, pearl barley and crumbly grains is limited.
- White cabbage, turnip, sorrel, sweet pepper, eggplant, radish, onion, garlic, spinach, mushrooms, radishes.
- Spices, spicy, fatty sauces, especially those cooked in broth.
- Coffee, cocoa, carbonated and cold drinks.
- Confectionery, chocolate, ice cream, sweets with a significant sugar content.
- Animal fats.
Nutritional Characteristics
Proper use of the diet for pancreatitis includes following a few of the following recommendations and dietary habits:
- The menu of acute pancreatitis or exacerbation of a chronic process includes a mandatory protection regimen. The amount of food is sharply limited up to temporary curative hunger (diet 0). As the severity of the inflammatory process decreases, the menu is gradually expanded, but the dish is served in a crushed form.
- In chronic pancreatitis, the 5p diet is used without a sparing regimen. It includes the usual temperature regime, with the 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 sets dietary recommendations. If in the first days there is a high probability of developing pancreatic necrosis, a diet 0 is prescribed under close medical supervision.
- It is recommended to take food at least 5 times a day in small portions, which makes it possible to 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 time between dinner and bedtime is increased to 3-4 hours.
- In chronic pancreatitis, a diet is prescribed for a long time, which is necessary primarily to prevent exacerbation of the inflammatory process in the tissues of the pancreas.
Sample menu for the week
Monday
- Breakfast - boiled buckwheat porridge in milk, bread and butter, weak black tea.
- Lunch - fresh pears.
- Lunch - minestrone, boiled chicken noodle casserole, apple jelly.
- Snack - biscuit cookies, rosehip juice.
- Dinner - boiled fish without bones, mashed potatoes with a small amount of butter, green tea.
Tuesday
- Breakfast - boiled vegetable salad, cheese sandwich, green tea.
- Lunch - cottage cheese casserole with the addition of prunes.
- Lunch - milk soup with rice, boiled carrots with boiled chicken, fruit compote.
- Afternoon snack - lean cookies with freshly squeezed juice.
- Dinner - pasta with cottage cheese, boiled in water, jelly.
Wednesday
- Breakfast - apple and carrot salad, chopped steamed cutlet, juice.
- Lunch is baked pears.
- 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 - carrot puree with apple jam.
- Lunch - vegetable soup cooked on dried fruit, cottage cheese pudding, baked apple decoction.
- Snack - fruit jelly.
- Dinner - buckwheat porridge, boiled in water, steam cutlets of beef, mineral water.
Friday
- Breakfast - carrot cheesecake, black tea.
- Lunch - cottage cheese with low-fat sour cream.
- Lunch - barley and carrot soup boiled in water, cabbage rolls cooked with rice and boiled chicken meat, fruit jelly.
- Snack - sweet fresh apple.
- Dinner - potatoes boiled in water, boiled fish without bones, kefir, a piece of bread.
Saturday
- Breakfast - cheesecake with fruit jam, green tea.
- Lunch is a fresh banana.
- Lunch - borscht stewed in vegetable broth, stew made of vegetables and chicken, fruit compote.
- Snack - dry biscuits, dried fruit compote.
- Dinner - stew with pasta and boiled veal, kefir.
Sunday
- Breakfast - soup with potato dumplings boiled in milk, weak black tea.
- Lunch is a fresh sweet apple.
- Lunch - cabbage soup stewed in vegetable broth, boiled pasta with steam cutlets, compote.
- Snack - biscuit cookies, rosehip juice.
- Dinner - an omelet made from chicken eggs, lazy meatballs with cottage cheese, kefir.
doctor's opinion
The diet for pancreatitis is biologically sound. By reducing the functional load on the pancreas, the risk of complications, including pancreatic necrosis, is significantly reduced, and the inflammatory process in organ tissues 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 tract. Dietary recommendations are aimed at reducing the functional load on the pancreas during the reduction of acute inflammation or against the background of the chronic course of the disease. In case of acute pancreatitis, diet 0 with therapeutic fasting can be prescribed, due to the high risk of developing pancreatic necrosis in a medical hospital.