The term pancreatitis defines a localized inflammatory process 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, affecting the digestive process. Treatment of pancreatitis, regardless of the severity of the process, the nature and origin of the pathological process, necessarily includes the use of dietary recommendations. According to the classification of the diet, the table for pancreatitis is marked 5p.
Main features of the diet
The main goal of the diet in acute or chronic pancreatitis is to significantly reduce the functional load on the pancreas, which contributes to a rapid reduction in the severity of the inflammatory process. The diet has some of the following distinguishing features:
- In the diet, the amount of carbohydrates (mainly due to sugars and other easily digestible disaccharides) and fats are reduced.
- Increase the protein content of the diet.
- Significantly limits the consumption of organic compounds extracted, purines, refractory fats, essential oils, cholesterol, crude fiber, which significantly increases the load on the organs of the digestive system.
- Increased content of lipotropic compounds and vitamins.
- Dishes should be steamed or boiled. Food stewing is limited. Avoid fried foods.
- The number of hot and cold dishes is limited.
The chemical composition, daily content of the main organic compounds, as well as the energy value of the diet for pancreatitis include the following indicators:
- Protein - 110-120 g, of which 60-65% should be of animal origin.
- Carbohydrates - 350-400 g, of which 30-40 g of sugar is allowed. It is recommended to use 20-30 g of xylitol sweetener.
- Fat - 80 g, of which 15-20% is of vegetable origin.
- Table salt (sodium chloride) - 10 g.
- Free liquid - 1. 5 liters.
- Energy value - 2600-2700 kcal.
The recommended amount of food is 5-6 times a day, while only a small portion should be eaten. This helps you to reduce the load on the entire digestive system in general and the pancreas in particular.
Mechanism of therapeutic action
The pancreas is an important functional organ of the digestive system. It produces several 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 due to various reasons, damage to glandular cells occurs, as well as tissue edema. Simultaneously, compression of the excretory ducts of the pancreas develops, the outflow of the contents is disturbed, which can then lead to tissue death, caused by the release of digestive enzymes (infectious diseases). pancreatitis). To prevent complications of inflammation, it is important to reduce the load on the pancreas, where 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 at the regulatory level causes a decrease in the functional activity of the pancreas, the production of digestive enzymes, and the reduced likelihood of developing pancreatic necrosis. The frequent division of meals into several small portions reduces the load on all the organs of the digestive system, which helps to quickly reduce the severity of the inflammatory process in the pancreas. By increasing the intake of lipotropic compounds and vitamins, it is possible to improve metabolism in the tissues of the liver and other parenchymal organs of the digestive system.
Point
The implementation of dietary recommendations is indicated in cases of chronic pancreatitis in remission (improvement of functional status) or acute exacerbations of the inflammatory process during convalescence (recovery). In addition, the diet can be applied to combined cases of pancreatitis, gallbladder, liver disease.
Contraindications
With a pronounced exacerbation of the inflammatory process, the application of a diet for pancreatitis is not recommended, since in this case table 0 (complete lack of nutrition) is prescribed for a period of timeup to several days. The major nutritional organic compounds in monomeric form are administered intravenously by intravenous drip (amino acids, glucose). In addition, if necessary, active treatment is prescribed using drugs of different pharmacological groups.
Products are allowed
Using a diet for pancreatitis includes the use of permissible foods, the list of which is quite diverse and includes:
- The first dishes are soups boiled in water with added vegetables (carrots, potatoes, pumpkins, zucchini), cereals (steamed rice flour, rice, buckwheat), noodles, allowing a small amount of butter.
- Meat - lean meat, including chicken, rabbit, veal, beef, skinless turkey. Before cooking, the meat is released from the skin (poultry), tendons. Should be boiled or steamed.
- Vegetables - potatoes, cauliflower, zucchini, green beans, carrots, beets, boiled, baked or steamed pumpkin.
- Cereals - cereals from oats, buckwheat, semolina, rice, cooked on water or with a little milk. They can also be added to soups and puddings.
- Ripe, sweet fruit that can be eaten fresh or baked.
- Dairy products - low-fat whole milk in limited quantities, subject to normal tolerance, yogurt, cheese, ice cream.
- Candy - mousse, jellies, jellies, marmalade, prepared with xylitol (sweetener).
- Chicken eggs - limited, 2 pieces per day as an omelet.
- Flour products - yesterday's bread made from flour or rye flour, lean products.
- Fat - butter, vegetable oil.
- Beverages - black tea, green tea, fruit juice, fruit juice, rosehip broth.
Prohibited products
In the context of the implementation of dietary recommendations for pancreatitis, the use of the following foods is excluded:
- Soup, cabbage soup, braised meat, fish broth, beets, okra.
- Fatty meats (duck, goose, pork, lamb), fried dishes, stews from it, smoked meat, sausages.
- Fatty fish, fried, stewed, salted fish, caviar, canned.
- Any dairy product that is high in fat and sugar, including lactose (milk sugar).
- Legumes, the use of barley, corn, pearl barley and crumbs is limited.
- White cabbage, radish, sorrel, sweet pepper, eggplant, radish, onion, garlic, spinach, mushroom, radish.
- Spices, spicy, fatty sauces, especially those cooked in meat broth.
- Coffee, cocoa, carbonated and cold drinks.
- Creamy confectionery, chocolate, ice cream, and sweets contain significant amounts of sugar.
- Animal fat.
Nutritional characteristics
Using the right diet for pancreatitis involves following some of the following nutritional recommendations and habits:
- The menu for acute pancreatitis or exacerbation of a chronic process includes an obligatory dietary regimen. The amount of food is severely restricted to the point of temporary hunger (diet 0). As the severity of the inflammatory process decreases, the menu gradually expands, but the food is served in mashed form.
- In chronic pancreatitis, the 5p diet was applied without the sparing regimen. It includes a normal temperature mode with the mandatory exception of very hot and very cold dishes.
- The acute course of the inflammatory process in the tissues of the pancreas requires a person's admission to a medical hospital, where the doctor determines dietary recommendations. If there is a high probability of pancreatic necrosis in the first days, diet 0 is indicated under close medical supervision.
- It is recommended to eat at least 5 times a day in small portions to significantly reduce the load on the pancreas.
- The last meal is recommended to be taken no later than 2 hours before bedtime. According to modern recommendations, the interval from dinner to bedtime is increased to 3-4 hours.
- In chronic pancreatitis, a diet is prescribed for a long time, which is mainly necessary to prevent the exacerbation of the inflammatory process in the tissues of the pancreas.
Sample menu of the week
Monday
- Breakfast - boiled buckwheat porridge with milk, bread and butter, black tea.
- Lunch - fresh pears.
- Lunch - soup with vegetables, broth, chicken noodle soup, apple jelly.
- Snack - biscuits, rosehip broth.
- Dinner - boneless boiled fish, mashed potatoes with some butter, green tea.
Tuesday
- Breakfast - boiled vegetable vinegar, cheese sandwich, green tea.
- Lunch - cheese casserole with extra prunes.
- Lunch - milk soup with rice, carrot stew with boiled chicken, juice.
- Afternoon snack - lean biscuits with freshly squeezed juice.
- Dinner - pasta with cheese, boiled in water, jelly.
Wednesday
- Breakfast - apple and carrot salad, steamed cutlets, chopped fruit juice.
- Lunch is a baked pear.
- Lunch - vegetable soup cooked with milk, snakehead fish porridge, fresh fruit.
- Snack - biscuits, dried fruit.
- Dinner - rice porridge cooked with milk, cheese sandwich, apple.
Thursday
- Breakfast - tapioca porridge, boiled in milk, add prunes, black tea.
- Lunch - carrot puree with apple jam.
- Lunch - vegetable soup with dried fruit, fresh cheese pudding, baked apple.
- Snack - fruit jelly.
- Dinner - buckwheat porridge, boiled in water, with beef balls, 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, cabbage rolls cooked with rice and boiled chicken, fruit jelly.
- Snack - sweet fresh apple.
- Dinner - boiled potatoes in water, boneless boiled 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, casserole cooked with vegetables and chicken, juice.
- Snack - dry biscuits, dried fruit.
- Dinner - casserole with pasta and boiled beef, kefir.
Sunday
- Breakfast - soup with potato dumplings, boiled with milk, black tea.
- Lunch is a fresh sweet apple.
- Lunch - cabbage soup cooked in vegetable broth, boiled pasta with steamed cutlets, stew.
- Snack - biscuits, rosehip broth.
- Dinner - an omelette made from chicken eggs, lazy dumplings with fresh cheese, kefir.
Doctor's opinion
The diet for pancreatitis is biologically appropriate. By reducing the functional load on the pancreas, the risk of complications, including pancreatic necrosis, is significantly reduced, and the inflammatory process in the tissues of the organ is also accelerated. At the same time, the degree of edema is reduced, the outflow of pancreatic juice and bile is improved, which contributes to the normalization of the functional activity of all organs of the digestive system. Dietary recommendations are aimed at reducing the functional load on the pancreas during the acute reduction of inflammation or in the setting of the chronic course of the disease. In the case of acute pancreatitis, due to the high risk of pancreatic necrosis in a medical hospital, diet 0, i. e. therapeutic starvation, may be prescribed.