The term pancreatitis defines an inflammatory process localized in the tissues of the pancreas (pancreas). As a result of the acute or chronic course of the disease of varying severity, the functional state of the organ is violated, which affects the digestive process. Treatment of pancreatitis, regardless of the severity of the course, the nature and basis of the pathological process, it is necessary to include the use of dietary recommendations. According to the classification of diets, the table for pancreatitis is marked 5p.
The main characteristic 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 reduction in the intensity of the inflammatory process. The diet has some of the following distinguishing characteristics:
- In the diet, the amount of carbohydrates (mainly due to sugar and other easily digestible disaccharides) and fats is reduced.
- Increase the protein content in the diet.
- A sharp restriction on the intake of extractive organic compounds, purine bases, refractory fats, essential oils, cholesterol, coarse fiber, which greatly increases the burden on the organs of the digestive system.
- Increase in the content of lyotropic compounds and vitamins.
- Dishes should be steamed or boiled. Stewing food is limited. Avoid fried foods.
- The number of cold and hot dishes is limited.
The following indicators are included in the chemical composition, the daily content of the main organic compounds, as well as the energy value of the diet for pancreatitis:
- Proteins - 110-120 g, of which 60-65% should be of animal origin.
- Carbohydrates - 350-400 g, which is allowed 30-40 g of sugar. It is recommended to take 20-30 g 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, and individual portions should be small. This makes it possible to reduce the burden 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 several digestive enzymes (protease, lipase, amylase) which are responsible for the breakdown of proteins, fats and carbohydrates in the lumen of the small intestine. With the development of an inflammatory reaction that is triggered for various reasons, damage to the 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 may subsequently trigger tissue death, which in turn triggers the release of digestive enzymes (pancreonercosis). To prevent complications of inflammation, it is important to reduce the burden on the pancreas, from which the 5p diet was developed.
The essence of the 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 likelihood of pancreatic necrosis. Frequent fractional meals in small portions can reduce the load on all organs of the digestive system, which helps to quickly reduce the intensity of the inflammatory process in the pancreas. By increasing the number of compounds and lipotropic vitamins, the course of metabolic processes can be improved in the tissues of the liver and other parenchymal organs of the digestive system.
indications
The implementation of dietary recommendations is indicated in the development of chronic pancreatitis in remission (improvement of the functional state) or the acute course of the inflammatory process during 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 (complete lack of nutrition) is prescribed for a period of time 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 treatment is prescribed using drugs of different pharmacological groups.
Approved Products
The use of a diet for pancreatitis involves taking approved foods, the list of which is quite diverse and includes:
- The first courses are soups boiled in water with vegetables (carrots, potatoes, pumpkin, zucchini), cereals (semolina, rice, buckwheat), vermicelli, a small amount of butter is allowed.
- Meat - Lean meat, including chicken, rabbit, veal, beef, skinless turkey. Before cooking, the meat is free from the skin (poultry), tendons. It is recommended to boil or steam it.
- Vegetables - potatoes, cauliflower, zucchini, green peas, carrots, beets, pumpkin boiled, baked or steamed.
- Cereals - cereals from oats, buckwheat, semolina, rice, which are cooked in water or with a little milk. They can also be added to soufflés and puddings.
- Ripe, sweet fruits or berries that can be eaten fresh or baked.
- Dairy products - low-fat whole milk in limited quantities, subject to normal tolerance, yogurt, cottage cheese, cream.
- Sweets - mousse, jelly, jelly, marmalade, prepared using xylitol (sweetener).
- Chicken eggs - limited, 2 pieces per day in the form of omelettes.
- Flour products - yesterday's bread made from wheat or rye flour, lean products.
- Fats - butter, vegetable oil.
- Drinks - green, weak black tea, fruit juices, compotes, rosehip broth.
Prohibited Products
In the context of the implementation of dietary recommendations for pancreatitis, the use of the following foods is excluded:
- Soups, cabbage soup, borsch on meat, fish broth, beetroot, okroshka.
- Fatty meat (duck, goose, pork, lamb), fried, stewed dishes, smoked meat, sausages.
- Salted fish, fried, stewed, salted, caviar, canned food.
- Any dairy products high in fat and sugar, including lactose (milk sugar).
- Legumes, the use of barley, corn, pearl barley and whole grains is limited.
- White cabbage, turnip, Samadh, sweet pepper, eggplant, radish, onion, garlic, spinach, mushrooms, radish.
- Spices, spicy, fatty sauces, especially those cooked in meat broth.
- Coffee, cocoa, carbonated and cold drinks.
- Confectionery cream, chocolate, ice cream, sweets containing a significant amount of sugar.
- Animal fats.
Nutritional Aspects
The correct use of the 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 a mandatory sparing regimen. The amount of food is severely limited up to temporary curative starvation (diet 0). As the intensity of the inflammatory process decreases, the menu gradually expands, but the food is served in mashed form.
- In chronic pancreatitis, a 5p diet is used without a saving regimen. It includes the normal temperature regime except for very hot and very cold dishes.
- The acute course of the inflammatory process in the tissues of the pancreas requires a person to be hospitalized in a medical hospital, where the doctor will determine dietary recommendations. If there is a high probability of developing pancreatic necrosis in the first days, a 0 diet 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 burden 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 period between dinner and bedtime is increased to 3-4 hours.
- In chronic pancreatitis, a diet is prescribed for a long period of time, which is mainly necessary 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, noodle casserole with chicken meat, apple jelly.
- Snack - biscuit cookies, rosehip broth.
- Dinner - boiled fish without bones, mashed potatoes with a small amount of butter, green tea.
Tuesday
- Breakfast - boiled vegetable vinaigrette, cheese sandwich, green tea.
- Lunch - cottage cheese casserole with prunes.
- Lunch - milk soup with rice, stewed carrots with boiled chicken, fruit compote.
- Afternoon snack - thin cookies 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 cooked 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, cooked in milk, with prunes, weak black tea.
- Lunch - carrot puree 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 beef steam cutlets, still mineral water.
Friday
- Breakfast - cheesecakes with carrots, black tea.
- Lunch - cottage cheese with low-fat sour cream.
- Lunch - soup with barley and carrots, boiled in water, cabbage rolls boiled with rice and boiled chicken meat, fruit jelly.
- Snack - fresh sweet apple.
- Dinner - potatoes boiled in water, boiled fish without bones, kefir, a piece of bread.
Saturday
- Breakfast - cheesecakes 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, dried fruit compote.
- 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, pasta cooked with steamed cutlets, compote.
- Snack - biscuit cookies, rosehip broth.
- Dinner - omelette made from chicken eggs, lazy dumplings 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 greatly reduced, and the inflammatory process in the tissues of the organ is also accelerated. At the same time, the intensity of the 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 burden on the pancreas during the period of alleviating 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, a 0 diet, with therapeutic starvation, can be prescribed.