The term pancreatitis defines 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 organs, which affects the digestive process. Treatment of pancreatitis, regardless of the severity of the course, the nature and origin of the pathological process, should include the use of dietary recommendations. According to the dietary classification, the table for pancreatitis is marked 5p.
The main characteristics 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 the following distinguishing characteristics:
- In the diet, the amount of carbohydrates (mainly due to easily digestible sugars and other disaccharides) and fats is reduced.
- Increase the protein content in food.
- A sharp restriction in the intake of extractive organic compounds, purine bases, refractory fats, essential oils, cholesterol, crude fiber, which significantly increases the load on the organs of the digestive system.
- Increase the content of lipotropic compounds and vitamins.
- The dish should be steamed or boiled. Limited food stew. Avoid fried foods.
- Limited number of cold and too hot dishes.
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 consume 20-30 g of xylitol sweetener.
- Fat - 80 g, of which 15-20% comes from vegetables.
- 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, while single servings should be small. This makes it possible 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 a number of digestive enzymes (proteases, lipases, 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 provoked by various reasons, glandular cell damage 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 further provoke tissue death, provoked by the release of digestive enzymes (pancreonercosis). To prevent inflammatory complications, 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 accompany meals. This at a regulatory level leads to a decrease in the functional activity of the pancreas, the production of digestive enzymes and the possibility of developing pancreatic necrosis is reduced. Frequent breakdown of food in small portions makes it possible to reduce the load on all organs of the digestive system, 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 system.
Indication
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 during the recovery (recovery) period. Also, the diet can be used for combined inflammation of the pancreas, gallbladder, liver.
Contraindications
With a pronounced acute inflammatory process, the use of a diet for pancreatitis is not recommended, since in this case table 0 (complete malnutrition) is prescribed for a period of up to several days. The main nutritional organic compounds in the form of monomers are administered parenterally by infusion (amino acids, glucose). Also, if necessary, intensive treatment is prescribed using drugs from various pharmacological groups.
Allowed Products
Using a diet for pancreatitis involves taking permissible foods, the list of which is quite 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 little butter is allowed.
- Meat - lean meats, which include chicken, rabbit, veal, beef, skinless turkey. Before cooking, the meat is freed from the skin (poultry), veins. It is recommended to boil or steam it.
- Vegetables - potatoes, cauliflower, zucchini, green beans, carrots, beets, pumpkin boiled, baked or steamed.
- Cereals - cereals from buckwheat, buckwheat, semolina, rice, cooked on water or with a small amount of milk. They can also be added to souffles and puddings.
- Ripe, sweet fruit or berry that can be eaten fresh or roasted.
- Dairy products - low-fat whole milk in limited quantities, subject to its normal tolerance, yogurt, cottage cheese, cream.
- Sweets - mousses, jellies, jellies, marmalades, which are prepared using xylitol (sweetener).
- Chicken eggs - limited, 2 pieces per day in the form of an omelet.
- Flour products - yesterday's bread is made 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 implementing dietary recommendations for pancreatitis, the use of the following foods is excluded:
- Soups, cabbage soup, borsch on meat, fish stock, beets, okroshka.
- Fatty meats (duck, goose, pork, lamb), fried, stewed dishes from it, smoked meats, sausages.
- Fat, fried, boiled, salted fish, caviar, canned food.
- Any dairy product that is high in fat and sugar, including lactose (milk sugar).
- Legumes, use of barley, corn, pearl barley and crumbly cereals are restricted.
- Cabbage, radish, sorrel, bell pepper, eggplant, radish, onion, garlic, spinach, mushroom, radish.
- Spicy, spicy, fatty sauces, especially those cooked in meat broth.
- Coffee, cocoa, carbonated and cold drinks.
- Creamy candy, chocolate, ice cream, candy that contains a lot of sugar.
- Animal fat.
Nutrition Features
The use of a proper diet for pancreatitis involves the following recommendations and nutritional habits:
- The menu for acute pancreatitis or exacerbation of the chronic process includes a mandatory sparing regimen. The amount of food is strictly limited to a temporary curative starvation (diet 0). As the severity of the inflammatory process subsides, the menu gradually expands, but the food is served in crushed form.
- In chronic pancreatitis, the 5p diet is used without a sparing regimen. This includes the usual temperature regime with the mandatory exception of very hot and very cold dishes.
- The acute course of the inflammatory process in the pancreatic tissue requires hospitalization of a person in a medical hospital, where the doctor determines dietary recommendations. If there is a high probability of developing pancreatic necrosis in the first days, diet 0 is prescribed under strict medical supervision.
- It is recommended to eat at least 5 times a day in small portions, which makes it possible to significantly reduce the load on the pancreas.
- The last meal is recommended to be taken no later than 2 hours before the intended bedtime. 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 necessary primarily to prevent exacerbation of the inflammatory process in the pancreatic tissue.
Sample menu for this week
Monday
- Breakfast - buckwheat porridge boiled in milk, bread and butter, weak black tea.
- Lunch - fresh pears.
- Lunch - soup with vegetables, boiled in water, noodle casserole with chicken, apple jelly.
- Snacks - biscuit cakes, rosehip broth.
- Dinner - boneless boiled fish, mashed potatoes with a little butter, green tea.
Tuesday
- Breakfast - boiled vegetable vinaigrette, 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 cake with fresh fruit juice.
- Dinner - pasta with cottage cheese, boiled in water, jelly.
Wednesday
- Breakfast - apple and carrot salad, sliced steamed minced meat, fruit juice.
- Lunch was roasted pears.
- Lunch - vegetable soup stewed in milk, boneless boiled fish with rice porridge, fresh fruit.
- Snacks - biscuit cakes, compote of dried fruit.
- 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 with a decoction of dried fruits, cottage cheese pudding, baked apples.
- Snack - fruit jelly.
- Dinner - buckwheat porridge, boiled in water, with sliced beef, 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 boiled rice and chicken, fruit jelly.
- Snack - sweet fresh apples.
- Dinner - boiled potatoes in water, boneless boiled fish, kefir, a piece of bread.
Saturday
- Breakfast - cheesecake with fruit jam, green tea.
- Lunch is fresh bananas.
- Lunch - borscht cooked in vegetable broth, casserole from vegetables and chicken, fruit compote.
- Snacks - dry biscuits, 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 fresh sweet apples.
- Lunch - cabbage soup cooked in vegetable broth, boiled pasta with steamed cutlets, compote.
- Snacks - biscuit cakes, rosehip broth.
- Dinner - omelet made from chicken eggs, lazy dumplings with cottage cheese, kefir.
Doctor's opinion
Diet for pancreatitis is biologically healthy. 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 severity of edema decreases, the outflow of pancreatic juice and bile increases, which contributes to the normalization of the functional activity of all organs of the digestive system. Dietary recommendations are intended to reduce the functional load on the pancreas during the period of subsided acute inflammation or against the background of a chronic course of the disease. In cases of acute pancreatitis, due to the high risk of developing pancreatic necrosis in a medical hospital, a diet 0, which is therapeutic starvation, can be prescribed.