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 organ, which affects the process of digestion. 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 of pancreatitis is marked 5p.
The main feature of the scheme
The main goal of the diet in acute or chronic pancreatitis is a significant decrease in the functional load of 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 due to sugar and other easily digestible disaccharides) and fats is reduced.
- Increase the protein content of the diet.
- A sharp restriction in the intake of extractive organic compounds, purine bases, refractory fats, essential oils, cholesterol, coarse fiber, which significantly increase the load on the organs of the digestive system.
- Increase the content of lipotropic compounds and vitamins.
- Dishes should be steamed or boiled. Food stew is limited. Avoid fried foods.
- The number of cold and too 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:
- Protein - 110-120 g, 60-65% of which should be of animal origin.
- Carbohydrates - 350-400 g, of which 30-40 g of sugar are allowed. 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, while individual portions should be small. This reduces the load on the entire digestive system in general and on 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 (protease, lipase, amylase) which are responsible for breaking down proteins, fats and carbohydrates in the lumen of the small intestine. With the development of an inflammatory reaction caused by various reasons, 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 subsequently cause the death of tissues, caused by the release of digestive enzymes (pancreonercosis). To prevent complications from 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 accompany 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 developing pancreatic necrosis decrease. Frequent meals in small portions 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.
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 period of convalescence (recovery). Also, the diet can be used for combined inflammation of the pancreas, gall bladder 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 nutrient organic compounds in the form of monomers are administered parenterally by intravenous drip (amino acids, glucose). Further, if necessary, intensive treatment is prescribed with the help of drugs of various pharmacological groups.
Authorized products
Using a diet for pancreatitis involves taking permitted foods, the list of which is quite extensive 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, which include chicken, rabbit, veal, beef and skinless turkey. Before cooking, the meat is stripped of the skin (poultry), tendons. It is recommended to boil or steam it.
- Vegetables - potatoes, cauliflower, zucchini, green peas, carrots, beets, boiled, baked or steamed pumpkin.
- Cereals - cereals of 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 cooked.
- Dairy products - low-fat whole milk in limited quantities, subject to its normal tolerance, yogurt, cottage cheese, cream.
- Candies - mousse, jelly, jelly, marmalade, which are prepared with xylitol (a sweetener).
- Chicken eggs - limited, 2 pieces per day in the form of omelets.
- Flour products - yesterday's bread made from wheat or rye flour, lean products.
- Fats - butter, vegetable oil.
- Drinks - green and 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, meat borscht, fish broth, beets, okroshka.
- Fatty meats (duck, goose, pork, lamb), fried dishes, stews, smoked meats, sausages.
- Oily, fried, stewed, salted fish, caviar, preserves.
- All dairy products high in fat and sugar, including lactose (milk sugar).
- Legumes, the use of barley, corn, pearl barley and crumbly cereals is limited.
- White cabbage, turnip, sorrel, pepper, eggplant, radish, onion, garlic, spinach, mushroom, radish.
- Spices, spicy, fatty sauces, especially those cooked in meat broth.
- Coffee, cocoa, soft and cold drinks.
- Confectionery cream, chocolate, ice cream, confectionery containing a significant amount of sugar.
- Animal fats.
Nutritional characteristics
Proper use of the pancreatitis diet involves following many of the following nutritional recommendations and habits:
- The menu for acute pancreatitis or exacerbation of a chronic process includes a mandatory sparing diet. The amount of food is severely limited until temporary curative starvation (regime 0). As the severity of the inflammatory process decreases, the menu gradually expands, but the food is served in crushed form.
- In chronic pancreatitis, a 5p diet is used without a sparing diet. It 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 tissues of the pancreas 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, 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 can significantly reduce the load on the pancreas.
- It is recommended to carry out the last meal no later than 2 hours before the planned sleep. In modern recommendations, the period 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 an 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 - vegetable soup, porridge in water, noodle casserole with chicken meat, apple jelly.
- Snack - cookies cookies, rosehip broth.
- Dinner - boiled fish without bones, mashed potatoes with a small amount of butter, green tea.
Tuesday
- Breakfast - dressing of boiled vegetables, cheese sandwich, green tea.
- Lunch - cottage cheese casserole with the addition of prunes.
- Lunch - milk soup with rice, carrot compote with boiled chicken, fruit compote.
- Afternoon snack - skinny cookies with freshly squeezed juices.
- Dinner - cottage cheese pasta, 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 fruits.
- Snack - cookies biscuits, compote of dried fruits.
- Dinner - rice porridge cooked in milk, cheese sandwich, applesauce.
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 cutlets, still mineral water.
Friday
- Breakfast - carrot cheesecakes, 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 - 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, 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 pasta with steamed cutlets, compote.
- Snack - cookies cookies, rosehip broth.
- Dinner - an omelet 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 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 improves, 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 period of subsiding acute inflammation or against the background of the chronic course of the disease. In acute pancreatitis, due to the high risk of developing pancreatic necrosis in a medical hospital, diet 0, which is therapeutic starvation, may be prescribed.