The term pancreatitis defines an inflammatory process localized in the pancreatic tissue (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, necessarily includes the use of dietary recommendations. According to the diet classification, the table for pancreatitis is marked 5p.
The main features of the diet
The main goal of the diet in acute or chronic pancreatitis is a significant decrease 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 features:
- In the diet, the amount of carbohydrates (mainly due to sugar and other easily digestible disaccharides) and fat is reduced.
- Increase the protein content in the diet.
- Sharp restrictions on the intake of extractive organic compounds, purine bases, refractory fats, essential oils, cholesterol, crude 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 stews are limited. Avoid fried food.
- The number of cold and super hot 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 come from animals.
- Carbohydrates - 350-400 g, of which 30-40 g of sugar is allowed. It is recommended to take 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 portions 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 organ in the digestive system. It produces several digestive enzymes (protease, lipase, amylase) that 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, damage to gland cells occurs, as well as tissue edema. At the same time, compression of the excretory duct of the pancreas develops, the outflow of contents is interrupted, which can then trigger tissue death, which is provoked by the release of digestive enzymes (pancreonercosis). To avoid inflammatory complications, it is important to reduce the burden on the pancreas, for which the 5p diet was developed.
The essence of the nutritional 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 possibility of developing pancreatic necrosis decreases. Frequent meals divided into small portions make 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 liver tissue and other parenchymal organs of the digestive system.
Guidance
The implementation of nutritional 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 recovery (recovery). Also, the diet can be used for combined inflammation of the pancreas, gall bladder, liver.
Contraindications
With a clear acute inflammatory process, the use of a diet for pancreatitis is not recommended, because in this case table 0 (complete nutritional deficiency) is prescribed for a period of time up to several days. Organic compounds of the main nutrients in the form of monomers are administered parenterally with intravenous drips (amino acids, glucose). Also, if necessary, intensive treatment is prescribed using drugs of various pharmacological groups.
Authorized Products
Using a diet for pancreatitis involves the consumption of permitted foods, the list is quite diverse and includes:
- The first dish is a soup boiled in water with the addition of vegetables (carrots, potatoes, pumpkin, zucchini), grains (semolina, rice, buckwheat), vermicelli, a little butter is allowed.
- Meat - lean meat, which includes chicken, rabbit, beef, veal, skinless turkey. Before cooking, the meat is freed from the skin (chicken), tendons. It is recommended to boil or steam it.
- Vegetables - potatoes, cauliflower, zucchini, green beans, carrots, beets, squash boiled, baked or steamed.
- Cereals - cereals from oats, buckwheat, semolina, rice, which are cooked on water or with a little milk. They can also be added to soufflés and puddings.
- A ripe, sweet fruit or berry 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 an omelette.
- Flour products - overnight bread made from wheat or rye flour, fat-free products.
- Fat - butter, vegetable oil.
- Drinks - green, weak black tea, fruit juice, compote, rosehip soup.
Prohibited Products
Against the background of the implementation of dietary recommendations for pancreatitis, the consumption of the following foods is excluded:
- Soup, cabbage soup, borsch on meat, fish soup, beetroot, okroshka.
- Fatty meat (duck, goose, pork, lamb), fried, boiled dishes from it, smoked meat, sausage.
- Fatty, fried, boiled, salted fish, caviar, canned food.
- Any dairy product is high in fat and sugar, including lactose (milk sugar).
- Legumes, the use of barley, corn, pearl barley and brittle grains are limited.
- White cabbage, carrot, red chocolate, sweet pepper, eggplant, radish, onion, garlic, spinach, mushroom, turnip.
- Spices, hot sauces, fats, especially those cooked in meat broth.
- Coffee, cocoa, carbonated and cold drinks.
- Sweet cream, chocolate, ice cream, sweets that contain a large amount of sugar.
- Animal fat.
Nutritional Characteristics
The use of the correct diet for pancreatitis involves some of the following recommendations and eating habits:
- The menu for acute pancreatitis or exacerbation of the chronic process includes a mandatory sparing regimen. The amount of food is sharply limited until temporary curative starvation (diet 0). When the severity of the inflammatory process decreases, the menu gradually expands, but food is served in crushed form.
- In chronic pancreatitis, the 5p diet is used without a sparing regimen. It includes the normal temperature regime with mandatory exceptions for 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 nutritional recommendations. If there is a high probability of developing pancreatic necrosis in the first days, the 0 diet is prescribed under close medical supervision.
- It is recommended to eat food at least 5 times a day in small portions, which makes it possible to significantly reduce the burden on the pancreas.
- The last meal is recommended to be carried out 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, the diet is prescribed for a long period of time, which is mainly necessary to prevent the 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, casserole noodles with chicken meat, apple jelly.
- Snacks - biscuit cookies, rosehip soup.
- Dinner - boiled fish without bones, mashed potatoes with a little butter, green tea.
Tuesday
- Breakfast - boiled vegetable vinaigrette, cheese sandwich, green tea.
- Lunch - cottage cheese casserole with added prunes.
- Lunch - milk soup with rice, boiled carrots with boiled chicken, fruit compote.
- Afternoon snack - fat-free cookies with freshly squeezed fruit juice.
- Dinner - pasta with cottage cheese, boiled in water, jelly.
Wednesday
- Breakfast - apple and carrot salad, steamed cutlets, fruit juice.
- Lunch is baked pears.
- Lunch - vegetable soup boiled in milk, boiled boneless fish with rice porridge, fresh fruit.
- Snacks - 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 stew, cottage cheese pudding, baked apple.
- Snack - fruit jelly.
- Dinner - buckwheat porridge, boiled in water, with steam cut 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 rice and boiled chicken meat, fruit jelly.
- Snack - sweet fresh apples.
- Dinner - potatoes boiled in water, boiled fish without bones, kefir, a piece of bread.
Saturday
- Breakfast - cheesecake with fruit jam, green tea.
- Lunch is fresh bananas.
- Lunch - borscht cooked in vegetable soup, casserole made 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 steam cuts, compote.
- Snacks - biscuit cookies, rosehip soup.
- Dinner - omelet made from chicken eggs, lazy dumplings with cottage cheese, kefir.
Doctor's opinion
Diet for pancreatitis is biologically good. By reducing the functional load on the pancreas, the risk of complications, including pancreatic necrosis, is significantly reduced, and the inflammatory process in the organ tissue 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 of acute inflammation or against the background of chronic diseases. In the case of acute pancreatitis, due to the high risk of developing pancreatic necrosis in a medical hospital, diet 0, which is a therapeutic starvation, can be prescribed.