The term pancreatitis defines an inflammatory process that is localized in the tissues of the 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 digestion 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 classification of diets, the table for pancreatitis is marked 5p.
The main characteristic of nutrition
The main goal of nutrition in acute or chronic pancreatitis is to significantly reduce the functional load of the pancreas, which contributes to a rapid reduction in the severity of the inflammatory process. The diet has several of the following characteristics:
- The amount of carbohydrates (mainly due to sugar and other easily digestible disaccharides) and fat is reduced in the diet.
- Increasing the protein content in the diet.
- A sharp restriction of the intake of extractive organic compounds, purine bases, refractory fats, essential oils, cholesterol, coarse fibers, which significantly increase the load on the organs of the digestive system.
- Increasing the content of lipotropic compounds and vitamins.
- Dishes should be steamed or boiled. Cooking food is limited. Avoid fried foods.
- The number of cold and 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:
- Proteins - 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 take 20-30 g of the sweetener xylitol.
- Fats - 80 g, of which 15-20% are of vegetable origin.
- Kitchen 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 load on the entire digestive system in general, and the pancreas in particular.
Mechanism of therapeutic action
The pancreas is a functionally important organ of the digestive system. It produces numerous 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 caused by various reasons, there is damage to glandular cells, 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 tissue death, caused by the release of digestive enzymes (pancreonercosis). In order to prevent complications of inflammation, it is important to reduce the burden 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 come with food. At the regulatory level, this causes a decrease in the functional activity of the pancreas, the production of digestive enzymes and the likelihood of developing pancreatic necrosis. Fractional, frequent meals in 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 flow of metabolic processes in liver tissues and other parenchymal organs of the digestive system.
Indications
The use 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 in the period of convalescence (recovery). Also, the diet can be used for combined inflammation of the pancreas, gallbladder, and liver.
Contraindications
With a pronounced acute course of the inflammatory process, it is not recommended to use a diet for pancreatitis, because in this case table 0 (complete lack of nutrition) is prescribed for a period of up to several days. The main nutritional organic compounds in the form of monomers are given parenterally by intravenous drip (amino acids, glucose). Also, if necessary, intensive treatment with drugs of different pharmacological groups is prescribed.
Allowed products
Using a diet for pancreatitis involves taking permitted foods, the list of which is quite diverse and includes:
- The first dishes 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 meat, which includes chicken, rabbit, veal, beef, skinless turkey. Before cooking, the meat is freed from the skin (poultry), tendons. Boiling or steaming is recommended.
- Vegetables - potatoes, cauliflower, zucchini, green peas, carrots, beets, pumpkin boiled, baked or steamed.
- Cereals - cereals made of oats, buckwheat, semolina, rice, which are cooked in 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 his normal tolerance, yogurt, fresh cheese, cream.
- Sweets - mousse, jelly, jelly, marmalade, which are prepared using xylitol (sweetener).
- Chicken eggs - limited, 2 pieces per day in the form of an omelette.
- 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 soup.
Prohibited products
Against the background of the implementation of dietary recommendations for pancreatitis, the use of the following foods is excluded:
- Soups, cabbage soup, meat borscht, fish broth, beetroot, okroshka.
- Fatty meat (duck, goose, pork, lamb), fried, stewed dishes from it, smoked meat, sausages.
- Fatty, fried, stewed, salted fish, caviar, canned food.
- All dairy products high in fat and sugar, including lactose (milk sugar).
- Legumes, the use of barley, corn, pearl barley and crumbly grains is limited.
- White cabbage, turnip, sorrel, 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.
- Cream confectionery, chocolate, ice cream, sweets that contain a significant amount of sugar.
- Animal fats.
Nutrition Features
Proper use of a diet for pancreatitis includes following several 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 severely limited until temporary curative starvation (diet 0). As the intensity of the inflammatory process decreases, the menu gradually expands, but the food is served in a crushed form.
- In chronic pancreatitis, the 5p diet is used without a sparing regimen. 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 prescribes 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 food at least 5 times a day in small portions, which allows for a significant reduction in the burden on the pancreas.
- The last meal is recommended no later than 2 hours before the planned bedtime. In modern recommendations, the time period between dinner and sleep is increased to 3-4 hours.
- In chronic pancreatitis, the diet is prescribed for a long period of time, which is primarily necessary to prevent the worsening of the inflammatory process in the pancreatic tissues.
Sample menu for the week
Monday
- Breakfast - buckwheat porridge cooked in milk, bread and butter, weak black tea.
- Lunch - fresh pear.
- Lunch - soup with vegetables, boiled in water, casserole with noodles with chicken meat, apple jelly.
- Snack - biscuits, rosehip soup.
- Dinner - boiled boneless fish, mashed potatoes with a small amount of butter, green tea.
Tuesday
- Breakfast - vinaigrette of boiled vegetables, sandwich with cheese, green tea.
- Lunch - cottage cheese casserole with added prunes.
- Lunch - milk soup with rice, stewed carrots with boiled chicken, fruit compote.
- Afternoon snack - lean cookies with freshly squeezed fruit juice.
- Dinner - pasta with fresh 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, dried fruit compote.
- Dinner - rice porridge cooked in milk, sandwich with cheese, apple compote.
Thursday
- Breakfast - semolina porridge, cooked in milk, with the addition of prunes, weak black tea.
- Lunch - carrot puree with apple jam.
- Lunch - vegetable soup cooked on dried fruit broth, cottage cheese pudding, baked apple.
- Snack - fruit jelly.
- Dinner - buckwheat porridge, boiled in water, with steamed beef cutlets, non-carbonated mineral water.
Friday
- Breakfast - cheesecakes with carrots, black tea.
- Lunch - fresh cheese with low-fat sour cream.
- Lunch - soup with barley and carrots, boiled in water, sarmica boiled with rice and boiled chicken meat, fruit jelly.
- Snack - sweet fresh apple.
- Dinner - potatoes boiled in water, boiled boneless fish, 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 cooked 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 - biscuits, rosehip soup.
- Dinner - chicken egg omelet, lazy dumplings with cottage cheese, kefir.
Doctor's opinion
Diet for pancreatitis is biologically correct. Reducing the functional load of the pancreas significantly reduces the risk of complications, including pancreatic necrosis, and also accelerates the inflammatory process in the tissues of the organ. 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. Nutritional recommendations are aimed at reducing the functional load on the pancreas during the period of subsiding of 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, diet 0, which represents therapeutic starvation, may be prescribed.