The term pancreatitis defines an inflammatory process that is 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 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 feature 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 the rapid decrease in the severity of the inflammatory process. The diet has several of the following distinguishing features:
- The amount of carbohydrates (mainly due to sugar and other easily digestible disaccharides) and fats is reduced in the diet.
- Increase the protein content in the diet.
- A strong 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 hot and cold 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:
- Proteins: 110-120 g, of which 60-65% must 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 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 to 6 times a day, while individual portions should be small. This allows 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 a series of 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 for 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 the contents is disturbed, which can subsequently lead to tissue death, provoked by the release of digestive enzymes (pancreonercosis). To prevent complications of inflammation, it is important to reduce the load on the pancreas, for 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. At a regulatory level, this causes a decrease in the functional activity of the pancreas, decreases the production of digestive enzymes and decreases the probability of developing pancreatic necrosis. Frequent meals divided into small portions allow 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.
Indications
The implementation of dietary recommendations is indicated in the development of chronic pancreatitis in remission (improved functional status) 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, gallbladder, 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 time up to several days. The main nutrient organic compounds in the form of monomers are administered parenterally by intravenous drip (amino acids, glucose). Also, if necessary, intensive treatment with drugs of various pharmacological groups is prescribed.
Permitted Products
Using a diet for pancreatitis involves taking permissible 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), noodles, a small amount of butter is allowed.
- Meat: Lean meats, including 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, peas, carrots, beets, pumpkin boiled, baked or steamed.
- Cereals: oatmeal, buckwheat, semolina, rice cereals, which are cooked in water or with a little milk. They can also be added to souffles 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 your normal tolerance, yogurt, cottage cheese, cream.
- Sweets - mousse, jelly, jelly, jam, which are prepared with xylitol (a sweetener).
- Chicken eggs: limited, 2 pieces per day in the form of tortillas.
- Flour products: yesterday's bread made from wheat or rye flour, lean products.
- Fats - butter, vegetable oil.
- Drinks: green, soft 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 with meat, fish broth, beetroot, okroshka.
- Fatty meats (duck, goose, pork, lamb), fried dishes, stews, smoked meats, sausages.
- Fatty, fried, stewed, salted fish, caviar, preserves.
- Any dairy product that is 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, sweet pepper, eggplant, radish, onion, garlic, spinach, mushroom, radish.
- Spices, hot, fatty sauces, especially those cooked in meat broth.
- Coffee, cocoa, carbonated and cold drinks.
- Cream candies, chocolate, ice cream, sweets that contain a significant amount of sugar.
- Animal fats.
nutritional characteristics
The proper use of the diet for pancreatitis implies following several of the following recommendations and nutritional habits:
- The menu for acute pancreatitis or exacerbation of a chronic process includes a mandatory sparing regimen. The amount of food is severely limited until temporary curative starvation (diet 0). As the severity of the inflammatory process decreases, the menu gradually expands, but the food is served mashed.
- In chronic pancreatitis, a 5p diet is used without moderation. 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 few days, a 0 diet is prescribed under close medical supervision.
- Food is recommended to be taken at least 5 times a day in small portions, which allows to significantly reduce the load on the pancreas.
- It is recommended to have the last meal no later than 2 hours before the expected sleep. In modern recommendations, the period of time between dinner and bedtime is increased to 3-4 hours.
- In chronic pancreatitis, a diet is prescribed for a long period, 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: 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: vinaigrette of boiled vegetables, cheese sandwich, green tea.
- Lunch: cottage cheese casserole with the addition of prunes.
- Lunch: milk soup with rice, stewed carrots with boiled chicken, fruit compote.
- Snack: lean crackers 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 boiled in milk, boneless fish boiled with rice porridge, fresh fruit.
- Snack: biscuit cookies, dried fruit compote.
- 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: 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 steamed veal 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, boiled cabbage rolls 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 stew, 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, boiled pasta with steamed cutlets, compote.
- Snack: biscuit cookies, rosehip broth.
- Dinner - an omelet made from chicken eggs, lazy dumplings with cottage cheese, kefir.
doctor's opinion
The pancreatitis diet 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 intended to reduce the functional load on the pancreas during the period of declining 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 may be prescribed, which is therapeutic starvation.