The term pancreatitis defines an inflammatory process located 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. The 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 to significantly reduce the functional load on the pancreas, which contributes to the rapid reduction of the severity of the inflammatory process. The diet has many of the following distinctive features:
- The amount of carbohydrates (mainly due to sugar and other easily digestible disaccharides) and fats is reduced in the diet.
- Increasing the protein content of the diet.
- A sharp restriction in 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 very 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:
- 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.
- Fat - 80 g, of which 15-20% is of vegetable origin.
- Table salt (sodium chloride) - 10 g.
- Free liquid - 1. 5 liter.
- Energy value - 2600-2700 kcal.
The recommended food intake is 5-6 times a day, while the individual portions should be small. This makes it possible to reduce the load on the entire digestive system in general and on 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 caused by various reasons, damage to glandular cells occurs, as well as tissue swelling. At the same time, compression of the excretory ducts of the pancreas develops, the outflow of contents is disturbed, which can then cause tissue death, caused by the release of digestive enzymes (pancreanecrosis). To prevent the complications of inflammation, it is important to reduce the load 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 accompany the food. This at a regulatory level causes a decrease in the functional activity of the pancreas, a decrease in the production of digestive enzymes and a decrease in the possibility 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 course of metabolic processes in the tissues of the liver and other parenchymal organs of the digestive system.
Clues
The application of nutritional recommendations is indicated in the development of chronic pancreatitis in remission (improvement of the functional state) or in 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 pronounced acute course of the inflammatory process, it is not recommended to use a diet for pancreatitis, since 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 administered parenterally by intravenous infusion (amino acids, glucose). Also, if necessary, intensive treatment is prescribed using drugs of various pharmacological groups.
Permitted Products
The use of 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 meats, which include chicken, rabbit, beef, 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, boiled, baked or steamed pumpkin.
- Cereals - cereals from 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, under its normal tolerance, yogurt, cottage cheese, sour cream.
- Sweets - mousse, jellies, jelly, jam, which are prepared with xylitol (sweetener).
- Chicken eggs - limited, 2 pieces per day in the form of an omelette.
- Flour products - yesterday's bread from wheat or rye flour, lean products.
- Fats - butter, vegetable oil.
- Drinks - green, weak black tea, fruit juices, compotes, rosehip broth.
Prohibited Products
In the framework of the implementation of nutritional recommendations for pancreatitis, the use of the following foods is excluded:
- Soups, cabbage soup, meat borscht, fish broth, beetroot, okroshka.
- Fatty meats (duck, goose, pork, lamb), fried, stewed dishes from it, smoked meats, sausages.
- Fatty, fried, boiled, salted fish, caviar, canned food.
- Any 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, 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.
- Pastry cream, chocolate, ice cream, sweets that contain a significant amount of sugar.
- Animal fat.
Nutritional characteristics
Proper use of the pancreatitis diet includes following many of the following recommendations and eating habits:
- The menu for acute pancreatitis or exacerbation of a chronic process includes a mandatory treatment regimen. The amount of food is severely limited until temporary therapeutic starvation (diet 0). As the severity of the inflammatory process recedes, the menu is gradually expanded, but the food is served in crushed form.
- In chronic pancreatitis, a 5p diet is used without a sparing scheme. 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 nutritional recommendations. If there is a high probability of pancreatic necrosis in the first days, a 0 diet is prescribed under close 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 no later than 2 hours before the intended sleep. In modern recommendations, the time interval between dinner and bedtime increases to 3-4 hours.
- In chronic pancreatitis, a diet is prescribed for a long time, which is necessary primarily to prevent the 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 pot with chicken meat, apple jelly.
- Snack - cookie cookies, rosehip broth.
- Dinner - boiled fish without bones, mashed potatoes with a small amount of butter, green tea.
Tuesday
- Breakfast - vegetable vinaigrette, cheese sandwich, green tea.
- Lunch - casserole with cottage cheese with the addition of plums.
- Lunch - milk soup with rice, boiled carrots with boiled chicken, fruit compote.
- Afternoon snack - lean cookies with freshly squeezed fruit juice.
- Dinner - pasta with cottage cheese, boiled in water, jelly.
Wednesday
- Breakfast - apple and carrot salad, steamed chopped cutlets, fruit juice.
- Lunch is a baked pear.
- Lunch - vegetable soup boiled in milk, boiled boneless fish with rice porridge, fresh fruit.
- Snack - biscuits cookies, dried fruit compote.
- Dinner - rice porridge cooked in milk, sandwich with cheese, 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 in a decoction of dried fruits, pudding with cottage cheese, baked apple.
- Snack - fruit jelly.
- Dinner - buckwheat porridge, boiled in water, with steamed beef cutlets, 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, 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, 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 steam cutlets, compote.
- Snack - cookie cookies, rosehip broth.
- Dinner - an omelet from chicken eggs, lazy pasta 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 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 remission of acute inflammation or in the context 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 is therapeutic starvation, may be prescribed.