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 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 classification of diets, the table of pancreatitis is labeled 5p.
The main feature of the diet
The main goal of the diet for acute or chronic pancreatitis is a significant reduction in the functional load of the pancreas, which contributes to a rapid reduction in the severity of the inflammatory process. The diet has the following distinctive features:
- The amount of carbohydrates (mainly due to sugar and other easily digestible disaccharides) and fats in the diet decreases.
- Increasing the protein content in the diet.
- A sharp restriction in the intake of extractable 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.
- Food should be steamed or boiled. Steaming 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, and the energy value of the diet for pancreatitis include the following indicators:
- Proteins - 110-120 g, of which 60-65% are of animal origin.
- Carbohydrates - 350-400 g, of which 30-40 g of sugar is allowed. It is recommended to consume 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 meals should be 5-6 times a day, and each portion should be small. This makes it possible to reduce the load on the entire digestive system in general and the pancreas in particular.
Therapeutic mechanism of action
The pancreas is a functionally important organ of the digestive system. It produces several 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 causes, gland cell damage and tissue edema occur. At the same time, the excretory ducts of the pancreas are compressed, the outflow of the contents causes a disturbance, which can subsequently provoke tissue death, which is caused by the release of digestive enzymes (pancreonercosis). In order 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 dietary recommendations is to significantly reduce the amount of carbohydrates and fats in 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 pancreatic necrosis. Frequent meals in fractional, 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 of the pancreas. By increasing the amount of lipotropic compounds and vitamins, the flow of metabolic processes in the tissues of the liver and other parenchymal organs of the digestive system can be improved.
Indications
The implementation of the dietary recommendations is recommended in the case of chronic pancreatitis in remission (improvement of the functional state) or in the acute course of the inflammatory process during the period of convalescence (healing). In addition, the diet can also be used in cases of inflammation of the pancreas, gall bladder, and liver.
Contraindications
In the case of a pronounced acute course of the inflammatory process, the use of the pancreatitis diet is not recommended, since in this case table 0 (complete lack of nutrition) is prescribed for a maximum of several days. The main nutrient organic compounds in the form of monomers are administered parenterally by intravenous drip (amino acids, glucose). In addition, if necessary, intensive treatment with drugs of various pharmacological groups is prescribed.
Authorized products
The diet for pancreatitis includes the consumption of permitted foods, the list of which is quite varied and includes:
- The first courses are soups boiled in water with the addition of vegetables (carrots, potatoes, pumpkins, zucchini), cereals (wheat, rice, buckwheat), vermicelli, a small amount of butter is allowed.
- Meat - lean meats, which include chicken, rabbit, veal, beef, skinless turkey. Before cooking, the meat is freed from the skin (poultry) and tendons. Boiling or steaming is recommended.
- Vegetables - potatoes, cauliflower, zucchini, green peas, carrots, beets, pumpkin boiled, fried or steamed.
- Cereals - cereals made from oats, buckwheat, semolina, rice, which are cooked in water or a little milk. It can also be added to souffle and pudding.
- Ripe, sweet fruits or berries that can be eaten fresh or baked.
- Dairy products - low-fat whole milk in limited quantities, depending on normal tolerance, yogurt, cottage cheese, cream.
- Sweets - mousse, jelly, jelly, jam, which are made with xylitol (sweetener).
- Chicken eggs - limited, 2 per day in the form of omelets.
- Products made from flour - bread made from yesterday's wheat or rye flour, lean products.
- Fats - butter, vegetable oil.
- Drinks - green, weak black tea, fruit juices, compotes, rosehip broth.
Prohibited products
Against the background of the implementation of dietary recommendations for pancreatitis, the use of the following foods is excluded:
- Soups, cabbage soup, borsch on meat, fish soup, beetroot, okroshka.
- Fatty meats (duck, goose, pork, lamb), fried and steamed dishes, smoked meats, sausages.
- Fatty, fried, steamed, salted fish, caviar, canned.
- Any dairy product high in fat and sugar, including lactose (milk sugar).
- The use of legumes, barley, corn, pearl barley and crumbly cereals is limited.
- White cabbage, turnips, sorrel, sweet peppers, eggplant, radishes, onions, garlic, spinach, mushrooms, radishes.
- Spices, spicy, fatty sauces, especially those cooked in broth.
- Coffee, cocoa, carbonated and cold drinks.
- Creamy sweets, chocolate, ice cream, sweets containing a significant amount of sugar.
- Animal fats.
Nutritional characteristics
Proper use of the pancreatitis diet includes following the following recommendations and eating habits:
- In case of acute pancreatitis or exacerbation of the chronic process, the menu includes a mandatory sparing regimen. The amount of food is sharply limited until temporary healing starvation (diet 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 5 p diet is used without sparing treatment. This includes the usual temperature regime, with the mandatory exception of very hot and very cold foods.
- 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 strict medical supervision.
- We recommend that you eat at least 5 times a day, in small portions, which allows you to significantly reduce the load on the pancreas.
- The last meal is recommended no later than 2 hours before the planned sleep. According to modern recommendations, the time between dinner and bedtime is increased to 3-4 hours.
- In case of chronic pancreatitis, a long-term diet is prescribed, which is primarily necessary to prevent the exacerbation of the inflammatory process in the tissues of the pancreas.
Sample menu for the week
Monday
- Breakfast - buckwheat porridge cooked in milk, bread and butter, weak black tea.
- Lunch - fresh pear.
- Lunch - vegetable soup, boiled pasta with chicken meat, apple jelly.
- Snack - biscuit cookie, rosehip broth.
- Dinner - boiled fish without bones, mashed potatoes with a small amount of butter, green tea.
Tuesday
- Breakfast - boiled vegetable vinaigrette, cheese sandwich, green tea.
- Lunch - cottage cheese casserole with the addition of prunes.
- Lunch - milk soup with rice, steamed carrots with boiled chicken, fruit compote.
- Afternoon snack - thin cake with freshly squeezed fruit juice.
- Dinner - cottage cheese pasta, boiled in water, jelly.
Wednesday
- Breakfast - apple and carrot salad, chopped steamed steak, fruit juice.
- Lunch is a baked pear.
- Lunch - vegetable soup cooked in milk, boiled boneless fish with rice, fresh fruits.
- Snack - biscuit 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 with a decoction of dried fruits, curd pudding, baked apple.
- Snack - fruit jelly.
- Dinner - buckwheat porridge, boiled in water, with beef steam slices, non-carbonated 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 with rice and boiled chicken, fruit jelly.
- Snack - sweet fresh apple.
- Dinner - potatoes boiled in water, boiled fish without bones, kefir, a piece of bread.
Saturday
- Breakfast - cheesecake with fruit jam, green tea.
- Lunch is a fresh banana.
- Lunch - borscht cooked in vegetable soup, vegetable and chicken casserole, fruit compote.
- Snack - dry biscuits, dried fruit compote.
- Dinner - casserole with pasta and boiled beef, kefir.
Sunday
- Breakfast - soup with potato dumplings, weak black tea boiled in milk.
- Lunch is a fresh sweet apple.
- Lunch - cabbage soup cooked in vegetable soup, boiled pasta with steam slices, compote.
- Snack - biscuit cookie, rosehip broth.
- Dinner - chicken egg omelette, lazy dumplings with cottage cheese, kefir.
Doctor's opinion
The diet for pancreatitis is biologically based. By reducing the functional load of the pancreas, the risk of complications, including pancreatic death, 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. The aim of the dietary recommendations is to reduce the functional load on the pancreas during the period of reduction of acute inflammation or against the background of the chronic course of the disease. In the case of acute pancreatitis, a 0-diet, which is therapeutic starvation, may be prescribed due to the high risk of pancreatic necrosis in the medical hospital.