The term pancreatitis defines an inflammatory process localized in the tissue of the 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 for pancreatitis is marked with 5p.
The most important feature of the diet
The main goal of the diet in acute or chronic pancreatitis is a significant decrease in the functional load of the pancreas, which contributes to the rapid decrease in the severity of the inflammatory process. The diet has several of the following characteristics:
- In the diet, the amount of carbohydrates (mainly due to sugar and other easily digestible disaccharides) and fats is reduced.
- 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 fibres, 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. The food pot is limited. Avoid fried food.
- The number of cold and too hot dishes is limited.
The chemical composition, the daily content of the most important 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 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 5-6 times a day, while 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 effect
The pancreas is a functionally important organ in the digestive system. It produces a number 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 causes, damage to the glandular cells occurs, 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). To prevent complications of inflammation, it is important to reduce the stress on the pancreas, for which the 5p diet was developed.
The essence of dietary recommendations is to significantly reduce the amount of carbohydrates and fat that comes with the food. This at the regulatory level causes a decrease in the functional activity of the pancreas, the production of digestive enzymes and the likelihood of developing pancreatic necrosis decreases. Fractionated 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.
Indications
The implementation 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). The diet can also be used for combined inflammation of the pancreas, gall bladder, liver.
Contraindications
With a pronounced acute course of the inflammatory process, the use of a diet for pancreatitis is not recommended, since table 0 (complete lack of nutrition) in this case is prescribed for a period of up to several days. The most important organic nutrients in the form of monomers are administered parenterally by intravenous drip (amino acids, glucose). Also, if necessary, intensive treatment is prescribed using drugs of various pharmacological groups.
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), grains (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 it is recommended.
- Vegetables - potatoes, cauliflower, zucchini, green peas, carrots, beets, pumpkin boiled, baked or steamed.
- 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 baked.
- Dairy products - low-fat whole milk in limited quantities, subject to its normal tolerance, yogurt, cottage cheese, cream.
- Sweets - mousse, jelly, jelly, marmalade, which are prepared using xylitol (a sweetener).
- Chicken eggs - limited, 2 pieces per day in the form of omelettes.
- Flour products - yesterday's bread made from wheat or rye flour, lean products.
- Fats - butter, vegetable oil.
- Drinks - green, weak black tea, fruit juice, compotes, rosehip broth.
Prohibited products
Based on the implementation of dietary recommendations for pancreatitis, the use of the following foods is excluded:
- Soups, cabbage soup, borsch on meat, 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 with high fat and sugar content, including lactose (milk sugar).
- Legumes, the use of barley, maize, pearl barley and crumbly cereals are limited.
- White cabbage, turnip, sorrel, sweet pepper, eggplant, radish, onion, garlic, spinach, mushrooms, radish.
- Condiments, spicy, fatty sauces, especially those cooked in meat broth.
- Coffee, cocoa, carbonated and cold drinks.
- Confectionery, chocolate, ice cream, sweets that contain a significant amount of sugar.
- Animal fat.
Nutritional functions
Correct use of the diet for pancreatitis involves 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 sharply limited up to temporary healing starvation (diet 0). As the severity of the inflammatory process decreases, the menu is gradually expanded, but the food is served in a crushed form.
- In chronic pancreatitis, a 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 tissue 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 diet 0 is prescribed under close medical supervision.
- It is recommended to take food 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 between dinner and bedtime is increased to 3-4 hours.
- In chronic pancreatitis, a diet is prescribed for a long period of time, which is necessary primarily to prevent aggravation of the inflammatory process in the tissue 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 - soup with vegetables, boiled in water, noodle pot with chicken meat, apple jelly.
- Snack - biscuit cookies, rose hip 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, stewed 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, chopped steamed chops, fruit juice.
- Lunch is a baked pear.
- Lunch - vegetable soup cooked in milk, boiled boneless fish with rice porridge, fresh fruit.
- Snack - biscuit cookies, dried fruit compote.
- Dinner - rice pudding 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 a decoction of dried fruits, cottage cheese pudding, baked apple.
- Snack - fruit jelly.
- Dinner - buckwheat porridge, boiled in water, with beef steam 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, cabbage rolls boiled 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, stew made from vegetables and chicken, fruit compote.
- Snack - dry biscuits, dried fruit compote.
- Dinner - stew 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 - biscuit cookies, rose hip broth.
- Dinner - an omelet made from chicken eggs, lazy dumplings with cottage cheese, kefir.
Doctor's opinion
The diet for pancreatitis 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 tissue 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 aim to reduce the functional load on the pancreas during the period of subsiding 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 is therapeutic starvation, can be prescribed.