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 digestive process. Treatment of pancreatitis, regardless of the severity of the course, the nature and origin of the pathological process, necessarily involves 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 reduction of the functional load on the pancreas, which contributes to the rapid reduction of the severity of the inflammatory process. The diet has some of the following distinguishing 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 in 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. Boiling 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 xylitol sweetener.
- Fats - 80 g, of which 15-20% are of plant origin.
- Table salt (sodium chloride) - 10 g.
- Free juice - 1, 5 liters.
- Energy value - 2600-2700 kcal.
The recommended intake of food is 5-6 times a day, while the single 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 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 provoked by various reasons, gland cell damage occurs, as well as tissue edema. At the same time, compression of the excretory ducts of the pancreas develops, the flow of contents is disturbed, which can then provoke tissue death, provoked by the release of digestive enzymes (pancreonecosis). 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 dietary recommendations is to significantly reduce the amount of carbohydrates and fats that come with food. This at the 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 likelihood of developing pancreatic necrosis. Frequent partial 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 implementation of dietary 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 recovery period (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, 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 nutritional organic compounds in the form of monomers are administered parenterally by intravenous drip (amino acids, glucose). Also, if necessary, intensive treatment using drugs of different pharmacological groups is prescribed.
Permitted Products
The use of a diet for pancreatitis includes taking permitted foods, the list of which is quite diverse and includes:
- The first courses are soups boiled in water with the addition of vegetables (carrots, potatoes, pumpkins, zucchini), cereals (oatmeal, rice, buckwheat), vermicelli, a small amount of butter is allowed.
- Meat - lean meat, which includes chicken, rabbit, beef, veal, turkey without skin. 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, boiled, baked or steamed pumpkin.
- Cereals - cereals from oats, buckwheat, oatmeal, 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 an omelette.
- Flour products - yesterday's bread made from wheat or rye flour, fat-free products.
- Fats - butter, vegetable oil.
- Drinks - green tea, weak black tea, fruit juices, compote, rose juice.
Prohibited Products
Against the background of the implementation of dietary recommendations for pancreatitis, the use of the following foods is excluded:
- Soup, cabbage soup, meat borsch, fish broth, beetroot, okroshka.
- Fatty meat (duck, goose, pork, lamb), fried dishes, boiled from it, smoked meat, sausages.
- Fatty fish, fried, boiled, salted, caviar, canned food.
- Any dairy product high in fat and sugar, including lactose (milk sugar).
- Legumes, the use of barley, corn, pearl barley and crushed cereals is limited.
- White cabbage, turnip, sorrel, sweet pepper, eggplant, radish, onion, garlic, spinach, mushroom, radish.
- Spices, spicy, fatty sauces, especially those cooked in meat broth.
- Coffee, cocoa, carbonated and cold drinks.
- Pastry cream, chocolate, ice cream, cakes that contain a significant amount of sugar.
- Animal fats.
Nutritional characteristics
Proper use of the pancreatitis diet includes following some of the following nutritional recommendations and 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 is gradually expanded, but food is served in granular 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 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 close medical supervision.
- It is recommended to eat 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 not later than 2 hours before the intended sleep. According to modern recommendations, the time period between dinner and sleep increases to 3-4 hours.
- In chronic pancreatitis, a diet is prescribed for a long period of time, which is necessary primarily to prevent a worsening of the inflammatory process in the pancreatic tissue.
Sample menu for the week
Monday
- Breakfast - buckwheat porridge boiled in milk, bread and butter, weak black tea.
- Lunch - fresh pear.
- Lunch - vegetable soup, boiled in water, chicken noodle casserole, apple jelly.
- Snack - shortbread cookies, rose soup.
- Dinner - boiled fish without bones, mashed potatoes with a small amount of butter, green tea.
Tuesday
- Breakfast - vinaigrette with boiled vegetables, cheese sandwich, green tea.
- Lunch - cottage cheese casserole with the addition of prunes.
- Lunch - milk soup with rice, boiled carrots with boiled chicken, fruit compote.
- Afternoon snack - fat-free cookies with freshly squeezed fruit juice.
- Dinner - pasta with cottage cheese, boiled in water, jelly.
Wednesday
- Breakfast - apple and carrot salad, steamed cutlets, fruit juice.
- Lunch is a ripe pear.
- Lunch - vegetable soup boiled in milk, boiled boneless fish with rice porridge, fresh fruit.
- Snack - cookies with cookies, compote with dried fruits.
- Dinner - rice porridge cooked in milk, cheese sandwich, apple compote.
Thursday
- Breakfast - oatmeal porridge, boiled in milk, with the addition of prunes, weak black tea.
- Lunch – carrot puree with apple jam.
- Lunch - vegetable soup cooked in a dried fruit stew, curd pudding, baked apple.
- Snack - fruit jelly.
- Dinner - buckwheat porridge, boiled in water, with steamed veal cutlets, still 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 noodles cooked with rice and boiled chicken, fruit jelly.
- Snack - fresh sweet 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 broth, vegetable and chicken casserole, fruit compote.
- Snack - dry biscuit, dry fruit compote.
- Dinner - casserole with pasta and boiled beef, kefir.
Sunday
- Breakfast - soup with potato noodles, 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 - shortbread cookies, rose soup.
- Dinner - an omelet made from chicken eggs, lazy dumplings with cottage cheese, kefir.
Doctor's opinion
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 tissues of the organ is also accelerated. At the same time, the severity of edema decreases, the flow of pancreatic and bile fluid 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 reduction 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 is therapeutic starvation, can be prescribed.