Diet in diseases of the pancreas
Gastroenterology / / May 04, 2016
Pancreatitis is a disease polietiologic.It noted his close relationship with the pathology of the neighboring organs and systems in the first place with the defeat of gastroduodenal and hepatobiliary systems.
At the heart of pancreatitis are inflammatory and degenerative changes in the parenchyma of the pancreas, which in acute disease can lead to pancreatic necrosis, and chronic recurrent pancreatitis - the development of fibrosis of the parenchyma of glandular tissue with loss of its digestive function, first looks, and then endocrine.
The majority of patients with acute pancreatitis in the early stages of disease and chronic illness in the acute stage due to violation of the outflow of pancreatic juice there is an increased concentration of pancreatic enzymes such as amylase, lipase, trypsin, and reduced activity of trypsin inhibitor.Because pancreatic enzymes play a major role in the digestive process, when it is broken lesion uptake primarily of proteins, so that for all phases of p
In acute and chronic pancreatitis progressing to some extent impaired endocrine function of the pancreas, resulting in a violation of carbohydrate metabolism as a result of involvement in the pathological process of insular apparatus is reduced glucagon levels, which leads to hyperglycemia and glycosuria.
Acute pancreatitis is acute inflammation of the pancreas due to activation of pancreatic enzyme complex produced by the pancreas tissue.As a result of an inflammatory response occurs digesting enzymes of the body and released into the bloodstream have a general toxic effect.
The etiology of acute pancreatitis may have a value of alcoholic and other toxic, infectious, allergic, traumatic, nutritional, mechanical factors, and others.
Treatment of acute pancreatitis or chronic to the acute stage should be comprehensive and primarily directed at reducing pain,giperfermentemii reduction, inhibition of the secretory function of the pancreas and duodenum, and also a remedy for metabolic processes;when indicated antibacterial therapy should be carried out.Along with drug therapy and compliance with bed rest to reduce gastric acid secretion, especially enzymes of the stomach and pancreas, in the first 2-3 days of patients with acute pancreatitis and exacerbation of chronic pancreatitis is appointed by starvation.In these days it is recommended to use 1-1.5 l (200 ml 4-5 times), mineral water (Borjomi) at room temperature and without gas, broth hips (1-2 glasses).
C 2-3-th day of the disease is assigned a diet number 5P (the first version of pancreatic diet), the most gentle of pancreatic function.It is low-calorie, protein contains physiological norm with a sharp restriction of fats and carbohydrates.
limited fats, mainly refractory and carbohydrate (sugar, honey, jam, pastries).
Diet mechanically and chemically gentle.Excluded are products that cause flatulence, containing crude fiber, rich in extractive substances that promote the secretion of digestive glands.Food is cooked in boiled, steam form, liquid or semi-liquid consistency.Eating 5-6 times a day.
chemical composition of diet number 5P (I variant) for the day: protein 80 g, fat 40-60 g, 200 g carbohydrate caloric 1500-1600 kcal.Salt 8-10 1.5-2.0 liters of fluids.
Recommended dishes and products
Rusk of wheat bread '50
Soups - the mucous membranes of different cereals (oat, rice, semolina, barley, etc., in addition to wheat.) Water or vegetable broth rather weak, suppositorycream of digested meat.
Meat and poultry - from the low-fat varieties (beef, chicken, turkey, rabbit) without tendon and fat, in the form of a souffle, steam cutlets or quenelle.
Fish - from the low-fat varieties (cod, perch, carp, perch, etc.) As a soufflé, quenelle.
Egg dishes - boiled egg, omelet steam (no more than 1-2 eggs per day).
dishes from milk - the milk only in dishes, cheese, freshly prepared in the form of pastes, steam puddings.
Fats - unsalted butter (added to the ready-made meals).
dishes and side dishes of vegetables - potatoes, carrots, zucchini, cauliflower in the form of puree, steam puddings.
Fruits - apples baked (Antonov excluded).
Sweet dishes - mashed compote of dried and fresh fruit, jelly, jelly, mousse for xylitol and sorbitol.
Drinks - rather weak tea, mineral water, broth hips.
prohibited meat, fish, mushroom and strong vegetable broths, fatty meats, poultry and fish (lamb, pork, goose, duck, sturgeon, sturgeon, catfish), fried foods and roasting, raw vegetables and fruits, cabbage, radish, onion, turnip, sorrel, lettuce, spinach, radishes, turnips, smoked, canned, sausages, muffins and freshly baked bread, pastries, rye bread, ice cream, alcoholic beverages, spices.
Diet appointed for 5-7 days.
Chronic pancreatitis often develops after acute pancreatitis, although sometimes marked long periods of time between the first attack of acute pancreatitis and the development of chronic pancreatitis.Chronic pancreatitis may occur in patients with cholelithiasis after cholecystectomy in patients with peptic ulcer.
Pathogenesis of chronic pancreatitis is the same as that of acute pancreatitis based disease are disorders outflow of pancreatic juice and bile, whereby there secret pancreatic function disorder.
should also bear in mind the reactive pancreatitis, flowing against the background of the underlying disease - peptic ulcer, chronic cholecystitis, enterocolitis, gastroduodenitis, after resection of the stomach, etc., which is a form of violation of pancreatic function..This type of destruction of the pancreas sometimes goes unnoticed in the background of the underlying disease.
Treatment of chronic pancreatitis is one of the most urgent problems of modern gastroenterology.It can be argued that without diet therapy is difficult to count on a sufficient therapeutic effect in these patients.
Nutritional care of patients with acute and chronic pancreatitis is required at all stages of their treatment in a hospital, sanatorium, at home and is a permanent factor in treatment.Properly organized health food can prevent the development of complications, worsening of the disease and its progression.
diet for chronic pancreatic diseases should contain a high amount of protein (up to 110-120 g), which reduces the protein deficiency in the body and at the same time increases the synthesis of trypsin inhibitors improves the reparative processes in the pancreas, promotes a more rapid elimination of the clinicalmanifestations of the disease.
Due to the fact that in chronic pancreatitis suffer endocrine function of the pancreas, in the diet should limit the amount of carbohydrates (300-350 g), mainly due to the simple digestible (honey, sugar, jam, candy, etc.).
In diseases of the pancreas is disturbed digestion of fat due to the decrease in pancreatic function and disorders zhelcheotdelitelnoy chologenic and functions, so the amount of fat in the diet is limited (up to 80 g).
All food is prepared in a shabby, steamed or zapekaetsya.Isklyuchaetsya copious introduction of food at once.Meals should be frequent and fractional (5-6 times a day).
chemical composition of diet «№2 5n (II variant) on the day : 110-120 g protein, 80 g fat, carbohydrates 300-350 of caloric 2500-2800 kcal.Salt 8-10 of fluids 1.5-2 liters.
list of recommended dishes and products
Bread.grain mill products - bread wheat varieties I and II, the baking of the previous day or the dried, 200-300 g, nesdobnoe cookies.Soups
- vegetarian vegetables (except cabbage), cereals (except millet) with pasta, noodle, pureed, or mucous membranes, with the addition of a small amount of butter (5 g) or cream (10 g).Meat and poultry - from the low-fat varieties (beef, veal, chicken, turkey, rabbit) without tendon and fat, boiled, baked, or steam (cutlets, dumplings, beef stroganoff, mashed potatoes, soufflé, roll, burgers and so on.).During remission, non-rigid, and lean meat, chicken, rabbit allowed in a piece of boiled.Fish dishes - various lean fish, preferably a river (cod, perch, pike, carp, pike, ice, etc.), Boiled whole or chopped (croquettes, dumplings, soufflés, cakes).
Egg dishes - steam omelette or boiled eggs (2 eggs per day).
dishes from milk - sour curd (homemade) calcined or buttermilk in its natural form or in the form of baked puddings, sour cream and cream (added to the dish), sour yogurt.Cheese "Dutch", "Russian".Fats - unsalted butter (30 g), refined vegetable (10-15 g), are added to the dish.
Dishes and garnishes from groats and pasta - porridge from a variety of cereals (excluding wheat) grated semi-viscous, homemade noodles, vermicelli, pasta, prepared on the water or on the water with milk (1: 1).
dishes and side dishes of vegetables - different kinds of boiled and roasted vegetables in a shabby (carrots, pumpkin, beets, cauliflower, green peas, young beans).
Fruits - apples sour when baked or grated peeled.
sweet dishes - compotes from fresh and dry fruit pureed, jelly, jelly, mousse of juice without sugar xylitol or sorbitol.
Drinks - weak tea with lemon, fruit and berry juices without sugar, diluted with water, broth hips and black currants.
Sauces - dairy imperfect in the vegetable broth, fruit and berry gravy.Flour for the sauce saute with butter.
prohibited meat, fish, mushroom broth, pork, lamb, goose, duck, fried foods, high-melting fats, meats, preserves, sausages, eggs Kets, sturgeon, sturgeon, salmon, catfish, carp, pickles, pickles, spices,mushrooms, strong tea, coffee, cocoa, chocolate, cabbage, spinach, lettuce, radishes, turnips, mature beans, raw vegetables and fruits, cranberries, sweet bread, pastry, rye bread, cold foods and drinks, ice cream,carbonated drinks and alcoholic beverages.
Food should not be too hot and cold.
diet patients with chronic pancreatitis are advised to observe systematically and for a long time.
- Pancreatitis: Causes, Symptoms, treatment of pancreatitis
- pancreas Anatomy
- Histological structure
- pancreas Diet for liver diseases
- Diet for peptic ulcer
Sample menu diet number 5P (I variant)
1st breakfast (9 am).Omelette protein steam of 2 eggs, buckwheat groats on the water semi-viscous,
rather weak tea.
2nd breakfast (11 hours).Baked apple tea.
Lunch (14 hours).Soup slimy oatmeal 1/2 servings souffle steam fish, jelly cherry juice on xylitol.
Afternoon (16 hours).Meat cheese, broth hips (1 cup).
Dinner (19 hours).Meat souffle cooked meat, carrot souffle steam, tea.
the night.1 glass of rose hips.All day.Crackers 50 g sugar '15
diet menu Approximate number 5n (II variant)
1st breakfast.Meat Cutlets steam, rice porridge semi-viscous mashed with milk.
2nd breakfast.Cottage cheese souffle freshly prepared cheese, tea with milk.Lunch, Potato soup vegetarian, fish baked with béchamel, compote of fresh fruit pureed sugar.
Snack.Omelette steam of 2 eggs, 1 cup broth hips.
Dinner.Roll the meat of boiled meat, stuffed with scrambled eggs, baked, baked pudding of fat-free yogurt, broth 1 cup of black currant.
the night.Kefir sour.
on all day.Wheat bread baking yesterday, 200 g sugar '30