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 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 nutritional recommendations. According to the classification of diets, the table for pancreatitis is indicated by 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 of the pancreas, which contributes to the rapid reduction of the severity of the inflammatory process. The diet has several 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.
- Sharp limitation of 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.
- Food should be steamed or boiled. Food stewing is limited. Avoid fried foods.
- The number of cold and too hot dishes is limited.
The chemical composition, 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% are 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.
- 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 intake of food is 5-6 times a day, and 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, damage to glandular cells occurs, as well as tissue edema. At the same time, compression of the excretory ducts of the pancreas develops, the outflow of the contents is disturbed, which can subsequently provoke tissue death provoked by the release of digestive enzymes (pancreonercosis). 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 dietary recommendations is to significantly reduce the amount of carbohydrates and fats that come with food. This at the regulatory level leads to a decrease in the functional activity of the pancreas, the production of digestive enzymes and the probability of developing pancreatic necrosis decreases. Partial frequent meals in small portions allow 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 application of dietary recommendations is indicated in the development of chronic pancreatitis in remission (improvement of the functional state) or an acute course of the inflammatory process during the period of convalescence (recovery). Also, the diet can be used for combined inflammation of the pancreas, gall bladder, and 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 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 with drugs from different pharmacological groups is prescribed.
Allowed products
The use of a diet for pancreatitis includes the intake of 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 oil is allowed.
- Meat – lean meats that include chicken, rabbit, veal, veal, skinless turkey. Before cooking, the meat is freed from the skin (bird), tendons. Boiling or steaming is recommended.
- Vegetables - potatoes, cauliflower, zucchini, green peas, carrots, beets, pumpkin boiled, baked or steamed.
- Cereals - cereals from oats, buckwheat, semolina, rice, which are boiled 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 roasted.
- Dairy products - low-fat whole milk in limited quantities, with normal tolerance, yogurt, cottage cheese, cream.
- Sweets - mousse, jelly, jelly, marmalade, which are prepared with xylitol (sweetener).
- Chicken eggs - limited, 2 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
Against the background of the implementation of dietary 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, stewed, salted fish, caviar, canned food.
- All 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, mushroom, radish.
- Spices, spicy, fatty sauces, especially cooked in meat broth.
- Coffee, cocoa, carbonated and cold drinks.
- Creamy confectionery, chocolate, ice cream, sweets containing a significant amount of sugar.
- Animal fats.
Nutrition characteristics
Proper use of the pancreatitis diet includes following several of the following recommendations and eating habits:
- The menu for acute pancreatitis or exacerbation of a chronic process includes a mandatory sparing regimen. The amount of food is sharply limited to temporary therapeutic fasting (diet 0). As the severity of the inflammatory process decreases, the menu is gradually expanded, but the food is served in broken form.
- In chronic pancreatitis, a 5p diet is used without a sparing regimen. 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 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 control.
- 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 planned sleep. In modern recommendations, the time period between dinner and bedtime increases to 3-4 hours.
- In chronic pancreatitis, a diet is prescribed for a long period of time, which is primarily necessary to prevent 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 - soup with vegetables boiled in water, noodle casserole with chicken meat, apple jelly.
- Snack - biscuit biscuits, rosehip broth.
- Dinner - boiled fish without bones, mashed potatoes with a little oil, green tea.
Tuesday
- Breakfast - vinaigrette of boiled vegetables, sandwich with cheese, 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 - low-fat cakes 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 baked pear.
- Lunch - vegetable soup cooked in milk, boiled boneless fish with rice porridge, fresh fruit.
- Snack - biscuit biscuits, 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 made with a decoction of dried fruits, cottage cheese pudding, baked apple.
- Snack - fruit jelly.
- Dinner - buckwheat porridge boiled in water, with veal steam 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 rolls, boiled 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 - 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 macaroni 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 biscuits, rosehip broth.
- Dinner - chicken egg omelet, lazy dumplings with cottage cheese, kefir.
Doctor's opinion
Diet for pancreatitis is biologically sustainable. By reducing the functional load of 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 designed to reduce the functional load of the pancreas in the period of subsidence 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 hospital, diet 0, which is therapeutic fasting, may be prescribed.