The term pancreatitis defines an inflammatory process localized in the tissue of the pancreas (pancreas). The acute or chronic course of diseases of varying degrees of severity causes 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 nutritional recommendations. According to the classification of diets, the pancreatitis table is marked with 5p.
The main 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 a rapid decrease in the severity of the inflammatory process. The diet has several distinct characteristics:
- The amount of carbohydrates (mainly due to sugar and other easily digestible disaccharides) and fat is reduced in the diet.
- Increasing the protein content in the diet.
- A sharp restriction on 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.
- Dishes 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, 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.
- Fat - 80 g, of which 15-20% is of vegetable origin.
- Table salt (sodium chloride) - 10 g.
- Free liquid - 1. 5 liters.
- Energy value - 2600-2700 kcal.
The recommended diet is 5-6 times a day, but individual portions should be small. This allows to reduce the load on the entire digestive system in general and especially on the pancreas.
Mechanism of therapeutic effect
The pancreas is a functionally important organ of the digestive system. It produces several digestive enzymes (protease, lipase, amylase), which are responsible for the breakdown of proteins, fats and carbohydrates in the lumen of the small intestine. During the development of an inflammatory reaction caused 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 outflow of contents is disturbed, which can then lead to tissue death due to the release of digestive enzymes (pancreonecosis). To prevent inflammatory complications, 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. At the regulatory level, it causes a decrease in the functional activity of the pancreas, the production of digestive enzymes and the possibility of the development of pancreatic necrosis. Fractionated 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 of 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 for the development of chronic pancreatitis in the remission stage (improvement of functional status) or during the acute inflammatory process during the recovery (recovery) period. Also, the diet can be used in case of combined inflammation of the pancreas, gall bladder, and liver.
Contraindications
With a pronounced acute course of the inflammatory process, the use of a pancreatitis diet is not recommended, because in this case table 0 (complete lack of nutrition) is intended for a period of up to several days. The main nutrient organic compounds in the form of monomers are administered parenterally with the help of intravenous drips (amino acids, glucose). Also, if necessary, intensive treatment using preparations of different pharmacological groups is prescribed.
Allowed products
The use of a diet for pancreatitis includes the use of permitted foods, the list of which is quite diverse and includes:
- The first dishes are soups boiled in water, with added vegetables (carrots, potatoes, pumpkin, zucchini), cereals (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, fried or steamed.
- Cereals - cereals made from oats, buckwheat, semolina, rice cooked on water or with a small amount of milk. They can also be added to soufflés and puddings.
- Ripe, sweet fruits or berries that can be eaten fresh or baked.
- Dairy products - whole milk with low fat content in a limited amount, observing normal tolerance, yogurt, cottage cheese, cream.
- Sweets - mousse, jelly, jelly, marmalade, for the preparation of which xylitol (sweetener) is used.
- Chicken eggs - limited, 2 pcs per day in the form of an omelette.
- Flour products - yesterday's bread from wheat or rye flour, lean products.
- Fat - butter, vegetable oil.
- Drinks - green, weak black tea, fruit juices, compotes, rosehip broths.
Prohibited products
Taking into account the implementation of dietary recommendations for pancreatitis, the following foods are excluded:
- Soups, cabbage soup, borscht on meat, fish broth, beets, okroshka.
- Fatty meat (duck, goose, pork, lamb), fried, stewed dishes from it, smoked meat, sausages.
- Fatty, fried, stewed, salted fish, caviar, canned food.
- Any dairy products with high fat and sugar content, including lactose (milk sugar).
- The use of legumes, barley, maize, groats and crushed cereals is limited.
- White cabbage, turnips, sorrel, sweet peppers, eggplants, radishes, onions, garlic, spinach, mushrooms, radishes.
- Spices, spicy, fatty sauces, especially those cooked in meat broth.
- Coffee, cocoa, carbonated and cold drinks.
- Cream pastries, chocolate, ice cream, sweets that contain a significant amount of sugar.
- Animal fats.
Nutritional properties
Proper use of the pancreatitis diet includes following several of the following recommendations and dietary habits:
- The menu of acute pancreatitis or an exacerbation of a chronic process includes a mandatory sparing regimen. The amount of food is severely limited to short-term medical fasting (diet 0). As the severity of the inflammatory process decreases, the menu gradually expands, but the food is served in chopped form.
- In case of chronic pancreatitis, the 5p diet is used without a sparing regimen. This includes the normal temperature regime, except for very hot and very cold foods.
- The course of the acute inflammatory process in the tissues of the pancreas requires hospitalization of the person in a medical hospital, where the doctor prescribes nutritional recommendations. If there is a high probability of developing pancreatic necrosis in the first days, diet 0 is prescribed under the strict supervision of a doctor.
- It is recommended to eat at least 5 times a day in small portions, which allows you to significantly reduce the load on the pancreas.
- It is recommended to have the last meal no later than 2 hours before the planned sleep. Modern recommendations increase the time between dinner and bedtime to 3-4 hours.
- In case of chronic pancreatitis, the diet is prescribed for a long time, which is mainly necessary to prevent the exacerbation of the inflammatory process of the pancreatic tissue.
Sample weekly menu
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.
- Appetizer - biscuit cookies, 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, stewed carrots with boiled chicken, fruit compote.
- Afternoon snacks - lean cookies with freshly squeezed fruit juice.
- Dinner - pasta with cottage cheese, boiled in water, jelly.
Wednesday
- Breakfast - apple and carrot salad, chopped steamed meatballs, 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 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 on dried fruit decoction, cottage cheese pudding, baked apple.
- Snack - fruit jelly.
- Dinner - buckwheat porridge, boiled in water, with beef steam cutlets, still mineral water.
on 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, fruit jelly.
- Snack - sweet fresh apple.
- Dinner - potatoes boiled in water, boiled fish without bones, kefir, a piece of bread.
on 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 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 meatballs, compote.
- Appetizer - biscuit cookies, rosehip broth.
- Dinner - omelet from chicken eggs, 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 necrosis of the pancreas, is significantly reduced, and the inflammatory process in the tissue of the organ is 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 intended to reduce the functional load of the pancreas during the period of reduction of acute inflammation or against the background of the course of a chronic disease. In case of acute pancreatitis, taking into account the high risk of developing pancreatic necrosis in a medical hospital, diet 0 can be prescribed, which is therapeutic starvation.