Diet for acute and chronic pancreatitis
Content:
- Diet for acute pancreatitis
- Diet for chronic pancreatitis
- Diet menu
- What to exclude?
- Answers to popular questions
It is very important to follow a diet for pancreatitis, especially with chronic pancreatitis. You should eat as much protein as possible and at the same time you need to reduce or completely eliminate fats and carbohydrates, especially sugar, which is 99% carbohydrates, exclude fried foods and any foods containing coarse fiber. It is advisable to start taking vitamins. You should eat little by little, but often, that is, 5-6 times a day.
The pancreas is necessary to ensure the normal functioning of the body: it is thanks to the digestive juice that it secretes into the lumen of the duodenum that the main components of food products - proteins, fats and carbohydrates - are broken down. As a result of the digestion process taking place in this part of the digestive tract, simpler compounds are obtained that enter the general bloodstream after absorption of the intestinal mucosa. Thus, nutrients, amino acids and vitamins necessary for metabolic processes in cells and for building tissues are formed from food in the duodenal region and reach all organs and systems of the body.
In addition, the pancreas produces insulin, which is necessary for the normal course of carbohydrate metabolism, and lipokine, which prevents fatty degeneration of the liver.
The cause of pancreatitis is most often the abuse of fatty foods and alcoholic beverages. The disease can occur in both acute and chronic forms. The diet for pancreatitis depends on the characteristics of the course of the pathological process: the acute period requires a more strict attitude to the diet and food products.
In acute or chronic inflammation of the pancreas, cardinal digestive disorders occur, including:
- the pH of the medium of the small intestine changes to the acidic side, as a result of this, the patient feels heartburn, burning sensation in the intestines;
- enzymes accumulate inside the gland, begin the process of self-digestion of tissues, causing severe pain in the abdomen in the navel, on the right;
- toxic substances accumulate, self-poisoning of the body occurs;
- violation of insulin secretion, provokes sugar diabetes.
The pathogenesis of pancreatitis develops as an acute or chronic inflammation. The principle of treatment for all forms of pancreatitis includes, according to indications:
- surgical intervention;
- drug substitution therapy, taking into account the nature of the inflammation, the patient's condition;
- therapeutic diet food.
Proper nutrition at the stages of rehabilitation of pancreatitis, especially after the patient is discharged from the hospital, significantly increases the chances of full recovery or stabilization of the pathology.
It is at home that the principle of dietary nutrition is often violated. Meanwhile, it is important to follow the immutable rules of a therapeutic diet. Moreover, diets do not contain expensive products, their preparation is the simplest, including: chopping, boiling, steaming.
Diet for acute pancreatitis
During the period of an exacerbation of an attack of pancreatitis, before the arrival of an ambulance, it is allowed to apply cold compresses to the area of pain, usually pain with a pad. During this period, it is allowed to drink mineral water (for example, Borjomi, Narzan). The daily volume of fluid is up to five to six glasses, with normal urination. Simple liquids suppress the release of pancreatic juice into the lumen of the duodenum, reduce pain, remove toxins from the body.
Upon admission of a sick person to a medical institution, the patient will be assigned a dietary meal developed by a dietitian.
Sets of products, names of diet, other information approved by order of the Ministry of Health of the Russian Federation No. 330 dated August 5, 2003 "On measures to improve medical nutrition in medical institutions of the Russian Federation" and the letter of the Ministry of Health of the Russian Federation dated April 7, 2004 No. 2510 / 2877-04-32. These documents are valid at the time of this writing.
To illustrate the principles of diets for pancreatitis, we made extracts from these documents. Numbered diets, officially, are not used in hospitals. With pancreatitis, diets with the abbreviation - SD and IAP are recommended.
In acute pancreatitis, hunger is prescribed to the patient in the first two days. It is allowed to drink only rosehip broth or mineral water - one glass up to five times a day. On the third day, it is allowed to eat, but only low-calorie foods, excluding fats, salt and dishes that increase the secretion of gastric juice and stimulate the process of gas formation in the intestines.
All subsequent days, while the patient is in the hospital, he must strictly adhere to the diet indicated by the doctor!
Stage of fading exacerbation of pancreatitis
A diet is recommended, taking into account the mechanical and biochemical sparing of the intestinal mucous membranes.
This food includes:
- physiological level of the main components of food - proteins, lipids, carbohydrates;
- an increased amount of fat and water-soluble vitamins;
- low content of substances that irritate the intestinal mucous membranes, including food spices;
- it is forbidden to use spicy, salty, spicy, smoked.
Cooking methods: heat treatment with steam. The food is chopped, wiped, small pieces of prepared food are allowed. The temperature of food served on the table should not exceed 65 0 C. The recommended number of meals is five to six per day.
- The daily portion contains 90 grams of total protein, 40 grams of animal origin.
- Containing 80 grams of fat per day, 30 grams of vegetable.
- The content of carbohydrates in a daily serving is 300 grams, easily digestible 60 grams.
- Energy value 2480 kilocalories.
After the symptoms of acute pancreatitis subside, it is better to switch to soups, eat lean meats and fish, fresh cottage cheese, cereals and vegetables, as well as puddings. Foods such as fruit juices, honey, jam, sugar should be reduced or eliminated from the diet. Before bedtime, laxative drinks are useful: kefir, yogurt, etc. It is important to completely abandon fatty foods, muffins, fried fish, bacon, sour cream, salty and smoked foods, pickles, onions, garlic, radishes, alcoholic beverages.
The recommended diet for acute pancreatitis should be followed from six months to a year. Almost one hundred percent of the patient's health depends on how strictly he adheres to the doctor's prescriptions regarding the diet. It is important to remember that all errors in the diet are immediately reflected in the state of the pancreas.
Chronic pancreatitis in remission
In this variant, a different approach to the patient's nutrition. During this period, nutritionists recommend including in the diet a high protein content, a physiological rate of fat. A more sophisticated approach to carbohydrates. The diet at the stage of remission involves:
- protein is allowed slightly above the physiological norm;
- norm for fats and complex carbohydrates in the form of cereals;
- below the norm include sugar, honey, jam, cakes, sweet pastries in the diet, and table salt is also below the norm.
With this option, it is forbidden to eat substances that irritate the mucous membranes of the gastrointestinal tract. Such products include vinegar, alcohol, and other substances used as seasonings.
Dishes are cooked boiled, stewed, baked, or steamed. It is allowed to serve food in a mashed, not mashed form. Feeding at short intervals, in small portions 4-6 times a day. Food is served warm. Its temperature is not higher than sixty degrees Celsius.
- The daily serving contains 120 grams of total protein, including 50 grams of animal origin.
- The content in a daily portion of fat is 90 grams, vegetable fat is 30 grams.
- The content in a daily portion of carbohydrates is 350 grams, easily digestible 40 grams.
- Energy value 2690 kilocalories.
Diet for chronic pancreatitis
Chronic pancreatitis of the pancreas develops in most cases against the background of an acute illness. At the same time, it can be primary if the patient suffers from cirrhosis of the liver, hepatitis, duodenal pathology, cholelithiasis, allergies, atherosclerosis, and abuses alcohol.
Diet with pancreatitis, which occurs in a chronic form, is considered the main one in the treatment of this disease. In remission, the number of calories in the daily diet should correspond to the physical activity. It is recommended to take food up to six times a day, not forgetting about food, which is characterized by a laxative effect.
It's important to keep track of your daily protein intake. Since it is necessary for the normal course of recovery processes, it must be consumed in sufficient quantities - up to 130 grams per day, and only 30% of the protein should be of plant origin.
The diet of a patient suffering from chronic pancreatitis should include beef, veal, rabbit meat, chicken, turkey, and lean pork. Prohibited: lamb, fatty pork, as well as goose, duck and game. If the patient is worried about frequent pains, meat dishes are boiled in chopped form or steamed, you cannot bake dishes in the oven, fry and stew. Lean fish is cooked in the same way.
Meat and fish dishes with a low fat content help the patient to avoid fatty degeneration of the liver, which is of great importance in chronic pancreatitis. Homemade cottage cheese has a similar property, but only if it is non-acidic and fresh, store cottage cheese is not recommended.
Pure milk in chronic pancreatitis is most often poorly tolerated, so it is better to add it to cereals, soups, jelly when preparing them. Even if milk is well tolerated by patients, it should not be abused, drinking no more than half a glass of warm milk per day in small sips. Fresh dairy products are much more useful for people suffering from pancreatitis. Cheese in remission, forbidden during an exacerbation of the disease, can be eaten in small quantities, provided that you feel well. The cheese should be lean and mild. Whole eggs are excluded from the diet, while steamed protein omelets, whipped protein dishes are allowed, in addition, eggs may be present as an additive in other dishes.
Proteins of vegetable origin can be represented by rice, yesterday's bread, bread crumbs, semolina, oatmeal, buckwheat, pasta. It is forbidden to eat legumes with pancreatitis.
Fats in the diet should be no more than 70 grams, and 80% of them are animal fats, it is better to eat them together with other dishes and food products. It is better to put oil in a ready-made dish immediately before eating, vegetable oil is permissible only if it is well tolerated. Cooking fats, margarine, beef and pork fat are prohibited.
Carbohydrates in the daily ration should contain no more than 350 grams, they can be represented by sugar, honey, jam, syrup. From foods rich in carbohydrates, crackers, semolina, oatmeal, buckwheat, barley, rice, pasta are allowed. Also, patients are allowed to eat potatoes, carrots, beets, pumpkin, zucchini, squash. Vegetable dishes should be steamed or water-cooked; you can eat vegetable steamed pudding. Boiled vegetables are best consumed in pureed form with the addition of cereal broth.
Of the fruits, non-acidic varieties of apples are recommended: ripe fruits can be baked, wiped, prepared compote from them, dried fruit compote is also useful.
Of all the sauces, bechamel based on milk and flour is considered the most optimal, and the flour is not sautéed, and very little salt is added.
- First courses (soups from cereals, vegetables, you can use milk, meat from low-fat meats, fish, as well as sweet soups from fruits).
- Second courses (boiled beef, poultry, fish, chicken omelette).
- Products containing cereals (cereals, pasta, white, black bread, vegetable oil).
- Dairy, fermented milk products (milk 2.5%, fermented milk products, butter).
- Berries, fruits, vegetables (ripe, sweet) in raw, baked form, carrots, beets - boiled, as a dressing for soups, as side dishes and independent dishes.
- Dessert (easily digestible carbohydrates with pancreatitis are limited, that is, below the physiological norm, jam, honey, sugar).
- Drinks (tea with milk, vegetable, fruit juices).
- Specialized products (dry protein composite mixture) Fat and water soluble vitamins are added.
It is also important not to overeat, reducing the daily amount of food to 2.5 kilograms, taking into account the liquid drunk. Food is taken frequently and in small portions.
Following all the rules of nutrition for pancreatitis can significantly increase the effectiveness of therapy in general.
Find out more: The most effective recipes for restoring the pancreas!
Diet menu for pancreatitis
The number of products must be calculated based on the above regulatory documents.
Here is a sample daily diet menu for pancreatitis:
The first meal (7: 00-7: 30): boiled beef, oatmeal in milk, tea.
Second meal (9: 00-9: 30) omelet, baked apple, rosehip decoction.
The third meal (12: 00-13: 00): vegetable soup, beef souffle, pasta, sweet berry jelly, compote.
The fourth meal (16: 00-16: 30): cottage cheese and tea.
The fifth meal (20: 00-20: 30): fish soufflé, tea.
What to exclude?
As you can see, in a diet with pancreatitis, all dishes are made from lean meat and fish - and then only in a boiled version. Fried foods are prohibited. You can eat dairy products with a minimum percentage of fat. It is advisable to drink only natural juices and compotes and tea from liquid.
Should be completely excluded:
- All types of alcohol, sweet (grape juice) and carbonated drinks, cocoa, coffee
- Animal products: offal, including the first category, pork meat and lard, fatty fish, all smoked meats, spicy, fried, instant products based on extractive substances.
- Vegetable products: legumes, mushrooms, spinach, sorrel, onions, baked goods based on butter dough.
- Desserts: chocolate, fat creams.
- Figs, grapes, bananas, dates.
- Confectionery, chocolate, ice cream, jam.
- Lard, cooking fats.
- Hard boiled eggs, whole egg dishes, fried eggs
Answers to popular questions
- Is goat milk allowed? This is a rather fatty product that is difficult for the pancreas. It is twice as fat as a cow. Peoples, whose diet has included goat's milk for centuries, are more adapted to the product. In an unaccustomed body, milk can provoke an upset stomach. The product should be included in the diet gradually, starting with small portions. If the body reacts well (no nausea and vomiting, normal stool), the portions can be increased.
- Is yogurt allowed? This fermented milk product is allowed for pancreatitis. Before using, you need to pay attention to the fat content of the milk from which it is made. High fat milk is not recommended for consumption.
- Are muffins, puff pastry, gingerbread allowed? At the stage of exacerbation, the listed products cannot be eaten. At the stage of remission, yeast baked goods are allowed in small quantities. The menu may include puff pastry products. As for the gingerbread, the quality and quantity of the glaze is important (if there are insulin disorders, they should be minimally sweet). Inexpensive products are coated with a glaze cooked in palm or coconut oil, which is extremely harmful to the gland.
- Is cinnamon allowed? Cinnamon is a condiment that can be purchased at a specialty store or supplied by distributors. What is presented in packaged form in hypermarkets is an inexpensive option called cassia. This “analogue” is associated with myths about its healing effects in type 2 diabetes. This is not associated with the work of the gland, but with the response of insulin receptors in the tissues. There is no official confirmation of this. As for real cinnamon, it enhances the production of digestive juice, which is undesirable in case of an exacerbation of the disease. (Read also: The benefits and harms of cinnamon)
- Are offal allowed? The heart, stomachs and liver are not a contraindication for pancreatitis if properly prepared. Such foods can be eaten boiled or stewed. It is not recommended to eat them fried.
- Is processed cheese, bread, chocolates, coffee allowed? Processed cheese should be as simple as possible, that is, without any seasonings and additives. Bread can be included in the menu. Chocolate is allowed in small quantities. Coffee is not recommended at any stage of the disease. Alternatively, you can drink coffee with milk and in small quantities.
- Is rice, olive oil allowed? Rice is allowed. You can add olive oil to salads and other dishes.
- Is brine allowed? During the remission stage, a small amount of brine will not harm, but you should not drink large amounts of it.
- Is salted lard allowed? The fat is hard on the liver and gallbladder. When used, the pancreas suffers a second time. Outside the exacerbation stage, fat is allowed, but in small quantities (up to two slices a day, up to twice a week).
The author of the article: Kuzmina Vera Valerievna | Endocrinologist, nutritionist
Education: Diploma of the Russian State Medical University named after NI Pirogov with a degree in General Medicine (2004). Residency at Moscow State University of Medicine and Dentistry, diploma in Endocrinology (2006).
