Diet in case of exacerbation of cholelithiasis

The causes of development of cholelithiasis are called malnutrition, metabolic disorders, infection, bile stasis, genetic predisposition. When these factors interact, the physico-chemical characteristics of bile change, it becomes lithogenic( capable of forming concrements).

The stones are formed due to the lack of bile acids that keep cholesterol, as a result of which cholesterol precipitates and the formation of the calculus begins. Undiluted cholesterol joins the formed stone and the concrement gradually increases( in a year by 1-4 mm).When the stone moves, the patient feels painful.

Nutrition( lack of a meal schedule, high energy value of meals, eating of "bad" cholesterol) is important in the development of pathology, so the diet with an exacerbation of cholelithiasis is an important component of therapy. Therapeutic nutrition accelerates the restoration of impaired functions of the hepatobiliary system.

General recommendations of

If gallstones were found during the study, the patient should refuse to eat food, which includes "bad" cholesterol, a lot of fats and carbohydrates, and also need to adhere to the meal schedule. In the early stages of the disease, a curative diet can completely correct the physicochemical parameters of bile and prevent the growth of concrements, and medicines can dissolve stones.

Even if the disease is started, then adhering to dietary nutrition can minimize the risk of stone outflow into the ducts( biliary colic).When the functions of the hepatobiliary system are violated, a diet table No 5 and its variations are prescribed. What kind of diet will be recommended for cholelithiasis( SCI), depends on the stage of the disease and the composition of stones.

Cholesterol stones, as a rule, appear in people who overeat, consume a lot of animal fats, in particular, fatty meat, eggs, caviar. From the diet should be excluded products with a high content of cholesterol, acute and fatty foods, limited( but not excluded) the use of vegetable oils, because they have choleretic properties and are able to cause exacerbation of SCI.

With cholelithiasis dietary recommendations, the following:

• restrict the intake of fats to 70-80 g( of which 75% must be of animal origin) and carbohydrates up to 350-400 g;
• has many vegetables and fruits, as it is necessary to increase the amount of dietary fiber in the diet;
• add to the diet products saturated with magnesium salts;
• use alkaline mineral water( Borjomi, Polyana Kvasova, Essentuki) to make cholesterol in bile dissolved;
• adhere to a fractional diet( eat every 3 hours in small portions to allow bile to stand out evenly);
• exclude alcohol;
• if there is obesity, then it is necessary to adhere to a hypocaloric diet, since weight loss contributes to the improvement of the functions of all body systems;
• to eliminate the lithogenicity of bile, it is necessary to take chenodeoxycholic and ursodeoxycholic acid for a long time.

At the initial stage of the disease there are no restrictions in the use of any products, but it is recommended to eat at regular intervals to stimulate separation of the liver secretion and contraction of the gallbladder.

During the period of remission, a moderate shaking of the hepatobiliary system is required, therefore a dietary table No 5 is prescribed. This curative nutrition replenishes the physiological needs of the body in chemical elements, so it can be recommended for a long period of time. On the day the patient can consume no more than 2400-2600 kcal. The diet should be limited to 80 g of protein, 80 g of fat and 400 g of carbohydrates, salt should not be consumed more than 10 g.

All dishes are cooked in a double boiler or boiled

When a disease is necessary, it should be ensured that there is a regular moderate outflow of bile,fractional nutrition, avoid foods that stimulate bile secretion, as well as containing cholesterol.

What products are allowed and forbidden in calculous cholecystitis

To prevent the growth of concrements, it is recommended to make the menu in such a way that it is present:

• products containing fiber. The most rich in food fibers are vegetables( cabbage, green peas, asparagus, carrots, corn, pumpkin), fruits( bananas, peaches, pears, apples), dried fruits( prunes, dried apricots, dates), nuts( almonds, cashews), cereals( buckwheat, oatmeal, white rice), bran, legumes;
• salads dressed with unrefined vegetable oil( olive, sunflower, linseed).The oil promotes bile secretion and prevents the development of fatty hepatosis;
• sour-milk products. Kefir, ryazhenka, yogurt promote an increase in the pH of the hepatic secretion;
• cereals with a high content of magnesium( buckwheat, millet, barley, oatmeal).They improve the performance of the cardiovascular, endocrine, digestive system, help absorb the B vitamins, which are necessary for liver function. Magnesium improves the condition of blood vessels and blood flow, therefore prevents vasospasm. A lot of magnesium in sesame, bran, cocoa, halva, soy, pistachios, seeds;
• protein products( low-fat fish, cottage cheese, chicken protein) and vegetable oil, as they contribute to the synthesis of endogenous bile acids, which do not allow cholesterol to crystallize;
• products saturated with vitamin A( milk, cottage cheese, cream, sour cream, butter).Retinol normalizes metabolism in the body, strengthens the immune system, accelerates the regeneration of tissues;
• products with lecithin( butter, sour cream, cream).They prevent the crystallization of cholesterol;
• free liquid of at least 2 liters. It prevents stagnation of bile and affects its consistency.

Magnesium diet is recommended if the LCB provokes constipation or there is stagnant processes in the gallbladder

At the heart of the diet with increased magnesium content diet table No 5, which is additionally prescribed the consumption of large amounts of food rich in magnesium. The microelement stimulates bile secretion, increases the motor activity of the gallbladder and intestines, which accelerates the excretion of cholesterol.

In diseases of the liver and gallbladder, it is necessary to limit the use of:

• products, which contain essential oils( citrus, garlic, onion, parsley, dill, celery);
• dishes with a high content of extractives( broth, broth based on cabbage, crust, formed when baking meat, tea);
• butter, puff pastry, short pastry;
• fatty meat and offal, which contain a lot of cholesterol, as well as all fried foods;
• alcohol;
• digestible carbohydrates( jam, sugar, confectionery, sweets, honey).

In cholelithiasis, biliary colic is likely, which can be triggered by negative emotions, the use of fatty foods, spices, spicy condiments, so it is necessary to monitor the diet and use only the permitted foods.

Nutrition for exacerbation of the disease

If the disease has worsened, then a more strict diet is required, which must be adhered to until the disappearance of clinical manifestations( pain, nausea, vomiting, stool disorders).Diet with cholelithiasis during an exacerbation in the first day recommends refusing food to ensure the functional rest of the inflamed gall bladder. Allowed to drink light tea, broth of wild rose, juices, diluted in equal proportion to water.

After 48-72 hours after the onset of an exacerbation the patient is transferred to a No 5B diet that provides mechanical and chemical shading. According to the recommendations, the patient should limit the intake of carbohydrates to 200 g and protein to 80 g. Do not add salt to the dishes and serve them in the garbage( it is better to cook meat soufflé, mucous soups, mashed potatoes).

The treatment table is prescribed taking into account the concomitant diseases and the pathology stage

You need small portions at least 5 times a day. The daily ration should not exceed 1600 kcal. Drinking should be about 2-2.5 liters of free liquid per day. With exacerbation of cholelithiasis, the first five days of the diet should consist of the following dishes:

• mucous soups made of oatmeal, rice or semolina, prepared without the addition of oil;
• liquid rubbed porridge( rice, oatmeal).Porridge can be cooked on milk;
• jelly, vegetable juices and compotes( fruits should be grinded);
• of low-fat cottage cheese;
• boiled fish and meat;
• crackers or wheat yesterday's bread.

The diet is not full, therefore it is impossible to stick to it for a long time. On the 5th-8th day after the onset of exacerbation the patient is transferred to a diet table No 5A, which is recommended before the onset of remission. Diet No 5A with exacerbation of cholelithiasis allows to consume:

• steamed and boiled vegetables;
• porridges cooked on the water;
• pasta;
• milk soups and soups on vegetable broth, borsch;
• milk, cottage cheese, sour cream with low fat content;
• lean meat and fish( stewed or boiled);
• pastille, honey, jujube, marshmallow;
• non-acid berries and fruits;
• greens( except spinach and sorrel);
• juices from pomegranate, blueberry, quince, bird cherry;
• salads with vegetable oil( oil after heat treatment can not be consumed);
• not strong tea, coffee with milk.

After the subsidence of the disease, the patient again must adhere to the basic diet No 5

. It is impossible to exacerbate fatty foods, there are fatty varieties of meat and fish, dishes with seasonings and spices, fresh pastries, cakes, muffins, chocolate, vegetables with coarse fiber( cabbage, radish, radish) and essential oils( garlic, fresh onions), pies, caviar, offal.

In cholelithiasis, pathological processes affect not only the liver and gallbladder, but also other organs of the digestive system, especially the stomach, intestines, pancreas, so therapeutic nutrition is recommended taking into account a secondary disease. So, with the development of pancreatitis, the diet No 5P is shown, which assumes an even greater restriction of fats and carbohydrates and is designed to stimulate the pancreas.

In contrast to the diet prescribed for CLD, it limits the use of dietary fiber. Depending on the concomitant disease, a diet table No 5A or No 5B may be prescribed. Both diets assume the exclusion from the diet of "bad" cholesterol, dietary fiber, essential oils or extractives, and also do not recommend eating dishes that promote fermentation processes.

These tables require you to eat everything in a grated or chopped kind, and vegetables and fruits, meat and fish should be cooked( baked or baked).Diets differ in calorie and the proportion of proteins, fats and carbohydrates.

If cholelithiasis is not amenable to conservative treatment, then the removal of the gall bladder is prescribed

After the operation, the diet No 5Sh or No 5Z is indicated. When the treatment table No 5CH decreases the intensity of bile secretion, and with the diet No 5Z the bile compartment is increased due to the introduction of high-grade proteins and polyunsaturated fatty acids. Diet with acute exacerbation of the lumbar spine provides shivering of the digestive system and relieves the load from the gallbladder, thereby reducing the severity of the pain syndrome and improving the condition of the inflamed organ.

Dietary nutrition should be adhered to for a long time, because the use of heavy food( fatty, fried, spicy) can lead to an exacerbation of the disease and movement of stones. In addition to the therapeutic diet, patients are prescribed long-term drug therapy that promotes the dissolution of cholesterol stones, but if the patient does not begin to adhere to a healthy diet, then the chance of forming new concrements is high.