- What effect do products have on stone formation?
- How to prevent bile stagnation with food?
- What is the "magnesium" diet?
- What can you eat in the absence of an exacerbation?
- How to eat a patient during an exacerbation?
- Features of postoperative nutrition
- Nutrition for postoperative bile congestion
- Related videos
In the formation of gallbladder stones, which is the basis of pathological changes in cholelithiasis, an important role belongs to non-observance of proper nutrition. To the violation of metabolism, which contributes to the formation of concrements in the bile, lead to liver disease, obesity, cholecystitis, diabetes, any causes that cause stasis( stasis) and thickening.
In case of cholelithiasis in women, pregnancy, fluctuations of the hormonal background during the menopause is important. Serious importance is attached to the lifestyle of a person( reduced motor activity).Diet with stones in the gallbladder helps restore metabolism, delay the process of growth of stones.
What effect do products have on stone formation?
Patients of the gastroenterologist need to clearly understand that nutrition with stones in the gallbladder is unable to dissolve them. In the treatment, in addition to the diet menu, you need medicines, surgical intervention. A healthy person in the gallbladder constantly form and dissolve crystals of salts.
With an excess of protein and fat in the diet, carbohydrates in the blood increase the level of cholesterol. The liver translates it into the gallbladder to be removed through the intestine. But the process of deriving salts disturbs the thickening of the bile. By composition, cholesterol, pigment, calcium and mixed stones are distinguished. The initial stage is difficult to identify, because it does not manifest symptoms.
Theoretically, if you choose the optimal diet, you can avoid the further stage of the disease. Nutritionists believe that those who are guided by family predisposition to metabolic disorders and who view nutrition as an important variant of prevention are right.
Saline sediment disrupts the physicochemical properties of bile, leads to thickening, promotes inflammation of the wall of the bladder. Usually cholelithiasis is necessarily associated with calculous cholecystitis. The regulation of the tone of the bile excretory system is disturbed. The person feels dull or cramping pain in the hypochondrium on the right, bitterness in the mouth. When clogged with bile duct stone, a severe pain attack occurs.
Deterioration of the state is provoked by the reception of alcoholic beverages, eaten fatty foods, lifting of gravity, jolting in transport, stressful situation. The composition of the bile is affected by irregular eating habits, alternating hunger and overeating, and a low intake of liquid.
In the initial period, salt crystals are glued together into short chains( sludges), they can be detected under the
microscope. How to prevent bile stagnation with food?
According to Pevsner's classification for patients with cholelithiasis( SCI), a dietary table number 5 with options is proposed. The menu requirements include:
- restriction in the diet of fats to 80 g( of which ¾ must be animals, ¼ - vegetable);
- mandatory availability of foods rich in dietary fiber( vegetables, fruits);
- inclusion of magnesium-containing food;
- prohibition of alcohol in any form.
Because cholesterol stones are more common in people who feed on predominantly animal fatty and fried foods, spicy dishes, eggs, and fish caviar that tolerate overeating, these foods should be excluded from the diet in the LCF.Vegetable oils can not be eaten without restrictions. They are cholagogue.
With increasing motor activity in the bile ducts, stones from the bladder are transferred and provoke an attack. Fiber helps restore intestinal peristalsis. It decreases because of the delay in the introduction of bile into the duodenum. This disrupts emptying, helps suppress the activity of useful intestinal flora. To prevent stagnation, it is necessary to organize meals in small portions 6 times a day.
It is not allowed to eat fried and smoked dishes, you just need to boil, stew, cook for a couple. Too hot or cold dishes are contraindicated. It should be provided for mechanical processing( twisting, grinding) to improve digestion.
With obesity and ZHB it is possible to reduce the amount of fats to 70 grams, limiting carbohydrates to 300 g
What kind of diet is called "magnesium"?
Food intake of foods enriched with magnesium salts is recommended for patients with bowel dysfunction with LCB.Magnesium diet with gallstones is useful for people with concomitant heart diseases, hypertension.
The ration necessarily includes:
- buckwheat, wheat, oat and barley porridge;
- products from soy, beans;
- wheat bran;
- nuts( preferably almonds);
- sea kale.
For drinking, a decoction of rose hips, dried apricots, milk is suitable. It is recommended to eat at least five times a day. Since salted, meat and fish dishes disrupt the absorption of magnesium, they are temporarily excluded from nutrition. It is recommended to observe the duration of the diet from four days to a month. Doctors note improvement in the patients' well-being, disappearance of abdominal pain, normalization of the stool, weight loss.
What can you eat in the absence of an exacerbation?
Diet in cholelithiasis, outside of marked signs of exacerbation( pain syndrome, nausea, vomiting, bloating) requires constant support of bile secretion at the proper level, the implementation of the rules of table number 5.Food should provide the energy balance of the body. The content of carbohydrates is allowed to increase to 400 g / day., Caloric content in the range of 2400-2600 kcal, liquid - 1,5-2 l, the salt is limited.
- dishes from fatty meat, offal, with high cholesterol( kidney, liver, brains), all fried, smoked, canned;
- products that stimulate the secretion of digestive juice( rich broths, cabbage, mushroom, garlic, citrus fruits, spicy sauces, condiments);
- vegetables, greens containing oxalic acid( spinach, sorrel);
- buns, puff pastry and short pastry, cream cakes;
- sweets because of the high concentration of easily digestible carbohydrates( honey, sugar, sweets, jam).
Products should be slightly stimulated biliary excretion. In the diet there are:
- salads from vegetables, vinaigrette with dressing with vegetable oil;
- to increase the content of fiber in cooked porridges add bran;
- from porridges is more preferable buckwheat, oatmeal, millet, barley;
- grain bread, bran, dietary;
- the necessary amount of protein is provided by low-fat fish, chicken meat, beef, veal, cottage cheese, with high cholesterol in the blood, it is advised to restrict the intake of eggs( not more than half of the yolk per day);
- vegetable oils are selected according to taste, tolerance, olive oil is not the best properties, nutritionists advise to use linseed, sunflower, corn, sesame, soybean( contain polyunsaturated fatty acids, vitamins A, E, K, D, F, improvingexchange of cholesterol);
- milk and sour-milk products limit with excess weight;
- vegetables, fruits, berries in a wide range.
Corn oil is not popular with everyone, but its useful properties differ little from olive
How to eat a patient during an exacerbation?
Nutrition for cholelithiasis in the acute stage begins with diurnal fasting. It is allowed only to drink water, broth of a dogrose, not strong green tea, diluted fresh juice. From the second day they pass to the table №5в( anti-inflammatory).
With pronounced phenomena of cholecystitis and colitis prescribe option 5a. If pancreatitis has joined the diet is built according to the scheme of the table 5p. All options include split meals semi-liquid dishes, mechanical shchazhenie. The differences are shown in the table.
|Number of diet table, duration of prescription||Intended use of concomitant diseases||Features|
|5a 7-14 days||gastroduodenitis, hepatitis, cholecystitis, condition after cholecystectomy||The most gentle diet, provides organs with maximum rest, limited to fats, protein up to 90 g / day., salt, carbohydrates 350. Lipotropic substances are increased due to cottage cheese, buckwheat, buttermilk. Dishes containing purines and oxalic acid, coarse fiber|
|5 in 6-7 days||cholecystitis, cholangitis, hepatitis, severe pain||protein and fats decrease to 80 g / day, carbohydrates to 200. Caloric content 1600 kcal. The volume of liquid up to 2.5 liters|
|5p only during the exacerbation, according to indications all life||pancreatitis, after fasting||Proteins decrease to 60-80 g / day, fats are 50-60 g / day, extractives, fiber. Gradually added protein products|
Table 5a - the most stringent in terms of restrictions, product grinding( double scrolling stuffing, grinding cottage cheese, vegetables in soups).Strictly forbidden:
- fresh pastry( bread, pies, cakes, puff pastry products);
- any broth in connection with a high concentration of extractives, cooking soup, okroshki;
- vegetables with essential oils( garlic, radish, onion, radish);
- coarse fiber in cabbage, trout, wheat, macaroni, legumes;
- meat or fish cooked by a piece( salmon, sturgeon, halibut), roast duck, smoked sausages, lard, fish caviar, any canned food, products from by-products;
- in the process of cooking food using culinary and animal fat;
- dairy products of high fat content, sour curd, spicy cheese;
- all spicy condiments( horseradish, pepper, mustard, pepper, mayonnaise, ketchup);
- coffee and cocoa, chocolate.
In the diet of table 5b there are:
- crackers from white bread;
- mashed dishes on water, without adding oil;
- mucous soups made from cereals( oatmeal, rice);
- liquid crushed porridge with milk additive;
- jelly from vegetables;
- broth of dogrose and fruit compotes;
- boiled twisted meat or fish;
- low-fat cottage cheese.
Table 5p is assigned when there is evidence of pancreatic injury. Do not recommend sweet fruit and berries, jelly is prepared on sorbitol. After restoration of a condition of the patient transfer on base table №5.
Modern steamers greatly facilitate the work of housewives
Features of postoperative nutrition
Stones in the gall bladder permanently injure the mucous membrane, support inflammation, with large dimensions lead to pressure ulcers and rupture of the wall. Therefore, a timely operation to remove the gallbladder with concrements helps to avoid serious complications.
The essence of the intervention is the excision of the bladder in the cervical region, creating a direct pathway for biliary excretion from the liver into the duodenum. It is very important after the operation to remove the stones( cholecystectomy) to maintain proper nutrition to prevent re-formation in the bile ducts.
The second day - added skimmed yogurt, tea without sugar, oat broth, portions by volume are not more than ½ cup, food is served every 3 hours. The third and fourth day - organize meals 8 times, in small portions. Allowed:
- liquid mashed potatoes;
- rubbed vegetable soup;
- steam omelet from proteins;Meatballs from twisted boiled fish;
- jelly or fruit compote, diluted juice, tea with sugar.
The fifth day - add bakery products in the form of dried white bread, biscuits. The seventh day - connect the mashed porridge from buckwheat, oatmeal, boiled meat dishes from minced meat, cottage cheese, yogurt, puree from vegetables. Then the patient is translated according to the indications for one of the variants of table 5 and the basic diet, which must be observed all life.
In the first 12 hours it is allowed only to moisten the lips and rinse the mouth, then they can drink water with small sips of 0.5 liters per day
Nutrition for postoperative bile stasis
If in the postoperative period, comorbidities become aggravated, the diet is built according to diet schemes 5a, 5b or5n. There is a danger of repeated stagnation of bile in the remaining bile ducts.
In this case, it is necessary to achieve with the help of a diet an intensive promotion of bile in the intestine. For this purpose, table №5 l / f( lipotropic fat) is prescribed. It is distinguished by a decrease in light carbohydrates and a uniform increase in animal and vegetable fats.
- food is not crushed;
- allowed steam and baked dishes;
- for the purpose of stimulation prepare snacks( without salt and inconsistent);
- can be cooked pasta;
- porridge more dense, crumbly;
- vegetables and fruits are baked;
- except for yesterday's wheat bread, you can eat a little rye;
- for tea and compote it is allowed to add a dry biscuit, a biscuit, a bun;
- from the first dishes are shown vegetarian soups with cereals, noodles, vegetables, dairy with noodles, non-fermented borsch with parsley and dill( the composition does not have to be wiped);
- for second meat dishes use boiled meat with a piece, chicken baked, boiled;
- fish is served with vegetables, pasta, in the form of steam cutlets, boiled;
- from cottage cheese and vegetables it is possible to prepare a casserole, vareniki;
- allowed seasoning of sour cream, kefir, bold cottage cheese, milk in porridges, tea, milk soups;
- eggs are better excluded because of increased cholesterol;
- salads, vinaigrettes, squash caviar allow to improve appetite, there are restrictions on vegetables, mushrooms, radish, sorrel, spinach;
- from fruits and berries are selected non-acid grades, you can eat fresh or in compote;
- sugar is restricted, chocolate is forbidden, but marmalade, marshmallow, pastilles, some honey and jam are allowed;
- , butter or vegetable oil is added to ready meals;
- you can drink light green tea, fresh juice from vegetables and fruits, broth of wild rose, mineral water without gas.
The result of treatment largely depends on the diet. Therefore, it is worthwhile to listen to the advice of a doctor and not hesitating to refuse from prohibited products.