- How does the digestive system change after removal of the body
- What diet is prescribed
- What can I eat after removing the organ
- What should I refrain after the operation
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After laparotomy and laparoscopy, during which the gallbladder is excised, the diet is the most significantcomponent of the rehabilitation period. It is especially necessary to reduce the functional load from the digestive system during adaptation. The diet after the operation of the gallbladder is strict, however, on its compliance depends on whether the body will respond to the development of complications.
How does the digestive system work after removal of the body
Bile is produced by the liver constantly, and not only during meals. The secret accumulates in the gallbladder and is released into the duodenum only after irritation of the chemical and mechanical receptors. The fatter the food, the stronger the receptors are irritated and the bile ducts contract more strongly.
Thus, the amount of ejected bile depends on the amount of food ingested in the stomach. Being in the gallbladder, the secret becomes more concentrated, which means that the enzymes break down the nutrients faster( in liver bile pH 7.3-8, and in the gall bladder, because hydrocarbonates are absorbed, pH 6-7).
After removal of the gallbladder, the liver secret is not "settled", but immediately enters the duodenum. And since bile is not concentrated and it is not enough, then the cleavage of nutrients takes a lot of time, hence the occurrence of reflux( throwing intestinal contents into the stomach), increased gas formation as a result of rotting and fermentation processes, inflammation of the duodenum
. To accelerate digestion, it is necessary to adhere to a diet thatinvolves the use of products, the cleavage of which does not require a lot of enzymes and organic substances. After cholecystectomy, it is important not only what the patient eats, but also the meal schedule. It is necessary that a conditioned reflex develops in a person, which starts the separation of bile at a certain time.
For this you need to eat at one time and in small portions. Within a month after the operation, it is recommended to arrange six meals a day, you need to eat every 3 hours. For 10-15 minutes before a meal it is desirable to drink a glass of water to stimulate the gland and the separation of bile.
What diet is prescribed
Food after the operation is limited, for 4-6 hours the patient is not allowed to drink and eat. After that, you can only rinse your mouth with water or a decoction of herbs. Drinking is possible only 12 hours after the operation. It is allowed to drink ordinary water for 1-2 sips every 10 minutes, but in total you can drink no more than 0.5 liters per day.
After 24 hours after removal of the bladder, the patient can drink lean yogurt, tea without sugar, jelly. In total, you can drink 1.5 liters a day( half a glass of liquid once every three hours).On the third or fourth day the patient can eat. It is allowed to eat semi-liquid mashed potatoes, mashed vegetable soups( without meat), protein omelet, grilled boiled fish, jelly, a little sour cream.
You can drink apple and pumpkin juice, tea with sugar. There is a need every 2 hours, but in portions of 150-200 g. On day 5, the postoperative diet allows you to enter a dry biscuit, dried white bread. The next day the menu can already be varied with buckwheat or oatmeal( boiled), soufflé from boiled fish or meat, low-fat cottage cheese, sour milk products, vegetable puree.
The patient is recommended to diet No 5 or its variations( 5A, 5P, 5H, 5J)
In the absence of complications on the 8-10th day after removal of the body, diet No 5A is prescribed, which ensures shining of the affected organs and helps normalize the functions of the hepatobiliary system. It assumes a normal intake of protein( 80-100 g) and carbohydrates( 350-400 g), but restricts fats to 70-80 g and salt to 8-10 g. Caloric content of the diet should be about 2300-2500 kcal.
For patients who developed a postcholecystectomy syndrome with severe duodenal inflammation or a relapse of chronic gastritis, hepatitis, a diet No 5CH( sparing) was developed. Against the background of cholelithiasis, pathologies of the biliary system are often formed, which provoke the release of low-concentration bile.
The diet promotes the maximum shading of the digestive system and reduces the production of bile. Adhering to this diet, a person should exclude completely from the diet vegetable fats and limit the intake of simple carbohydrates to 30-50 g.
It is necessary to refrain from eating raw fruits and vegetables, fatty meat and fish, smoked products and spicy dishes, rich broths. The chemical composition of food is as follows: 90-100 g of proteins, 50-60 g of fats, 300-350 g of carbohydrates. Calories should not exceed 2000-2400 calories. Diets 5CH must be adhered to the disappearance of clinical manifestations of the disease( 2-3 weeks), and then go on to diet No 5.
If in the postoperative period a bile duct syndrome develops, in which the motor activity of the bile ducts is reduced, a diet No 5Z is prescribed. In contrast to the diet SCH, it, on the contrary, stimulates bile secretion. Also, therapeutic nutrition has a lipotropic effect( the "burning" of fat in the liver tissues), since it introduces polyunsaturated fatty acids and full proteins into the diet.
According to the diet the patient should include in the daily diet 100 g of proteins, 120-130 g of fats( half of which are vegetable), 400-450 g of carbohydrates. In the diet are added protein products that have lipotropic properties( dietary meat, egg white, cottage cheese, fish), bran, vegetable refined sunflower or olive oil, vegetables.
Caloric content of dishes eaten per day should not exceed 3100-3400 kcal. At 3-4 days after the operation with the development of an inflammatory process, diet No 5B, which limits the amount of food taken, can be recommended. The daily ration of the patient includes 1600-1700 kcal( 55-65 g of proteins, 250 g of carbohydrates, 30-40 g of fats).
Mucous cereal soups and semi-liquid porridges are rubbed and served without adding oil( it is allowed to add a little low-fat milk to the cereal).In the menu can be present compotes, vegetable juices, jelly, steamed meat patties, boiled fish, low-fat cottage cheese, breadcrumbs and dried bread.
It is recommended not to salt dishes. Eating at least five times a day in portions up to 200 grams. It is necessary to drink a large amount of liquid daily( up to 2.5 liters).After a week of such a diet, a less stringent diet No 5A or No 5 is prescribed, which depends on the degree of inflammation of the gastrointestinal tract.
It's important to eat at a certain time
Diet No 5 is physiologically complete, so it is prescribed for a long time. Its goal is to normalize the bile secretion and reduce the concentration of cholesterol in the blood. It involves the consumption of a large number of vegetables( except for those that contain a lot of oxalic acid or essential oils), which it is desirable to fill with unrefined vegetable oil.
It is also recommended to eat berries and fruits, chicken eggs, to strengthen the bile secretion. To prevent stagnation of bile from the diet, digestible carbohydrates( candies, jam, sugar, honey) are removed, and the amount of salt is reduced to 8-10 g per day. The total daily calorie is 2800-3000 kcal( 90 g of fat, 100 g of protein, 450 g of carbohydrates).
If after cholecystomy the inflammatory process in the pancreas is aggravated, then a diet table No 5P is prescribed. The patient is recommended to limit for a few days the intake of fats, proteins and digestible carbohydrates, the calorie content of a daily diet should not exceed 1300-1800 kcal.
After reduction of the pain syndrome, the patient can go to the second variant of the diet and diversify the menu, and also increase the calorie to 2300-2500 kcal. The chemical composition is as follows: 120 g protein, 70 g fat, 300-350 g carbohydrates.
Table "5P" prohibits the use of hot, spicy, sweet, sour and fatty foods, as well as foods containing high amounts of fiber, purines and extractives, as they stimulate the functions of the pancreas.
Diets should be adhered to from three months
What you can eat after removing the body
After the operation, you can eat the following foods and dishes:
- soups with vegetables and cereals;
- wheat bread( not for today's baking), crackers, biscuit, dry biscuits;
- lean meat( rabbit, beef, chicken, veal);
- sour-milk products( kefir, fermented baked milk, cottage cheese, curdled milk, cream cheese);
- chicken eggs and albumen omelet;
- buckwheat and oatmeal;
- salads from allowed vegetables( aubergines, broccoli and cauliflower, carrots, cucumbers, tomatoes, zucchini), dressed with vegetable oil;
- fruit and berry juices;
- dried fruits( raisins, dried apricots, almonds, hazelnuts, prunes);
- sweet fruit and berries( apples, bananas);
- pastille, marmalade, marshmallow;
- black and green tea, broth of wild rose, still mineral water.
It should be remembered that all dishes must be cooked in a double boiler or boiled, before serving, they should be crushed( meat and fish are made with souffle, cutlets, meatballs), porridges should be well-brewed, and salads finely chopped.
Vegetable oil is better to add to the finished dish, as it is not recommended to heat it, and milk, on the contrary, it is better not to eat raw. At first, it is necessary to grind all products, even apples from compote, and in the subsequent it is recommended to develop a habit carefully and chew food for a long time.
What you can eat after the operation depends on the individual tolerability of the products and on the accompanying diseases
What should be refrained after the operation
After removal of the gall bladder from the diet, it is necessary to exclude:
- soups on broth( meat, mushroom, fish);
- fat, fat;
- fatty meat( goose, duck, pork);
- smoked products, canned food;
- freshly baked bread, butter and puff pastry;
- fried or hard-boiled eggs;
- fatty and salted fish;
- whole milk fatter 6%, cream, fatty cottage cheese and sour cream, salty cheese;
- sauces( mustard, mayonnaise, horseradish);
- sharp and fatty foods;
- products with cream, chocolate, ice cream;
- sour berries;
- black coffee, cocoa, alcohol.
You should also limit the use of foods that are difficult to digest, contain essential oils or purines. These are all kinds of legumes, radish, radish, mushrooms, sorrel, green onions, spinach, garlic, pickled and canned vegetables. After cholecystectomy, the diet should be maintained on an ongoing basis.
Many patients, having noticed the absence of dyspeptic disorders, soon begin to eat, as before, that provokes the development of gastrointestinal diseases. In the first three months, eat strictly adhering to a nutritional diet and allow the body to adapt to new conditions.
Over time, you can digress a little from the therapeutic diet, and add your favorite foods to the diet, but you'll have to forget about fatty, sharp, heavy meals. Mandatory after the surgical removal of the gallbladder compliance with the rules of fractional nutrition.
Persons after the operation are prohibited from fasting and skipping meals, as the bile constantly enters the small intestine and, if there is a shortage of "work", damages the mucous membrane. According to the patients' reviews, after a year they hardly notice the consequences of the operation and can switch to a healthy diet without the occurrence of pain and digestive disorders.