Diet 5 with pancreatitis

Pancreatitis( inflammation of the pancreas) is a serious debilitating disease that occurs in acute and chronic form. Medical measures do not do without a dietary approach to feeding the patient, adhering to the basic rules of cooking and eating.

General requirements are included in the recommendations for use in pancreatitis table number 5, compiled in accordance with the classification of M.I.Pevzner for patients with liver damage, bile ducts( hepatitis, cholecystitis, dyskinesia), pancreas containing modifications for postoperative treatment. However, the course of the disease has its own peculiarities, their relevance must be taken into account when drawing up an individual menu of the 5p diet( for pancreatitis) for a week.

The goals of therapeutic nutrition

Whatever wonderful solutions are administered to a patient with pancreatic pathology intravenously, they can not replace nutrients supplied by food, they are always used for a very limited time. An acute inflammatory process in the pancreas requires the maximum removal of it from the digestive process for the normalization of functions.

This is achieved through complete hunger and a ban on drinking for 1-2 days. The attending physician conducts a special procedure for suctioning the contents of the duodenum and stomach with the probe, so that no discharge irritates the gland. As a result of starvation, it is possible to block excessive synthesis of enzymes and the process of self-destruction of the parenchyma of the organ.

Subsequent power should:

• normalize secretory activity;
• provide intensive biliary excretion in disorders of the gallbladder;
• affect the liver to activate fat metabolism and glycogen storage;
• provide the optimal amount of protein, vitamins and trace elements to support the generation of energy needed for recovery;
• delay the development of fibrous tissue( important for chronic pancreatitis);
• stimulate general and local immunity.

Parenchyma edema in inflammation disrupts lobular pancreatic structure of the pancreas

The main principles that require dieting 5 in pancreatitis

To restore the functions of the pancreas it is necessary: ​​

• exclude foods that stimulate the secretion of pancreatic juice( fatty meat and fish products, boiled and fresh cabbage, mushrooms);
• to change the ratio of nutrients by increasing the amount of protein consumed( lean meat, fish, cottage cheese) to 150 g per day, reducing fats to 70-80 grams, limiting carbohydrates to 300-350 g( especially easily digested types of sugars, honey);
• follow the rules of cooking correctly;
• to control the volume of single feeding, not to allow one-time overeating, the weight of each dish should not exceed 150 g;
• observe the fractional power mode up to six times a day( after three hours);
• any changes agreed with the doctor based on the results of the control studies.

What features of cooking recommend diet 5?

The rules of nutrition for pancreatitis prohibit fried and smoked dishes, finished products. You can not feed the patient pickled and salted vegetables, canned food( including juices).As the fats are sharply limited, a spoonful of butter is put directly on the plate. It is allowed to use boiling, baking, quenching, steam cooking of food products.

It is forbidden to use cooking oil, margarine, lard

during cooking. Vegetables can not be passaged in a frying pan, they are finely cut or grinded, boiled. The intake of salt is limited to 10 g per day( the norm of 12-15 g).At home, it is better to measure 2 teaspoons and put the salt shaker on the table to salivate from this amount during the day, and during the cooking process, salt is not used.

It is forbidden to use spicy seasonings( pepper, mustard, horseradish), ketchup, mayonnaise, sauces for refueling. They are replaced with vegetable oils in limited quantities. There are dishes only warm, categorically contraindicated hot and cold temperature, as a strong stimulus of the digestive system. Diet 5p in pancreatitis, in contrast to table number 5 should consist of dishes of liquid consistency. All products are pre-twisted or rubbed.

Indications for the diet 5p

Diet No. 5p is recommended for a two-week period after the fasting period in acute pancreatitis and the next exacerbation of chronic. It should provide a gradual "exit" of digestive functions from the "non-working" regime and restoration of organs for transfer to the full table number 5.

In the transition period, the maximum shaking of the pancreas, stomach, intestines continues, the reflex stimulation of digestive juices and bile production is prevented.

Temporary application of diet No. 5p is justified with augmentation of pain against a background of chronic pancreatitis

What is included in the diurnal composition of the diet 5n?

With all the restrictions, the composition of the daily menu should ensure sufficient caloric content, vitamins, increased content of pectins, lipotropic substances. The average energy intensity of the diet corresponds to 1700-2500 kcal.

Carbohydrates are reduced as much as possible in the first days to 50 g( gradually increase to physiological norm, but sugar remains no more than 30 g), fats up to 70 g( butter about 30 g per day, vegetable not more than 15 ml per dish), proteinsmake up the predominant component in the menu( 100 g).The composition varies depending on the duration and severity of the acute stage of pancreatitis.

Obligatory vitamin-salt components of food:

• retinol and thiamine for 10 mg;
• ascorbic acid 150 mg;
• riboflavin 2 mg;
• nicotinic acid 1.6 mg;
• phosphorus 1.3 g;
• sodium 3 g;
• magnesium 0.5 g;
• iron 0.03 g,
• calcium 0,8 g.

All useful components correspond to a certain content of products, so it is important to try to combine and use different permitted combinations. They provide not only taste qualities, but also the permanence of the therapeutic effect.

Allowed products

The first days, after the fasting regime, the patient is allowed only vegetable soups with cereal, jelly from berries slightly sweetened, steam omelet, broth of wild rose. Every 2-3 days the diet expands. Low-fat meat and fish are used to prepare not broths, but steam wiped meatballs.

Porridges are prepared first on water, then on diluted milk, semi-liquid from oat, buckwheat, rice cereal, mango. Bread of wheat varieties is allowed only dried( yesterday), small breadcrumbs, you can eat unsweetened dry biscuits( biscuits).Once a day - a soft-boiled egg or as a steam omelet.

Vegetables are added to soups, boiled and grinded. By the end of the week, milk soups, boiled vermicelli, stewed or baked apples without skins, grinded low-fat cottage cheese are introduced. Of fruit and berries, it is better to cook jelly, juices without sugar. Concentrated freshly squeezed juice is brewed in half boiled water.

Non-fat tea with lemon without sugar is allowed, broth of wild rose

Unsupported products

The 5p diet includes many restrictions. The list includes:

• fresh pastry, bread made from rye flour;
• sweets and culinary products with cream;
• alcohol in any form, strong tea, coffee, carbonated drinks;
• cold dishes( ice cream), hot tea;
• rich broths of meat and fish;
• smoked sausages, sausages, semi-finished products;
• drinks from yoghurt( kefir, yoghurt, ayran);
• fish caviar;
• radish, turnip, radish, spinach and sorrel;
• dishes from mushrooms and cabbage;
• spicy seasonings;
• pickles and marinades;
• milk and products from it at high fat content;
• canned fish, meat products, vegetables and juices;Oranges and tangerines, grape juice;
• fast food, different chips, nuts, crackers with condiments.

How does the diet depend on the duration of the exacerbation?

Diet 5p is designed for the gradual expansion of the diet, depending on the period from the onset of the disease. In the first 3 days after a hungry diet, it is allowed to eat a little and fractional up to 6-7 times a day. For the patient prepare liquid grinded porridge on the water. Give a half of the vegetarian slimy soup without salt, jelly, broth of wild rose.

Some nutritionists also recommend a decoction of black currant. You can slightly sweeten the drink. Categorically prohibited anything that causes a sokogonnoe action( salt, fats, seasonings, cabbage).On the fourth day, the caloric content increases to 600-800 kcal. The amount of protein rises to 15 grams, carbohydrates - 200 g.

From the fifth day to the end of the week, calorie content rises and reaches 1000 kcal. Fats are added to the dishes( butter 10 grams), proteins are allowed to increase to 40 grams, carbohydrates up to 250 g. The menu includes vegetarian soups, cereals are cooked more steep, but without milk, connect grated boiled meat, fish meatballs and meatballs, steamcutlets.

Vegetable purees from potatoes, carrots, low-fat cottage cheese, ground apple are allowed. In addition to the broth of wild rose, freshly diluted juices, cranberry juice are added to the drink. From the ninth day the calorie content is 2000 kcal. In the diet menu 5n, the proportion of fats( 20 g), proteins( 60 g), carbohydrates( 300 g) increases. One-off portions become larger.

Because of low caloric intake, the intravenous infusion of glucose and protein preparations( parenteral nutrition) continue to be supplied to the diet.

Food is continued without salt. A tablespoon of vegetable oil is added to the plate with the prepared dish. After the twentieth day from the onset of the disease, the diet expands significantly. It is allowed to use 40 g of fat, 100 g of proteins, it is possible to bring carbohydrates to a physiological norm( 400-450 g).Continue to grind and wipe dishes, boil without salt or bake.

The patient is fed: mashed cereal soups, liquid porridges( buckwheat, oatmeal, until recommended rice and semolina), vegetable puree, boiled pumpkin, fruit jelly. Cottage cheese pudding is allowed. Gradually, milk is introduced into the food, various milk porridges, kefir. Boiled meat and fish are allowed to cook with a piece.

How long should a diet?

A strict diet of 5p is usually prescribed for 20 days. The period is determined by the patient's condition, by the coping of the pain syndrome, by the results of the examination of the functions of the pancreas. After suffering acute pancreatitis, at least a year will have to follow a diet of 5. With a chronic form of the disease, the 5n diet will be required at each exacerbation of the process, and following the requirements of Table 5 remains for life.

One-day menu with exacerbation of

Serious restrictions can be mitigated by alternating porridges, vegetable purees, dairy products, baked fruit.

• Breakfast - liquid oatmeal in divorced milk, broth of dogrose with rusks.
• The second breakfast - slightly sweetened wiped cottage cheese, green tea with milk without sugar.
• Lunch - vegetable soup-puree from carrots, potatoes, cauliflower, fish cutlets, steamed, berry jelly.
• Snack - stewed apple, milk with biscuits.
• Dinner - steam omelet from two proteins, kefir.
• During the day, you must drink at least 1.5 liters of fluid.

Nutritionist will write the menu individually for the patient

Sample diet menu №5 for a week without exacerbation

Recommended food is allowed after strictly observing the diet of 5p, in the absence of pain.

Day 1

• In the morning - semi-liquid oatmeal in diluted milk, broth of wild rose with biscuits.
• The second breakfast is a baked apple.
• Lunch - soup with meatballs, vegetable puree, kissel from berries.
• Snack - kefir with crackers.
• Dinner - boiled chicken piece, buckwheat porridge, green tea.
• Before going to bed - milk.

Day 2

• In the morning - curd casserole with raisins, tea with milk.
• The second breakfast is a banana;
• Lunch - vegetarian soup with finely chopped vegetables, lazy cabbage rolls, compote of dried fruits.
• Snack - jelly with biscuits.
• Dinner - semi-liquid milk rice porridge.
• Before going to bed - yogurt.

Day 3

• In the morning - buckwheat porridge with milk, broth of dogrose.
• The second breakfast - apple juice, biscuits.
• Lunch - steamed chops with vegetable puree, berry jelly.
• Snack - rice pudding with fruit. Dinner - boiled fish, mashed potatoes, green tea.
• Before going to bed - herbal tea with chamomile, unsweetened biscuits.

Day 4

• In the morning - pumpkin milk porridge from rice and pyshenki, green tea.
• The second breakfast - vinaigrette from boiled vegetables without pickles and cabbage.
• Lunch - fish soup from cod, rice porridge, tomato juice.
• Snack - jelly with berries.
• Dinner - a piece of boiled chicken with grated beets, tea with milk.
• Before going to bed - yogurt.

Day 5

• In the morning - milk semolina porridge, green tea, a sandwich with hard cheese.
• The second breakfast - low-fat cottage cheese, carrot juice.
• Lunch - chicken soup with vermicelli, mashed potatoes( suitable carrots, zucchini, potatoes, cauliflower), unsweetened tea.
• Snack - grated apple with carrots.
• Dinner - curd casserole, jelly from the berries.
• Before going to bed - milk with crackers.

Day 6

• In the morning - buckwheat porridge, milk.
• The second breakfast is baked fruit( pear or apple).
• Lunch - vegetarian borscht, steamed meat from turkey meat, tea with lemon.
• Snack - berry jelly.
• Dinner - milk soup with noodles, green tea with biscuits.
• Before going to bed - yogurt.

Day 7

• In the morning - oatmeal milk porridge with fruit, tea with crackers.
• The second breakfast - cottage cheese, broth of a dogrose with a teaspoon of honey.
• Lunch - vegetable soup, rabbit meat baked in sour cream sauce and buckwheat, green tea.
• Snack - apricot juice with biscuits.
• Dinner - fish steamed meatballs with rice, jelly.
• Before going to bed - milk with dry biscuits.

Compliance with the rules of diet number 5 will require significant limitations from patients, but they are justified by the rapid reduction of mild pain and recovery. Usually, the cause of exacerbation of pancreatitis is a violation of these requirements. Therefore, sick chronicles well understand the importance of proper nutrition.