- The essence of the operation and the problems that arose
- The consequences of removing the gallbladder and how this is associated with a diet
- Requirements for the composition of food after removal of the gallbladder
- How to eat immediately after surgery and in the first week?
- How to eat from the second to the sixth week?
- Features of expansion of a diet at a laparoscopic operation
- The main requirements of the dietary table №5
- Related Videos
Removal of the gallbladder (an operation called cholecystectomy) is a radical treatment of cholelithiasis, a purulent cholecystitis with the threat of spreading to the abdominal cavity.
Delay with surgical intervention threatens with necrosis and thinning of the wall, breakthrough of the membrane and severe peritonitis. A rational diet after removal of the gallbladder is necessary both to ensure healing processes, and to prevent the creation of conditions for the formation of new stones in the bile ducts.
The essence of the operation and the problems that arose
The gallbladder as anatomical formation serves as a store and storage of bile, which is produced by the liver. At the right time, he throws a portion of bile acids through the bile duct into the duodenum, where they are included in the digestion process.
The formation of concrements (salts, stones) is promoted by stagnant phenomena, a violation of the composition of bile. And this, in turn, is caused by inflammatory diseases of the bladder, liver (biliary hepatitis and cirrhosis), ducts, malnutrition.
The most common eating disorders:
- prevalence of fatty foods with high cholesterol;
- non-compliance with the diet (prolonged interruptions, overeating);
- passion for fashionable dietary recommendations for weight loss and cleansing.
The stages of the operation in the classical method of cholecystectomy involve the dissection of the abdominal cavity with a cut
Cholecystectomy consists in careful allocation of the gallbladder, bandaging of the vesicle artery in the zone of the vesicle-hepatic ligament, imposing a clamp on the neck of the formation, and then crossing at a distance of 1.5-2 cm from the common bile duct. If there is a purulent effusion before the suturing of the wound, drainage is left for several days.
Finally, the gallbladder is removed, there are no bouts of pain, the postoperative wound is gradually tightened by the scar. But have the biochemical processes in the body changed? Can the patient be sure that the disease will not recur?
Liver cells, as before, produce bile. Now there is nowhere to accumulate, so it constantly flows slowly through the bile ducts into the intestine. Nutrition of a person without a gallbladder should halt the increase in bile secretion, its stagnation, eliminate bad habits and metabolic disorders. Otherwise, the calculi are formed again, but already in the hepatic ducts.
The consequences of removing the gallbladder and how this is associated with a diet
Exclusion of the gallbladder from the process of digestion does not pass for the body painlessly. A period of adaptation to the new conditions is necessary. There are problems that need to be addressed.
The bile stored in the bladder becomes more concentrated, saturated with fatty acids. In the absence of a gallbladder, the composition and quantity change. Since the enzyme activity is lacking for the former digestion, the intake of fatty foods, of large volume, becomes an even more difficult "work" for the intestines. Digestive disorders are manifested in a feeling of heaviness in the hypochondrium on the right, nausea.
It is observed in the first month after the surgery. Symptomatology is caused by excessive growth of the intestinal microflora. Previously, it was inhibited by bile enzymes. Altered bile loses its activity, it makes it possible to multiply intensively the pathogenic microflora. As a result, the intestine is continuously fermentation and decay.
Patients complain of constant bloating "not to eat", a feeling of bursting
Relapse of stone formation
The problem can be considered the worst variant of the operation. The main reason is the continuing stagnation of bile, the composition is broken due to the ingestion of foodstuff with which digestion is not able to cope.
When the metabolism is disturbed, caused by the pathology of the internal organs, the negative properties grow gradually. But man is capable of his behavior (lack of motor activity, irregular nutrition) and the preservation of food habits to stimulate a relapse.
Requirements for the composition of food after removal of the gallbladder
Doctors, nutritionists are sure that with the help of the correct selection of permitted products, it is possible to stop metabolic disorders, not to allow the recurring formation of stones. In this case, you need to consider the body's need for basic nutrients.
Fats - in the form of cholesterol are the main constituent part of the stones. This is especially true of animal fats. For correction, it is necessary to exclude products containing high cholesterol concentration (fatty meat and fish, egg yolk, liver) from the postoperative diet.
But you need to keep the intake of unsaturated fats and lipoproteins as much as possible, because they "dilute" the bile, prevent precipitation of salts. Similar substances are contained in vegetable oils (sunflower, olive, corn, linseed).
On the question of which one is preferable to a particular patient, there is the opinion of a number of scientists that it is necessary to use products that grow in the habitual zone where the patients themselves and their ancestors lived for a long time. So, olive oil works best on the inhabitants of the Mediterranean. And for the inhabitants of Russia fit linen, sunflower, from milk thistle.
Carbohydrates are an essential component of the diet, since nutrition after the operation to remove the gallbladder should provide the body with sufficient energy for complete recovery. However, not all carbohydrates are useful. In cereals and baked goods are species that acidify the composition of bile. A deviation reaction to the acid side leads to the precipitation of salts, turning into stones.
Easy to assimilate carbohydrates are found in sweet dishes (jam, marmalade, fruit paste). They do not have such an effect, but they are dangerous for their caloric content, their effect on weight gain and metabolic disorders.
Proteins are necessary for healing processes, biochemical reactions in the hepatic tissue to combat intoxication. The greatest amount is contained in lean meat, fish, cottage cheese, dairy products, egg whites.
The composition of vitamins, which must contain a diet when removing the gallbladder, must ensure the performance of all liver functions. Especially shown are products with ascorbic acid, B vitamins, retinol, K. It is proved that the deficiency of retinol causes the crystallization of bile.
The entire composition of the daily diet should consistently contain useful products. The proportions of the main components should be ensured by:
- ¼ part - proteins, can be obtained from cooked dishes from lean meat, chicken, fish, cottage cheese;
- ¼ - fatty unsaturated type of vegetable oils, animal fats remain in small quantities, come with meat and dairy products;
- half of the nutrients - are "slow" carbohydrates from cereals, vegetables, fruits, a very small part is obtained from "light" varieties of sugars.
With this balance of substances, nutrition after removal of the gallbladder maintains normal digestion, protects the body from new problems. The most severe diet is needed in the first months after the operation.
It is established that, if the conditions of adaptation are observed, the functions of the gallbladder pass to the intrahepatic and common bile duct
If the rehabilitation period proceeds normally, then bile stagnation is prevented. This allows patients in a year to move from a strict diet to normal diet with some restrictions. We propose to consider the features of the early and subsequent diet of patients with a distant gallbladder.
How to eat immediately after surgery and in the first week?
The first days after cholecystectomy the patient spends in the ward of the surgical department. The average length of the hospital period is a week, if there are no complications. Diet after removal of the gallbladder in the early days is calculated by the specialists of the medical institution.
It should ensure:
- the maximum mode of fractional nutrition is 6-7 times a day;
- strict feeding schedule;
- sparing digestion due to rubbed, liquid dishes;
- removal of intoxication with abundant drink (up to 1.5 liters per day).
Usually, the operation is performed under general anesthesia. This excludes the use of food for a period of about 12 hours, necessary for rest and sleep. There is nothing you can not forbid even to drink. Doctors are allowed to rinse your mouth or rub your lips.
After 12 hours, the patient is given a liquid broth, jelly, it is allowed to drink water. On the second day, the most sparing diet is recommended, table number 0a (low-fat meat broth, cereal mucus broths, kissel from non-acid fruits and berries, jelly, vitamin broth of dogrose).
Kissel from red currant covers the need for vitamin C, stimulates immunity
On the third-fifth day the patient eats dietary dishes from the recommendations of tables No. 0b and 0c. They allow: mucous cereal soups on vegetable decoction, liquid porridge from buckwheat, oatmeal, rice, egg white omelette, steamed or soft-boiled egg, sweet fresh juices, sweetened weak tea, mashed potatoes, dried white bread.
On the sixth day, the patient is transferred to the diet table No. 5a and observed for a week. It consists of low-fat meatballs, steamed meatballs, boiled fish, vegetables (can be stewed), chicken or vegetable soup, skimmed yogurt, dairy cereals and semi-liquid mashed cereals, low-fat cottage cheese. You can eat white dried bread to 100 grams per day.
How to eat from the second to the sixth week?
On the eighth day with a good current the patient is discharged from the hospital and provides recommendations that you can eat at home and how to behave. The whole first month you must observe the conditions of sparing the digestive tract. Some nutritionists are of the opinion that such a regime should be left for a month and a half.
This means that you should eat often and gradually, at the same time. Dishes cook only boiled, steamed and stewed, served to the table in a warm form. Meat products are crushed or prepared from minced meat. Prohibited rye bread and pastries, fresh vegetables and fruits.
The daily sample menu of the patient should include:
- steam cutlets, meatballs or meatballs, soufflé, boiled meat and fish;
- milk porridge and soups;
- kefir or yoghurt;
- soups on vegetable broth,
- pudding or casserole from cottage cheese;
- vegetables in a wipe or stewed;
- jam from non-acid fruits, compote from dried fruits, fresh juice.
The healing and recovery of the digestive process after laparoscopic surgery is faster
Features of expansion of a diet at a laparoscopic operation
Laparoscopic technique less traumatizes tissues. Immediately after the operation you are allowed to drink, and after 12 hours you can eat liquid low-fat soup, drink berry jelly. Do not eat solid food. From the second day you can eat small portions of boiled meat, scrambled eggs, fish, cottage cheese, sweet fruit. From the third day the patient is transferred to the table №5.
The main requirements of the dietary table №5
After a month and a half from the operation of cholecystectomy, a rather dense scar in the hypochondrium on the right should form. The digestive organs have already adapted to functioning without a gallbladder. The patient remains to protect the gastrointestinal tract from irritation, overload, with the help of nutrition to help dilute the composition of bile.
These criteria are feasible when using diet number 5. She will have to stick to the patient all her life. The purposes of a diet are:
- normalization of the formation and composition of bile in the liver;
- prevention of stagnant phenomena;
- support the necessary level of metabolism in hepatocytes;
- prevention of escalating connective tissue in the liver in patients at risk of cirrhosis.
At this stage, the diet after the operation to remove the gallbladder does not differ from the recommendations to patients without surgical intervention. The basic rules of nutrition continue the frequency requirements (can be reduced to 5 times a day), the regime, the temperature of the food intake, small portions, drinking up to 1.5 liters of water a day, excluding fried foods.
The following products are prohibited:
- wheat or rye bread, fresh pastry, culinary products;
- rich soups from fat meat, fish, mushrooms;
- fried and smoked meat and fish dishes, lard, sausages;
- canned food;
- porridge of pearl, millet, barley, corn;
- beans (peas, beans, lentils);
- dairy products of high fat content (whole milk, cream, sour cream, cottage cheese, processed cheese);
- vegetables that enhance the acidity of gastric juice (cabbage, turnip, radish) and having in the composition oxalic acid (parsley, spinach, onions, garlic, sorrel);
- sour fruits and berries;
- chocolate, sweets;
- spicy seasonings (pepper, mustard, horseradish, ketchup, adzhika, mayonnaise);
- hard boiled tea, coffee, cocoa, drinks with gas.
Dieticians have a different opinion about alcohol. Some believe that half a glass of grape wine in the feast can be afforded. Moreover, wine reduces the risk of stone formation. But strong drinks and beer are strictly forbidden.
Marmalade without sugar powder has a lower caloric value, is shown to people with excess weight
- bread rye-wheat, dietary, yesterday's;
- meat of lean sorts, chicken, lean fish, rabbit, shrimp, squid;
- skimmed milk products, hard cheese;
- cereals from buckwheat, oatmeal, rice;
- vegetable dishes from boiled beets, potatoes, carrots, bell peppers, zucchini, tomatoes (peel);
- sweet berries and fruits;
- eggs can be consumed in the form of an omelet made from protein, occasionally it is allowed to add ground yolk to the porridge;
- for drinking fresh berry and fruit juices, weak tea, compote of dried fruits, broth of wild rose;
- Butter is very limited, a teaspoon is put into the ready porridge;
- vegetable oils for dressing salads, soups;
- from sweets - marmalade, pastille, marshmallow, honey is limited.
Each new product should be tested carefully, listening to the body's reaction. On the question of how long it will be necessary to follow a diet after removal of the gallbladder, and how long the strict limitations will be required by the attending physician in a particular case. It depends on the course of the disease, the consequences of the operation, the general condition. One can argue: without dieting treatment, medical products are not effective.