Diet for the pancreas and liver

With a decrease in the function of one of the organs of the digestive tract, other organs are inevitably involved in the pathological process. For example, inflammation of the pancreas often causes inflammation of the gallbladder, biliary tract, liver, and the functioning of the sphincter of the stomach and duodenum (often with pancreatitis is diagnosed gastroesophageal reflux disease (GERD), reactive hepatitis, cholestasis, cholangitis, cholecystitis).

To reduce the severity of the inflammatory process that occurs in the hepatobiliary system and stop its spread, a therapeutic diet is prescribed that includes useful products for the liver and pancreas.

Also, with a decrease in the motor and secretory function of the glands of the digestive tract, it is necessary to know that he does not like the liver and pancreas, so as not to cause a relapse of the disease. Nutrition in therapy takes the leading place, and drug treatment is appointed as an auxiliary.

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With the purpose of restoration of the broken functions of bile ducts and liver, a therapeutic diet No 5 is prescribed. Depending on the pathology of the hepatobiliary system and its stage, modifications are made to the diet table, which differ in the chemical composition of the diet and in energy value.

Small changes in the basic diet No 5 can accelerate or inhibit bile secretion. All variants of the diet suggest mechanical shaking of the digestive tract, which means that products with coarse fiber are excluded from the menu. Some variants of the diet require chemical shchazheniya, so excluded a number of products that can increase the production of hydrochloric acid and enzymes.

With liver and pancreas disease, it is necessary often, but in small portions, to irritate the receptors responsible for the production and separation of bile. The main diet No 5 will be prescribed for chronic inflammation of the liver and gallbladder, cholelithiasis, as well as after relapse of hepatitis.

The diet not only removes the functional load from the gland and promotes the improvement of bile secretion, but also provides mechanical shaking of the digestive tract, which is often involved in the pathological process. Caloric content of a daily diet should not exceed 3100 kcal.

100 g of proteins, 100 g of fats and 450 g of carbohydrates should be fed into the patient's body, the amount of table salt should not exceed 10 g. When preparing the menu, the daily doses of essential microelements and vitamins (carotene 10.5 mg, thiamine 2 mg, riboflavin 4 mg, vitamin PP 20 mg, ascorbic acid 200 mg, calcium 0.8 g, magnesium 0.5 g, phosphorus 1.6 g, iron 15 mg).

According to the No 5 diet everything should be cooked for steaming, boiling or baking

In acute hepatitis, cholecystitis, cholangitis, angiocholite, as well as during their recurrence, diet No 5A is prescribed. It minimizes the workload from the hepatobiliary system to normalize the functional state of the glands, gallbladder and ducts, intestines and stomach. It implies not only mechanical shaking of the digestive tract, but also chemical.

Diet No 5A reduces the recommended intake of fats to 70-80 grams and carbohydrates to 350-400 grams, the protein content of the daily ration remains within 80-100 grams. Caloric content of the diet should be 2300-2500 kcal. Despite the decrease in the volume of food consumed, the content of vitamins and minerals remains the same as in diet No 5.

After removal of the gallbladder, an even more stringent diet No 5Sh is prescribed. It should ensure complete shaking of the liver and reduce the production of bile. From the diet of the patient completely eliminated vegetable fats, and also limited to the use of simple carbohydrates to 30-50 grams per day.

The chemical composition of food is approximately the following: proteins 90-100 g, fats 50-60 g, carbohydrates 300-350 g. In the post-operation period, the daily norm of minerals and vitamins decreases, except for iron and ascorbic acid. Thus, the patient should receive daily retinol 0.3 mg, carotene 6.7 mg, thiamine 1 mg, riboflavin 1,5 mg, nicotinic acid 13 mg, vitamin C 200 mg, sodium 3.7 g, calcium 0.3 g, potassium 2.8 g, phosphorus 1.2 g, iron 50 mg.

If, after cholecystectomy, a gallbladder syndrome develops with a decreased motility of the biliary tract, then diet No 5J is shown. It promotes bile secretion and has a lipotropic effect (burns fat), since it introduces full proteins and polyunsaturated acids into the diet.

The chemical composition of food in the diet No 5J is the same as in diet No 5, only 20-30 grams of fat is increased, half of which must be of plant origin. Caloric content of products should not exceed 3400 kcal per day.

When the inflammation in the pancreas exacerbates, a diet No 5P is prescribed, which has two options. First, nutrition is recommended, which helps to relieve pain and reduce the load from the pancreas, as well as reducing reflex excitation of the gallbladder. This diet presupposes chemical and mechanical shuddering of the tract and urges you to refrain from food altogether for the first 24 hours.

To adhere to a diet on this diet can be no more than a week. The patient should limit the use of proteins (up to 40-80 g), fats (up to 40-70 g) and easily digestible carbohydrates (total carbohydrates 200 g), as well as salts (not more than 8 g). Unlike other variants of diets, it requires eating only mashed dishes and foods. Total daily calorie 1300-1800 kcal.

The second variant of the No 5P diet is prescribed after the acute pancreatitis subsides and with a not very pronounced inflammatory process. In addition to boiled food, it is allowed to eat fried foods, but all of them must be rubbed up to a puree state. The chemical composition of food should be as follows: proteins 120 g, carbohydrates 300-350 g (limited to simple), fat 70 g. Caloric content of the diet is up to 2500 kcal.

When determining the variant of the diet, it is necessary to know exactly which processes occur in the liver and pancreas, and also how much the pathology affects the stomach and intestines

Nutrition rules for diet No 5

In diseases of the hepatobiliary system, there are general recommendations that will reduce the severity of the inflammatory process:

• Remove from the diet products that increase the secretion of gastric juice. These are vegetables with essential oils (garlic, onion, radish, radish, celery), rich broths, dried and smoked foods;
• components that mechanically irritate the gastrointestinal mucosa should be excluded. Such products include vegetables with coarse fiber, meat with veins and tendons, baked goods from wholemeal flour;
• dishes are cooked in a double boiler or boiled. You can bake only if the disease is in remission, there is not a crust formed;
• the volume of refractory and poorly fissile fats decreases, they are replaced by vegetable oils. With inflammation of the pancreas and deposition of stones in the gallbladder, the total amount of fats should be reduced in the diet;
• from the diet, products with a high quantitative index of purines are removed. This is the meat of the young runoff, the liver and other offal, sardines, tuna, herring, sprats, salmon, shrimp, seafood, dried ceps, yeast, smoked eel;
• the use of table salt is limited, since it affects the quality of bile (causes it to thicken), which slows its outflow;
• the amount of products with lipotropic properties (beef, lean fish, cottage cheese, whey, buckwheat, soybean flour) increases in the diet. Due to this, lipolysis in liver cells normalizes and the likelihood of developing fatty hepatosis decreases;
• food is necessarily fractional, so that bile and enzymes do not accumulate in the glands, but are thrown into the duodenum. When pancreatitis is recommended, eat every two hours, but in portions of 50-100 grams;
• in the period of relapse, as well as with severe inflammation of the liver and pancreas, all products must be rubbed to speed up their cleavage and reduce the mechanical stress on the digestive tract.

Sample menu

With inflammation of the pancreas, the diet in the first days after a one-two-day unloading diet should consist mainly of carbohydrate food (liquid porridges, compotes with ground fruits, crackers, kissels, tea with sugar).

Then gradually introduced cottage cheese (grated), steam omelet, creamy soups with meat, meat and fish souffle, cutlets cooked in a double boiler. With the improvement of well-being in the menu, you can add vegetable soups and mashed potatoes (based on potatoes, carrots, beets).

Approximate menu

In chronic pancreatitis, enzymes that are necessary for the complete digestion of food are often not sufficiently synthesized. Because of the lack of these substances, proteins, fats and carbohydrates are not split, so patients suffer from increased gas formation as a result of putrefaction of proteins and fermentation of carbohydrates, symptoms such as weight deficiency and steatorrhea (fat feces) are also observed, since fats are not digested.

To normalize the work of the pancreas, it is recommended to increase the amount of proteins in the diet to 120-150 g, with proteins of animal origin prevailing, and fats, on the contrary, should be less (up to 70 g). Refractory fats can cause pain in the abdomen, so they are replaced by vegetable.

To insulin deficiency did not lead to diabetes, it is necessary to reduce the amount of incoming simple carbohydrates (confectionery, white bread, sugar, sweets, potatoes, oatmeal, rice, manga), sugar should be replaced with xylitol or saccharin. With a strong inflammation in the liver and ducts, the menu is more diverse.

It is allowed to eat vegetable puree from potatoes, pumpkin, cauliflower, beets or carrots, vegetable soups filled with cream or butter, cooked on the water porridges (semolina, rice, buckwheat, oatmeal), steam meatballs, cutlets, soufflé. Also allowed to eat sweet fruit and berries, which must be boiled, baked or grinded. You can eat sour-milk products of low fat content and omelettes from proteins.

Nutrition in diseases of the liver and pancreas in a period outside the exacerbation is balanced, so the diet should be adhered to for a long time

Which products are useful

Therapeutic diet in diseases of the liver and pancreas can include the use of:

• vegetable soups. If there is croup in the soup, then it should boil well. During an exacerbation it is desirable to grind all the vegetables and serve a dish in the form of liquid soup-puree. It is allowed to fill the soup with sour cream, cream, butter;
• vegetable purees. From vegetables to eat potatoes, pumpkin, zucchini, carrots, green peas, beets, cauliflower. After the abatement of the inflammatory process, it is allowed not to grind vegetables, but to chop fine. During remission, you can eat raw, grinded vegetables, it is permissible to include tomatoes, eggplants and cucumbers in the diet (they must be peeled off), greens;
• porridge from manna, oatmeal, rice, buckwheat (you need to cook on the water);
• dietary meats (chicken, veal, rabbit, beef);
• lean fish (hake, cod, pollock, perch, pike perch, pike, blue whiting, pike perch). With pancreatitis, you can not extinguish the fish, since such dishes are rich in extractives, it must be cooked in a double boiler;
• fermented milk products with low fat content. Sour cream and milk is used only as an additive to the dish. In the diet, there may be a mild cheese, again in frayed form;
• crackers, dried white bread, dry biscuits;
• steam protein omelets;
• sweet fruits and berries after heat treatment (in compotes, baked, jam, kissels, pastilles). You can eat apples, pears, bananas, raisins, dried apricots, prunes, figs. If the function of the pancreas is not broken, then it is allowed to consume raw sweet fruits and berries.

It is useful for the liver to use hepatoprotectors, which improve the condition of the gland cells. They include artichoke, pumpkin seed oil, milk thistle. Medicines based on these natural ingredients can be purchased at the pharmacy.

To improve bile secretion it is recommended to use:

• cold pressed vegetable oil, which was not subjected to heat treatment;
• vegetables and fruits, berries (especially useful food for the gland are watermelons, melons, mandarins, oranges, prunes, pears, lemons, spinach, rhubarb);
• cabbage, beet, cranberry juice;
• bran;
• egg yolk;
• turmeric, barberry, oregano, coriander, dandelion, mountain ash, caraway, chicory, rosehip.

What products are useful, the attending physician will tell, based on the medical history, the symptoms of the disease, the functional state of the digestive tract.

Products to be restricted

In diseases of the hepatobiliary system, the body is difficult to digest:

• soups on strong broth, as well as borsch, okroshka, beetroot, shchi;
• vegetables with a high content of cellulose (cabbage, bell pepper, rutabaga, radish, radish) and with essential oils (garlic, onion);
• mushrooms;
• by-products;
• fatty meat and fish, lard, stews with meat and fish, any fried foods;
• Smoked meat, pickles, sausages, canned food;
• freshly baked or rye bread, products on yeast and confectionery, puff pastry;
• pearl barley, corn, barley, millet should not be used in diseases of the pancreas;
• raw vegetables and fruits, especially sour;
• black strong coffee, cocoa, chocolate, ice cream, carbonated drinks;
• seasonings and spices, sauces (ketchup, mustard, mayonnaise);
• alcohol.

If there is a violation of the liver, it can be harmful to use many medications and herbs from the home medicine chest, so before prescribing medications, you must always warn your doctor about the presence of a chronic disease.

Products that are harmful in patients with liver and pancreas should not be included in the diet, even in a minimal amount, as they are capable of provoking bile stasis and relapse of the disease, as well as its complications

Even a healthy pancreas is hard to split fried, smoked and spicy dishes, and the inflamed organ especially does not like them and will respond to such a treat with vomiting, nausea, bloating, stool, pain. The diet for the liver and pancreas quickly eliminates the symptoms of pathology, however, when they return to heavy and fatty foods, they return, so it is necessary to adhere to the therapeutic diet constantly.

Products useful for the liver and pancreas should be used both during an exacerbation, and during remission. A diet filled with healthy foods will not only help to restore the liver and pancreas, also improve bowel and stomach function, normalizes weight.