Diet for chronic pancreatitis

Chronic pancreatitis is a slow inflammation of the pancreas. The disease manifests itself during periods of exacerbations by intense attacks of shingles in the upper abdomen. From the acute form is characterized by progressive fibrosis of the organ tissues with loss of functions. Dysfunction of diet in chronic pancreatitis is one of the important reasons for activating the inflammatory process. In the treatment of pathology, an important role is given to the right diet.

What should I know about the disease?

The causes of chronic pancreatitis are inextricably linked with the pathology of the bile excretory system, liver, duodenum. These organs are united by anatomical proximity and functional dependence of the secret produced.

Bile and pancreatic juice are given portion by portion in response to the quality and quantity of food ingested. Overloading with frequent use of alcohol, fatty and spicy dishes leads to hyperfunction, then cell depletion. Under such conditions, the infection does not meet the proper local resistance.

Stressful situations disrupt the mechanism of "management" of secretion and secretion, cause a spasm of feeding vessels, ducts. Parenchyma of the pancreas receives less nutrients, oxygen, energy, and therefore gradually dies. A dense scar tissue forms on the site of necrosis.

Pancreas diminishes in volume, loses structural structure of lobular structure

Chronic form can go untreated acute pancreatitis. Secretory insufficiency affects digestion in general. In addition to the pain syndrome, patients develop such unpleasant symptoms as frequent loose stools of oily consistency, bloating, heartburn, weight loss.

Dietary food tasks

In the medical process, it is important to maximally protect the pancreatic gland from the effects of stimulants in order to enable the restoration of the functioning of intact cells and to compensate for the loss of replacement on fibrous tissue.

For this, in the diet for chronic pancreatitis, it is required to provide:

• the exclusion of irritants( animal fat, essential oils, extractives, salt, spices);
• gentle action on the stomach and intestines by means of food processing methods( grinding before grinding, boiling, steam cooking, quenching) with refusal of fried, smoked dishes;
• control of the temperature regime - the patient is allowed to eat ready meals with a temperature of about 38 degrees, forbidden cold drinks, ice cream and too hot products;
• for the restoration of bowel function from the diet, products that enhance fermentation processes rich in fiber are excluded;
• in order to support protein and fat metabolism, providing energy reserves in the daily and weekly menu provide the necessary amount of carbohydrates, protein products, reduce gross fats;
• providing vitamins necessary to support the body's work, restoration of immunity;
• compliance with the frequency of meals at least 6 per day, reducing portions in a volume of up to 250-300 g, preventing single overeating.

The diet for chronic pancreatitis in adults requires a complete rejection of alcoholic beverages( including beer), dry food, canned food

What "classic" diet meets the necessary requirements?

Classification of diets according to Pevzner was developed in accordance with pathophysiological disorders of the digestive system. With changes in the pancreas( chronic pancreatitis) is shown a dietary table № 5п.This is one of the variants of table number 5, which is also prescribed for patients with pathology of the liver, bile ducts.

Differs from the base table using only liquid mashed food. Nutrition for chronic pancreatitis is performed depending on the stage of inflammation:

• immediately after fasting with exacerbation for several days the patient is fed only liquid food, the calorie is sharply reduced( 1,700 kcal), the set of products is limited for the maximum mode of shaving - this is diet No. 5a, it is also recommended for treatmenthepatitis, cholecystitis in the acute stage;
• is then prescribed a transitional diet No. 5b for a period of 1 to 2 months, usually the pain subsides, but the inflammation is not relieved, so the period of the disease is called "unstable remission";
• with the improvement of the patient's condition should stick to the diet No. 5p all his life.

Changes in diet are characterized by a gradual load on the pancreas and expansion of the set of allowed products. Duration is determined for each case by the attending physician. Consider in more detail the difference in the composition of the diet.

In the diet number 5a - the amount of protein is reduced to a minimum( 60-80 g), fats to( 50-60 g), carbohydrates to 200 g to exclude pancreatic stimulation. In diet No. 5b, the amount of protein is increased to 120 g, fats remain at 70 g( 1/5 of the composition must fall on vegetable oils), carbohydrates grow to 350 g. The calorie content reaches 2500 kcal per day. Hardly restricted food with extractives( broths of meat and fish, cabbage, mushrooms), coarse fiber. All dishes remain wiped.

Description of the diet № 5p

The variant of diet No. 5p is suitable for long-term use in the interictal period( remission) for chronic pancreatitis. By composition: the content of carbohydrates is brought to the norm of 400 g / day, but there are restrictions for simple carbohydrates( sugar, honey, jam in the amount of not more than 30 g), the amount of proteins is maintained at 130 g, fats are limited to 80 g.

The jewelery increasesup to 2700 kcal, the volume of liquid up to 1.5 liters, salt is limited( 6-10 g).The diet should stabilize the work of the gastrointestinal apparatus. Supported by all the requirements to ensure a sparing regimen for the pancreas. Do not forget that with chronic pancreatitis, the likelihood of developing secondary diabetes mellitus increases. Then the detailed amount of carbohydrates will be calculated by the endocrinologist depending on the level of glucose in the blood and urine.

Chronic pancreatitis is characterized by the development of the first type of diabetes

What can not be eaten by a patient without exacerbation?

From the diet with pancreatitis are excluded:

• fresh pastries, rye bread, confectionery, especially with cream, from yeast and puff pastry:
• rich broths of meat, fish;
• soups with mushrooms, cabbage, beets, okroshka;
• any fried foods( including pancakes, cheese cakes);
• fatty meat and fish( halibut, salmon, sturgeon) in a piece, in salted form, caviar;
• duck meat;
• smoked products, canned food, sausages;
• meat by-products with a high cholesterol content( brains, liver, kidneys);
• porridge in crumbly form, not recommended cereals: barley, pearl barley, corn, millet;
• vegetables, including coarse fiber( radish, radish, turnip, white cabbage);
• legumes( beans, peas, lentils), foods from soybeans are allowed by dieticians;
• fat and cooking oil;
• salads from unfertile vegetables and fruits are limited, are introduced individually;
• fruits, which contain a significant amount of light carbohydrates( grapes, bananas, dates);
• soups with milk, fatty cream, sour cream, cottage cheese, hot kinds of cheeses;
• eggs hard boiled and fried in fried eggs;
• seasonings and spices( pepper, horseradish, mustard, ketchup, mayonnaise);
• strong black coffee, cocoa, grape juice;
• chocolate products, jam, honey;
• ice cream;
• fizzy drinks, any alcohol;
• chips, fast food.

What can I eat with chronic pancreatitis?

Maximum nutritional limits for patients should be provided during the period of acute pancreatitis for a period of weeks to two months. In the absence of serious violations of digestion and pain, the diet should provide the physiological needs of the body, restore and compensate for the functions of the pancreas.

The permitted products and dishes are:

• dried white bread, crackers, dry biscuits;
• the first dishes should preferably be cooked on vegetable broth, the vegetables are wiped, the soups have the form of mashed potatoes or cream, it is allowed to add cereals( oatmeal, mango, rice) and boil them well;
• vegetarian soups cooked from pumpkin, potatoes, zucchini, carrots;
• milk soup with shallow vermicelli bred in half with water;
• for filling use sour cream, cream, milk, butter, a little flour, onions and carrots can not be roasted;
• meat dishes from low-fat varieties and poultry are limited due to the high concentration of purines in them, the products are boiled, cooked from minced meat for a couple( cutlets, meatballs, soufflé, meatballs, knels);
• chicken meat is allowed to be served by a piece;
• low-fat fish in steam cutlets, boiled;
• porridge on water or diluted milk from rice cereals, buckwheat, oatmeal, "Hercules", manki cook until a semi-viscous condition, prepare soufflé and casseroles;
• one soft-boiled egg is useful once a day, scrambled;
• from dairy products choose skimmed yogurt, curdled milk, curd( better than calcined), curd casseroles and puddings are shown, to improve the absorption of milk it is recommended to add to the dishes, drink warm;
• sauces for second courses are prepared on vegetable broth with flour, sour cream or milk;
• vegetables are useful in boiled form( potatoes, zucchini, pumpkin, beets, carrots, cauliflower), of which mashed potatoes, vegetarian soups, sometimes patients tolerate vegetable salads well;
• sweet apples are used for boiling, in compotes, baked, from berries prepare jelly, jelly, mousse in xylitol, dried fruits in compote wipe;
• of sweets is allowed pastille and marmalade.

Rough cheese can be rubbed and added to the porridge

Fat is gradually added to the food: butter is not more than two teaspoons in the finished porridge or vegetable puree, sunflower, olive, soybean oil to 15 ml per day. For drinking it is recommended: a weak green or black tea with lemon, juices from sweet fresh berries and fruits, in dilution with boiled water, broth of wild rose, compotes of dry and fresh fruits, mineral water without gas.

Approximate product composition in the menu for the week

Day 1

• In the morning at 8.00.Porridge semolina on diluted milk with a spoon of butter, broth of wild rose with biscuits.
• Snack at 11.00.Baked apple.
• Lunch at 14.00.Soup puree from vegetables, meatballs with buckwheat.
• Snack at 5 pm. Tea with biscuits
• Dinner at 19.00.Milk rice porridge.

Day 2

• In the morning at 8.00.A steam omelet made from two proteins and one yolk. Tea with lemon, white crackers.
• Snack at 11.00.Carrot juice.
• Lunch at 14.00.Milk soup with vermicelli. Boiled fish with a piece of mashed potatoes.
• Snack at 5 pm. Rice pudding.
• Dinner at 19.00.Chicken is a piece of stewed vegetables.

Day 3

• In the morning at 8.00.Oatmeal porridge with fruit. Berry jelly.
• Snack at 11.00.Oatmeal.
• Lunch at 14.00.Soup with meatballs. Vegetable puree.
• Snack at 5 pm. Baked apple.
• Dinner at 19.00.Protein omelet, boiled fish.

Day 4

• In the morning at 8.00.Curd casserole with dried apricots. Tea with biscuits.
• Snack at 11.00.Kissel made from sweet berries.
• Lunch at 14.00.Fish soup. Stew of vegetables.
• Snack at 5 pm. Compote of dried fruits with biscuits.
• Dinner at 19.00.Chicken breast with vegetable puree.

Day 5

• In the morning at 8.00.Buckwheat porridge with milk. Carrot juice.
• Snack at 11.00.Baked pear.
• Lunch at 14.00.Borscht on vegetable broth without cabbage, fish cutlets with boiled potatoes.
• Snack at 17.00.Cottage cheese, diluted with sour cream.
• Dinner at 19.00.Fish balls with rice.

You can drink low-fat milk, kefir, berry jelly, fermented baked milk, mineral water, fruit juice drink or fruit compote,

carrot juice before going to bed. Day 6

• In the morning at 8.00.Calcined curd 150 grams, tea with lemon.
• Snack at 11.00.Vinaigrette without cabbage and pickled cucumbers, white bread.
• Lunch at 14.00.Rice soup with vegetable broth. Steam cutlets from ground beef.
• Snack at 17.00.Carrot juice.
• Dinner at 19.00.Rice porridge with apples. A cheese sandwich.

Day 7

• In the morning at 8.00.Rice pudding with fruit. Milk with white bread.
• Snack at 11.00.Baked apple.
• Lunch at 14.00.Chicken soup with noodles, chicken with a piece of rice.
• Snack at 5 pm. Berry jelly.
• Dinner at 19.00.Fish fillet with vegetable puree.

The problems of dietary nutrition are inseparable from medicinal preparations that replace the enzymatic activity of the pancreas, vitamin remedies. The dosage is prescribed by the physician to the particular patient. Refusing medications and hoping only for a diet is not worth it.