No matter how wonderful solutions are administered to a patient with intravenous pancreatic pathology, they cannot replace the nutrients supplied by food products; they always use a very limited time. The acute inflammatory process in the pancreas requires its maximum removal from the digestive process to normalize functions.
This is achieved through complete hunger and a ban on drinking for 1-2 days. The attending physician conducts a special procedure for aspirating the contents of the duodenum and stomach with a probe so that no secretions irritate the gland. As a result of fasting, it is possible to block the excessive synthesis of enzymes and the process of self-destruction of the organ parenchyma.
Subsequent nutrition should:
- normalize secretory activity;
- provide intensive bile secretion in case of gallbladder dysfunction;
- act on the liver to activate fat metabolism and glycogen accumulation;
- provide the optimal amount of protein, vitamins and trace elements to support the production of energy needed for recovery;
- delay the development of fibrous tissue (important in chronic pancreatitis);
- stimulate general and local immunity.
Swelling of the parenchyma with inflammation violates the lobular structure of the pancreas
The main principles that require diet 5 for pancreatitis
To restore pancreatic function, you must:
- exclude products that stimulate the release of pancreatic juice (fatty meat and fish products, boiled and fresh cabbage, mushrooms);
- change the ratio of nutrients by increasing the amount of protein used (lean meat, fish, cottage cheese) to 150 g per day, reducing fat to 70–80 g, limiting carbohydrates to 300–350 g (especially easily digestible types of sugars, honey);
- strictly follow the rules of cooking;
- control the volume of single feeding, prevent one-time overeating, the weight of each dish should not exceed 150 g;
- observe the regime of fractional nutrition up to six times a day (after three hours);
- coordinate any changes with the doctor based on the results of control studies.
Option 5p has more stringent restrictions.
What cooking features does diet 5 recommend?
The nutritional rules for pancreatitis prohibit fried and smoked dishes, finished products. You can not feed the patient with pickled and salted vegetables, canned goods (including juices). Since fats are sharply limited, a spoonful of butter is placed directly on the plate. It is allowed to use boiling, baking, stewing, a steam method of culinary processing of food products.
In the process of cooking, it is forbidden to use cooking oil, margarine, lard
Vegetables can not be passaged in a pan, they are finely cut or frayed, boiled. Salt intake is limited to 10 g per day (normal 12-15 g). At home, it is better to measure 2 teaspoons and put the salt shaker on the table to add salt from this amount during the day, and do not use salt during cooking.
It is forbidden to use hot seasonings (pepper, mustard, horseradish), ketchup, mayonnaise, dressing sauces. They are replaced with vegetable oils in limited quantities. You can only eat warm dishes, hot and cold temperatures are strictly contraindicated, as a strong irritant to the digestive organs. Diet 5p with pancreatitis, unlike table number 5, should consist of dishes of liquid consistency. All products are pre-twisted or wiped.
Indications for the 5p diet
Diet No. 5p is recommended for a two-week period after a period of starvation in acute pancreatitis and another exacerbation of chronic. It should provide a gradual “exit” of the digestive functions from the “idle” mode and restoration of organs for transfer to the full table No. 5.
In the transition period, the maximum sparing of the pancreas, stomach, intestines continues, reflex stimulation of the production of digestive juices and bile is prevented.
The temporary use of diet No. 5p is justified in the intensification of pain against chronic pancreatitis
What is included in the daily diet 5p?
With all the limitations, the composition of the daily menu should provide sufficient calorie content, vitamins, an increased content of pectins, lipotropic substances. The average energy intensity of the diet corresponds to 1700–2500 kcal.
Carbohydrates are maximally reduced in the first days to 50 g (they gradually increase to a physiological norm, but sugar remains no more than 30 g), fats up to 70 g (butter about 30 g per day, vegetable no more than 15 ml per dish), proteins make up the predominant component in the menu (100 g). The composition varies depending on the duration and severity of the acute stage of pancreatitis.
Mandatory vitamin-salt components of food:
- retinol and thiamine 10 mg each;
- ascorbic 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 specific content of the products, so it is important to try to combine and use different permitted combinations. They provide not only taste, but also the constancy of the therapeutic effect.
In the first days, after the fasting regimen, the patient is allowed only vegetable soups with cereals, a slightly sweetened kissel of berries, a steam omelet, a rosehip broth. Every 2-3 days, the diet expands. Low-fat meat and fish are not used for cooking broths, but for steam mashed meatballs.
Porridge is prepared first on water, then on diluted milk semi-liquid from oat, buckwheat, rice, semolina, semolina. Wheat bread is allowed only dried (yesterday), with small crackers, you can eat unsweetened dry cookies (biscuits). Once a day – soft-boiled egg or in the form of a steam omelet.
Vegetables are added to soups, boiled and grated. By the end of the week, milk soups, boiled vermicelli, stewed or baked apples without skin, and grated low-fat cottage cheese are introduced. From fruits and berries it is better to cook jelly, juices without sugar. Concentrated freshly squeezed juice is diluted in half with boiled water.
Weak tea with lemon without sugar is allowed, a rosehip broth
5p diet includes many restrictions.
The list includes:
- fresh pastries, rye bread;
- sweets and culinary products with cream;
- any kind of alcohol, 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 sour milk (kefir, yogurt, ayran);
- fish roe;
- radish, turnip, radish, spinach and sorrel;
- dishes of mushrooms and cabbage;
- spicy seasonings;
- pickles and pickles;
- milk and products from it at high fat content;
- canned fish, meat products, vegetables and juices;
- oranges and tangerines, grape juice;
- fast food products, various chips, nuts, crackers with spices.
How do diet rules depend on the duration of exacerbation?
Diet 5p is designed to gradually expand 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 fractionally up to 6-7 times a day. For the patient prepare liquid grated porridge on the water. They give half a portion of a vegetarian mucous soup without salt, jelly, a rosehip broth.
Some nutritionists also recommend blackcurrant decoction. You can slightly sweeten the drink. Everything that causes sokogonny action (salt, fats, seasonings, cabbage) is strictly forbidden. On the fourth day, calories increase to 600-800 kcal. The amount of protein rises to 15 g, carbohydrates – 200 g.
From the fifth day to the end of the weekly period, calorie content increases and reaches 1000 kcal. Fats are included in the dishes (butter 10 g), proteins are allowed to be increased up to 40 g, carbohydrates – up to 250 g. Vegetarian soups are introduced on the menu, cereals are cooked steeper, but without milk, they include mashed boiled meat, meatballs and meatballs, steam cutlets.
Allowed vegetable mashed potatoes, carrots, low-fat cottage cheese, grated apple. In addition to the broth of wild rose, fresh diluted juices and cranberry juice are added to the drink. From the ninth day, the calorie content is 2000 kcal. In the diet menu 5p, the proportion of fats (20 g), proteins (60 g), carbohydrates (300 g) increases. Single servings become larger.
Due to the low calorie intake, the intravenous infusion of glucose and protein preparations is continued (parenteral nutrition)
Cooking continues without salt. A tablespoon of vegetable oil is added to the plate with the finished dish. After the twentieth day from the onset of the disease, the diet expands significantly. The use of 40 g of fat, 100 g of protein is allowed, it is possible to bring carbohydrates to the physiological norm (400-450 g). Continue to grind and wipe the dishes, boil without salt or bake.
The patient is fed: mashed cereal soups, liquid cereals (buckwheat, oatmeal, rice and semolina is not recommended yet), vegetable puree, boiled pumpkin, fruit jelly. Curd pudding is allowed. Gradually, milk, various milk porridges, kefir are introduced into the diet. Boiled meat and fish are allowed to cook in pieces.
How long should a diet last?
A strict 5p diet is usually prescribed for 20 days. The term is determined by the condition of the patient, the relief of pain, the results of a study of pancreatic functions. After suffering acute pancreatitis for at least a year, diet 5 will have to be observed. In the chronic form of the disease, diet 5p will be required for every exacerbation of the process, and following the requirements of table No. 5 remains for life.
One-day menu for exacerbation
Serious restrictions can be mitigated by alternating cereals, vegetable purees, dairy products, and baked fruits.
- Breakfast – liquid oatmeal porridge with diluted milk, a rosehip broth with crackers.
- Second breakfast – slightly sweetened mashed cottage cheese, green tea with milk without sugar.
- Lunch – vegetable soup from carrots, potatoes, cauliflower, fish cakes, steamed, berry jelly.
- Snack – stewed apple, milk with biscuits.
- Dinner – a steam omelet from two proteins, kefir.
During the day, you must drink at least 1.5 liters of fluid.
The nutritionist will write the menu individually for the patient.
Example of a diet menu No. 5 for a week without exacerbation
Recommended nutrition is allowed after strictly following a 5p diet, in the absence of pain.
- In the morning – semi-liquid oatmeal porridge with diluted milk, a rosehip broth with biscuits.
- The second breakfast is a baked apple.
- Lunch – soup with meatballs, mashed vegetables, jelly from berries.
- Snack – kefir with crackers.
- Dinner – a piece of boiled chicken, buckwheat porridge, green tea.
- Before going to bed – milk.
- In the morning – cottage cheese casserole with raisins, tea with milk.
- Lunch – banana;
- Lunch – vegetarian soup with finely chopped vegetables, lazy cabbage rolls, dried fruit compote.
- Snack – jelly with biscuits.
- Dinner – semi-liquid milk rice porridge.
- Before going to bed – yogurt.
- In the morning – buckwheat porridge with milk, a rosehip broth.
- Second breakfast – apple juice, biscuits.
- Lunch – steam cutlets with mashed potatoes, berry jelly.
- Snack – rice pudding with fruit.
- Dinner – boiled fish, mashed potatoes, green tea.
- Before going to bed – herbal tea with chamomile, unsweetened cookies.
- In the morning – pumpkin milk porridge from rice and wheat, green tea.
- Lunch – a salad of boiled vegetables without pickles and cabbage.
- Lunch – cod fish soup, rice porridge, tomato juice.
- Afternoon snack – jelly from berries.
- Dinner – a piece of boiled chicken with grated beets, tea with milk.
- Before going to bed – yogurt.
- In the morning – milk semolina, green tea, a hard cheese sandwich.
- Second breakfast – low-fat cottage cheese, carrot juice.
- Lunch – chicken soup with noodles, mashed vegetables (carrots, zucchini, potatoes, cauliflower are suitable), unsweetened tea.
- Afternoon snack – grated apple with carrots.
- Dinner – cottage cheese casserole, jelly from berries.
- Before going to bed – milk with crackers.
- In the morning – buckwheat porridge, milk.
- Lunch – baked fruit (pear or apple).
- Lunch – vegetarian borsch, steam cutlets from turkey meat, tea with lemon.
- Afternoon snack – berry jelly.
- Dinner – milk soup with noodles, green tea with cookies.
- Before going to bed – yogurt.
- In the morning – oat milk porridge with fruits, tea with crackers.
- The second breakfast is cottage cheese, a rosehip broth with a teaspoon of honey.
- Lunch – vegetable soup, rabbit meat, baked in sour cream sauce and buckwheat, green tea.
- Afternoon snack – apricot juice with biscuits.
- Dinner – fish steaks with rice, jelly.
- Before going to bed – milk with dried biscuits.
Compliance with dietary rules number 5 will require significant restrictions from patients, but they are justified by the rapid reduction of moderate pain and recovery. Usually the cause of exacerbation of pancreatitis is a violation of the above requirements. Therefore, sick chronicles are well aware of the importance of proper nutrition.