Diet for pancreatitis

diet for pancreatitis

Pancreatitis affects an important part of the digestive tract - the pancreas, which produces insulin and many enzymes involved in digestion. Not surprisingly, diet is important in the treatment and prevention of this disease. With pancreatitis, the diet should not contain alcohol, large amounts of fat and fiber.

What is pancreatitis

Pancreatitis is an acute or chronic inflammation of one of the main organs of the endocrine system of our body - the pancreas. The functioning of the entire gastrointestinal tract and the process of digestion of food depends on the normal functioning of this organ.

The pancreas is located close to the liver, behind the stomach and has many functions, including the synthesis of hormones, especially insulin. It also produces digestive enzymes that support the breakdown and assimilation of fats, proteins and carbohydrates. Digestion occurs under the influence of pancreatic juice, which flows directly into the duodenum.

In fact, pancreatitis is a self-poisoning by enzymes produced by pancreatic tissue. Inflammation begins with the overproduction of certain enzymes with increasing pressure in the ducts of the gland. Excess enzymes enter the general bloodstream and adversely affect the brain, kidneys and other internal organs.

Causes of inflammation of the pancreas:

  • Alcohol abuse. More than half of pancreatitis cases are regularly associated with high doses of alcohol.
  • Pancreatitis often develops with gallstones, abdominal trauma, cysts in the bile ducts and malignant tumors of the gland.
  • The disease can be a side effect of some medications, such as diuretics.

The risk group includes patients with diabetes, other endocrine pathologies and hepatitis B or C. Sometimes pancreatitis develops during pregnancy or after a kidney transplant.

How alcohol affects the pancreas

Alcohol in the body breaks down to form acetaldehydes, which are toxic to humans. Pancreatic cells are particularly sensitive to harmful effects. In addition, drinking alcohol can cause spasms and narrowing of the pancreas, which leads to accumulation of pancreatic juice. As a result, digestive enzymes begin to process the gland itself, which causes inflammation. If the disease is not treated over time, glandular cells die (pancreatic necrosis) and are replaced by scar tissue, and the body loses its ability to function as before.

Types of pancreatitis

The most common classification of pancreatitis is based on the nature of the disease: acute pancreatitis with acute attack or periodic relapses. These two forms differ in the severity of symptoms and require different approaches to treatment.

Acute pancreatitis

In acute pancreatitis, the inflammatory process develops very quickly and is always accompanied by severe pain. In most cases, the disease occurs against the background of alcohol abuse or after eating large amounts of fatty foods. Occasionally there is an attack of acute hepatic colic before inflammation.

Symptoms of acute pancreatitis:

  • Severe pain in the left organs, spreads to other organs. A painful attack lasts about half an hour or an hour. The pain is especially strong when lying on your back. The attack worsens, especially after fried and spicy foods and any alcoholic beverages.
  • Vomiting, often indigestible, mixed with bile and bitter taste. Persistent nausea that does not disappear after vomiting.
  • Subfebrile or high fever.
  • Sometimes there is a yellowing of the whites of the eyes due to impaired bile flow, and very rarely - a yellow discoloration of the skin.
  • In some cases, the pain is accompanied by heartburn and abdominal pain.

An attack of acute pancreatitis requires urgent medical attention. Painkillers provide only temporary relief, but do not work due to inflammation. In the absence of qualified care, the risk of serious complications increases rapidly: infection of inflammatory tissues, necrosis and abscesses.

Severe acute pancreatitis can cause shock and multiple organ failure.

Chronic pancreatitis

After an attack of acute pancreatitis, if a person does not follow the advice of doctors and continues to drink alcohol and eat poorly, the disease is likely to become chronic. Chronic pancreatitis develops with significant damage to the pancreas during the first episode of the disease.

The disease is characterized by gradual pathological changes in the structure of cells in the pancreas. Over time, it begins to lose its main function - the production of enzymes needed to digest food. Exocrine deficiency manifests itself:

  • diarrhea,
  • swelling,
  • A change in the nature of the stool - due to the large amount of fat in it, the adhesive acquires a consistency and is poorly washed from the walls of the toilet bowl.

Chronic pancreatitis can be asymptomatic for a long time: acute pain occurs when there are significant pathological changes in the pancreas. During an attack, chronic pancreatitis presents with the same symptoms as acute pancreatitis:

  • severe abdominal pain,
  • nausea,
  • vomiting,
  • intestinal diseases.

Diagnosis is based on ultrasound, computed tomography or magnetic resonance imaging. Narrowed pancreatic ducts are usually found during the study due to the formation of stones - calcifications. Supply methods can also detect cysts in the surrounding tissue. Laboratory blood tests for chronic pancreatitis are not very informative.

Importance of enzymes in digestion

The work of the human body is provided by a complex system of interconnected and interdependent biochemical reactions. Thanks to special protein compounds - enzymes or enzymes, all these reactions are accelerated and provide a faster metabolism. The effect of enzymes is very selective: each is able to initiate, accelerate or slow down only one reaction.

Digestion is based on the work of digestive enzymes. Their main task is to make the process of energy absorption fast and efficient. Enzymes break down food components (proteins, fats and carbohydrates) into absorbed substances. In addition, the amount of enzymes produced depends on the quantity and quality of the food eaten.

Digestion of food already begins in the mouth. The food, cut into small pieces by the teeth, is mixed with saliva, which contains the enzyme alpha-amylase. The better we chew our food, the easier it is for the salivary gland enzyme to convert starch molecules into soluble sugars and facilitate further processing.

After primary processing, food enters the stomach through the esophagus, where the digestive enzyme pepsin and hydrochloric acid begin to work. These substances produce gastric juice, which are:

  • provides antibacterial protection of the body;
  • stimulates the production of pancreatic hormones;
  • regulates gastric motility;
  • breaks down fats and performs a number of other functions.

In addition to pepsin, which is responsible for breaking down large protein molecules, other enzymes are also produced in the stomach:

  • gelatinase - a solvent for collagen, gelatin and other connective tissue proteins;
  • lipase - an enzyme that breaks down some fat molecules into fatty acids and monoglycerides;
  • chymosin - begins the process of digestion of milk protein.

Bile plays an important role in the digestive process. Contains bile acids that stimulate the production of pancreatic secretions.

A piece of food is emptied from the stomach into the duodenum, where the main digestion of food takes place. More than 20 pancreatic enzymes provide it. Enzymes are found in pancreatic water, which is produced by the pancreas in a volume of about two liters per day.

Functions of pancreatic enzyme:

  • proteases - the breakdown of proteins into amino acids;
  • nucleases - DNA affects nucleic acids;
  • amylase - breaks down starch into simple sugars;
  • lipases - break down fats into higher fatty acids and glycerin.

Digestion is complemented by small intestinal enzymes and beneficial bacteria living in the intestine. Processed food is absorbed into the body in the intestine (Figure 1).

When the digestive system, especially the pancreas, disrupts enzyme production, the whole organism becomes unbalanced. This imbalance causes nausea, diarrhea, flatulence, followed by anemia and exhaustion.

What to eat with pancreatic enzyme deficiency

In pancreatitis, the production of digestive enzymes by the pancreas is disrupted, resulting in discomfort and pain in the stomach. In this case, replacement therapy may be prescribed after a thorough examination.

Important!The effects of all enzyme preparations begin 20-30 minutes after a meal, so you should be drunk at the dose prescribed by your doctor before eating!

Modern pharmacology offers a large number of different enzyme preparations of animal and plant origin. Some just aim to make up for any enzyme deficiency, such as breaking down lactose or fats. There are also complex effects prescribed for several enzyme deficiencies in various organs of the digestive system.

What is the diet for pancreatitis

Nutrition plays no less important role in the treatment of pancreatitis than drugs. The main purpose of the prescribed diet is to restore the function of the pancreas and normalize the production of digestive enzymes.

Heavy foods increase the burden on the inflamed organ. After a hearty meal of fried foods, the pancreas begins to produce powerful enzymes for digestion. If the ducts of the gland become narrowed, the pancreatic juice, which is formed in an excessive mode, accumulates in the gland and further increases the development of the disease - the affected pancreas begins to digest itself.

High-performance supply signals include:

  • heaviness in the stomach after eating,
  • heartburn,
  • burp,
  • Stomach pain attacks.

Of course, sticking to a strict diet is not easy, especially at home. People with dietary restrictions are forced to cook separately for themselves and to avoid eating anything fried or spicy.

Diet number 5: what to eat and what not to eat with pancreatitis

There are many restrictions on the pancreatitis diet, both in terms of the foods allowed and the rules of preparation. Especially for people with pancreatic problems, one of the founders of the Russian diet and gastroenterology, Professor I. İ. Pevzner has developed a diet table number 5.

But before getting acquainted with the specific provisions of this diet, it is necessary to consider the general principles of nutrition for pancreatitis:

  1. eat in small portions 5 times a day;
  2. exclude fried and salty foods;
  3. In the acute stage of the disease, food should be chopped or removed;
  4. animal protein should predominate in the diet;
  5. the amount of fat per day should not exceed 50 grams;
  6. sugar is also severely limited - no more than 30 g per day;
  7. Prohibited foods that increase flatulence - sweet carbonated drinks, any legumes, sweet apples and grapes, sweet pastries, etc . ;
  8. salt intake is minimized - no more than three to five grams.

Important!With pancreatitis, you can eat slow carbs, you need to monitor the amount of food in the dishes. You should not deceive yourself that sugar can be replaced with honey, and its consumption should be controlled. First of all, you will definitely need a calculator. Based on the body mass index, it is necessary to immediately calculate the daily caloric intake and the balance of proteins, fats and carbohydrates. This information is easy to find on sites on the Internet dedicated to proper nutrition and healthy living. Various mobile apps are available to calculate calories and nutrients.

All these principles are taken into account in the diet number 5, which is available in the basic and advanced versions.

The main version is characterized by recurrences of chronic pancreatitis and the acute nature of the disease. In the acute phase, the diet is stricter with many restrictions. It is aimed at emptying the pancreas and relieving the symptoms of acute inflammation. During the first 3 days of the acute phase, the patient is advised to fast to relax the pancreas. In addition, it is allowed to eat carbohydrate foods in small portions at small intervals for 3-7 days. These days, the caloric content of the diet should be reduced and the food should be consumed only in the form of puree or semi-liquid.

Important!Rich broth, especially chicken broth, is widely used to help with any digestive problems. With pancreatitis, gallbladder disease and other pathologies of the gastrointestinal tract, fat-rich broths are completely contraindicated! Excess animal fat significantly increases the load on the pancreas and prevents the normalization of the condition.

The diet includes cereals in various grains, water and vegetable soups, with the exception of millet and corn, boiled or steamed mashed vegetables. Weak tea, jelly, dried fruit compote are allowed. Only white and slightly dried bread is allowed, you can eat crackers and biscuits like biscuits.

On the third day of a carbohydrate diet, protein foods are gradually introduced:

  • lean meat soup, broth is recommended to boil from veal, turkey or chicken breast, the meat should be cut from the broth or cut in a blender;
  • steamed omelet or soft-boiled egg;
  • steamed cutlets made of lean meat or lean fish;
  • cottage cheese stew and cottage cheese souffle with minimal fat.

Diet No. 5 is known for protecting the pancreas as much as possible, which needs complete rest in the acute phase. Permitted and prohibited foods for the main diet are shown in Table 1.

Important!The predominance of protein in the diet can cause constipation. In this case, you should add more raw vegetables and fruits than allowed. For gout, plant proteins or sea fish are preferred.

Table 1. Permitted and prohibited foods according to the basic variant of diet # 5.
Category OK not allowed
Drinks

Light tea with lemon and a little sugar

Rosehip Decoction

Vegetable and fruit juices diluted with water

Sugar-free compotes and fruit drinks from fresh fruits

Strong coffee

Chocolate and cocoa

Carbonated Drinks

Any alcohol, including beer.

Packaged juices

Green Tea

Soups (basic diet)

Unfried vegetable soups

Grain or noodle soup

Borscht without frying in lean meat broth

Milk noodles

Classic borsch with fried vegetables

Acid

Ear

sorrel or spinach soup

Solyanka

Okroshka with kefir, kvass or whey

Porridge and cereals

buckwheat, oatmeal, rice porridge in water or diluted milk

Dried fruit pilaf

Flaxseed porridge

Cereal Casseroles and Puddings

Millet porridge

Pea puree

Pasta Any wheat Pasta with meat additives and hot sauces like Carbonara pasta
Meat and fish

Beef, veal

Skinless turkey and chicken, preferably white meat

Seafood - limited quantity

Salted fish (2-3 times a week)

Milk sausages - very limited

Pork

Lamb

Oily tea fish

By-products

Canned fish and meat

Smoked sausage

Sushi rolls

Semi-finished meat

caviar

Bread

Yesterday's White

Dandruff bread

Dry cookies

Croutons

Any sweet baked product

Dough dough

Pancake, pancake

Fresh bread

Fried pie with any filling

Dairy products

Low fat fermented milk products

Pickled cheese

Natural yogurts without additives

% 10 xama

Fatty Fermented Dairy Products

Whey

Hard cheeses

Very salty cheeses

Vegetables (preferably seasonal)

Avocado

Potatoes

Zucchini

Cauliflower

Tomatoes (only in remission and in small quantities)

seaweed

Celery

Canned and pickled

Mushrooms

Onion, garlic

Corn, asparagus, eggplant, radish and radish

Raw white cabbage

Fruits and berries

Apples

Limited amount of bananas

Grenade

Dried plums

Watermelon (not more than 200 grams)

Hazelnut

Seeds

Any fresh berries

Figs

Citrus

melon

date

Oil

Creamy - 30 g per day

Delicate sunflower

Olive

Unpeeled Vegetables

Salo

Margarine

Eggs

Steamed or oven-baked omelette, preferably protein

Cool or Soft

Fried Egg

Fried egg with tomato

Omelette in the pan

Salads and snacks

Caviar

Lightly salted herring

Vegetable salads

Cabbage pickle

ginger

Olive

Canned vegetables and snacks

Sweets and desserts

Marmalade, lollipops

Kissel, jelly

Caramel

Dry cookies

Cookies

Cakes, pastries

Ice cream

Chocolate

Walnut desserts - kozinaki and others

Once the symptoms of acute pancreatitis have resolved, the diet is expanded to include other foods, the amount of protein in the diet, and total caloric intake. At the same time, the principle of nutrition has long been maintained to minimize the risk of recurrence of the disease. All dishes must be cooked or steamed; foods that are too hot or cold cannot be eaten. At the first sign of exacerbation, you should immediately switch to the first diet option with fewer calories and greater restrictions.

Important!When pancreatitis is especially harmful: alcohol, chocolate, coffee, fizzy drinks.

Partially Limited Products

In the second version of the diet, you can sometimes pamper yourself with marshmallows and jam dissolved in tea. Parsley and other herbs are best used only to decorate dishes. Melons and pineapples are dried, but can be eaten in small quantities.

What herbs can you drink

You can drink herbal decoctions after consulting a doctor to alleviate the condition.

Parsley

Parsley has a pronounced anti-inflammatory and antioxidant effect, stimulates gastric secretion. In chronic pancreatitis, an infusion of freshly chopped parsley is taken 2-3 times a day, half an hour before meals.

Herbal collection

The collection includes a number of plants that are useful for inflammation: chamomile, wormwood, horsetail and other herbs. Collection-based solutions are prepared according to the recommendations on the packaging.

Diet for children

Chronic pancreatitis is extremely rare in children under 14 years of age. When diagnosing an acute form of the disease, nutrition is organized as in adults.

Diet for pregnant women

Pregnant women often face digestive problems. Pancreatitis can develop as a result of abuse of vitamin complexes or excessive pressure on the pancreas from the uterus.

The principles of diet for pregnant women do not differ from the general diet for pancreatitis. However, during pregnancy, it is extremely important to provide a complete diet necessary for the development of the fetus. There should be enough food:

  • proteins (lean meat and fish, dairy products, eggs, legumes),
  • complex carbohydrates (cereals, pasta, fruits and vegetables),
  • oils (vegetable oils),
  • vitamins and minerals.

Result

Compliance with a strict diet for pancreatitis is the basis of successful therapy. The effectiveness of diet No. 5 has been confirmed by many years of clinical experience. Proper nutrition is as much a part of treatment as medication, so the advice of the attending physician should never be ignored.