Diet for pancreatitis

diet for pancreatitis

Pancreatitis affects an important part of the gastrointestinal tract - the pancreas, which produces insulin and many enzymes involved in digestion. Not surprisingly, diet is essential 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 work of the entire gastrointestinal tract and the process of food digestion depend on the normal functioning of this organ.

The pancreas is located in close proximity to the liver just behind the stomach and performs many functions, the main one being the synthesis of hormones, in particular insulin. It also produces digestive enzymes that provide the processes of splitting and assimilating fats, proteins and carbohydrates. Digestion of food occurs under the influence of pancreatic juice, which flows directly into the duodenum.

In fact, pancreatitis is a self-poisoning of the pancreatic tissue by the enzymes it produces. Inflammation begins with the overproduction of certain enzymes in combination with increased pressure in the ducts of the gland. Excess enzymes enter the general bloodstream, negatively affecting the functioning of the brain, kidneys and other internal organs.

Causes of inflammation of the pancreas:

  • Alcohol abuse. More than half of the cases of pancreatitis are associated with regular consumption of large doses of alcohol.
  • Pancreatitis often develops with gallstone disease, abdominal trauma, the formation of cysts in the bile ducts, and malignant tumors in the gland.
  • Illness can be a side effect of certain medications, such as diuretics.

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

How alcohol affects the functioning of the pancreas

Alcohol in the body breaks down to form acetaldehydes, which are toxic to humans. Pancreatic cells are especially susceptible to their damaging effects. In addition, drinking alcohol can cause spasms and narrowing of the pancreatic ducts, which leads to the accumulation of pancreatic juice in it. As a result, digestive enzymes begin to process the gland itself, causing inflammation. Over time, if the disease is not treated, the cells of the gland die (pancreatic necrosis) and are replaced by scar tissue, the organ loses its ability to function as before.

Types of pancreatitis

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

Acute pancreatitis

The inflammatory process in acute pancreatitis 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 a large amount of fatty foods. Sometimes an exacerbation is preceded by an attack of acute hepatic colic.

Acute pancreatitis symptoms:

  • Severe pain in the left hypochondrium, radiating to other organs. A painful attack lasts about half an hour or an hour. The pain is felt especially strongly when lying on the back. The attack worsens after eating food, especially fried and spicy food, and any alcoholic beverages.
  • Vomiting, often uncontrollable with an admixture of bile and a bitter taste. Constant nausea that does not disappear after vomiting.
  • Subfebrile or high fever.
  • Sometimes, due to a violation of the outflow of bile, yellowing of the whites of the eyes is observed, very rarely - a yellow tint of the skin.
  • In some cases, the pain syndrome is accompanied by heartburn and bloating.

An attack of acute pancreatitis requires immediate medical attention. Pain relievers provide only temporary relief, but do not work on the cause of the inflammation. In the absence of qualified assistance, the risk of severe complications rapidly increases: infection on inflamed tissues, necrosis and abscesses.

Severe acute pancreatitis can lead to shock and multiple organ failure.

Chronic pancreatitis

If, after an attack of acute pancreatitis, a person does not follow the recommendations 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 insufficiency manifests itself:

  • diarrhea,
  • bloating,
  • changes in the nature of feces - they acquire a sticky consistency due to the large amount of fat in them and are poorly washed off the walls of the toilet bowl.

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

  • severe girdle pain,
  • nausea,
  • vomiting,
  • bowel disorders.

Diagnosis is based on ultrasound, computed tomography, or magnetic resonance imaging. During the study, narrowed pancreatic ducts are usually found due to the formation of stones - calcifications in them. Hardware techniques can also detect cysts at the site of atrophied tissue. Laboratory blood tests for chronic pancreatitis are not very informative.

The importance of enzymes in digestion

The functioning of the human body is provided by a complex system of interrelated and interdependent biochemical reactions. Thanks to special protein compounds - enzymes or enzymes - all these reactions are accelerated, ensuring a fast metabolism. The action of enzymes is very selective: each of them 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 absorbing energy fast and efficient. Enzymes break down food components (proteins, fats, and carbohydrates) into absorbable substances. Moreover, the amount of enzymes produced depends on the amount and quality of food eaten.

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

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

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

In addition to pepsin, which is responsible for the breakdown of large protein molecules, other enzymes are produced in the stomach, for example:

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

Bile plays a significant role in the digestion process. It contains bile acids that stimulate the production of pancreatic secretions.

From the stomach, the food lump is evacuated to the duodenum, where the main process of food digestion takes place. It is provided by over 20 pancreatic enzymes. Enzymes are found in pancreatic juice, which is produced by the gland in a volume of about two liters per day.

Pancreatic enzyme functions:

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

The digestion process is completed under the influence of enzymes of the small intestine and beneficial bacteria that live in the intestine. In the intestine, processed food is absorbed into the body (Fig. 1).

If the function of enzyme production by the organs of the digestive system, especially the pancreas, is impaired, the whole organism becomes unbalanced. This imbalance leads to nausea, diarrhea, flatulence, followed by anemia and exhaustion.

What to eat with pancreatic enzyme deficiency

In pancreatitis, the process of production of digestive enzymes by the pancreas is disrupted, as a result of which a person suffers from discomfort and pain in the stomach. In this case, after a complete examination, substitution therapy can be prescribed.

Important!The action of all enzyme preparations begins 20-30 minutes after a meal, so they must be drunk strictly before meals in the dosage prescribed by your doctor!

Modern pharmacology offers a large number of different enzyme preparations of animal and plant origin. Some of them are aimed only at replenishing the lack of any one enzyme, for example, breaking down lactose or fats. There are also complex effects prescribed for a deficiency of several enzymes in various organs of the digestive system.

What is a diet for pancreatitis

In the process of treating pancreatitis, nutrition plays no less role than drugs. The main goal of the prescribed diet is to restore the functions of the pancreas and normalize the production of digestive enzymes.

Foods that are heavy to process increase the burden on the inflamed organ. After a plentiful feast with fatty fried dishes, the pancreas begins to intensively produce enzymes for its digestion. If the ducts of the gland are narrowed, the pancreatic juice produced in extreme mode accumulates in the gland, exacerbating the development of the disease - the affected pancreas begins to digest itself.

Signals that the hardware is working in an increased mode include:

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

Of course, sticking to a strict diet is not easy, especially at home. People with strict dietary restrictions are forced to cook for themselves separately and resist the temptation to eat something fried or spicy.

Diet rules number 5: what you can and cannot eat with pancreatitis

The pancreatitis diet has many restrictions on both the permitted foods and the way they are prepared. Especially for people experiencing problems with the pancreas, one of the founders of Russian dietetics and gastroenterology, Professor I. I. Pevzner developed a diet table number 5.

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

  1. you need to eat 5 times a day in small portions;
  2. exclude fried and pickled foods;
  3. in the acute stage of the disease, food should be chopped or wiped;
  4. animal protein should prevail in the diet;
  5. the amount of fat per day should not exceed 50 g;
  6. sugar also falls under a strict limitation - no more than 30 g per day;
  7. banned foods that increase flatulence - sweet carbonated drinks, any legumes, sweet apples and grapes, sweet pastries and some others;
  8. salt intake is minimized - no more than three to five grams.

Important!With pancreatitis, you can eat slow carbohydrates, while you need to monitor the ratio of nutrients in the dishes. You should not deceive yourself that sugar can be replaced with honey, its consumption should also be controlled. At first, you will definitely need a calculator. It is necessary to immediately calculate the calorie intake per day and the balance of proteins, fats and carbohydrates based on the body mass index. This information is easy to find on the Internet at sites dedicated to proper nutrition and healthy living. There are various mobile applications for calculating calories and nutrients.

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

The basic version is indicated for relapses of chronic pancreatitis and with an acute nature of the disease. In the acute phase, the diet is stricter with many restrictions. It is aimed at unloading the pancreas and relieving symptoms of acute inflammation. In the first 3 days of the acute stage, fasting is recommended for the patient to rest the pancreas. Further, for 3-7 days, it is allowed to eat carbohydrate foods in small portions at short intervals. The calorie content of the diet these days should be lowered, and food is consumed only in mashed or semi-liquid form.

Important!It is widely believed that rich broth, especially chicken broth, helps with any problems with digestion. With pancreatitis, diseases of the gallbladder and other pathologies of the gastrointestinal tract, fatty rich broths are categorically contraindicated! An excessive amount of animal fat significantly increases the load on the pancreas and prevents the normalization of the condition.

The diet includes cereals on water and vegetable soups with various cereals, except for millet and corn, boiled or steamed mashed vegetables. From drinks, 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 the carbohydrate diet, protein foods are gradually introduced:

  • lean meat soup, it is advisable to boil the broth from veal, turkey or chicken breast, meat from the broth should be minced or chopped in a blender;
  • steamed omelet or soft-boiled eggs;
  • steamed cutlets made from lean meat or lean fish;
  • curd casseroles and curd soufflé with minimal fat content.

Diet No. 5 is recognized to spare the pancreas as much as possible, which needs complete rest in the acute stage. Allowed and prohibited foods for the basic diet are shown in table 1.

Important!The predominance of protein foods in the diet can lead to constipation. In this case, you need to add more raw vegetables and fruits from the allowed list. For gout, plant proteins or marine fish are preferred.

Table 1. Permitted and prohibited foods according to the basic variant of diet No. 5.
Category OK Not allowed
Drinks

Light tea with lemon and a little sugar

Rosehip decoction

Vegetable and fruit juices diluted with water

Compotes and fruit drinks from fresh fruits without sugar

Strong coffee

Chocolate and cocoa

Fizzy Drinks

Any alcohol, including beer

Packaged juices

Green Tea

Soups (basic diet)

Vegetable soups without toasted

Cereal or noodle soup

Borscht on lean meat broth without frying

Milk Noodles

Classic borsch with fried vegetables

Pickle

Ear

Sorrel or spinach soup

Solyanka

Okroshka with kefir, kvass or whey

Porridge and cereals

Buckwheat, oatmeal, rice porridge in water or diluted milk

Pilaf with dried fruits

Flaxseed porridge

Grain Casseroles and Puddings

Millet porridge

Pea puree

Pasta Any durum wheat Pasta with meat additions and hot sauces, such as Carbonara pasta
Meat and fish

Beef, veal

Skinless turkey and chicken, preferably white meat

Seafood - in limited quantities

Saltwater fish (2-3 times a week)

Dairy sausages - very limited

Pork

Lamb

Oily river fish

By-products

Canned fish and meat

Smoked sausages

Sushi rolls

Meat semi-finished products

Caviar

Bread

Yesterday's White

Bran Bread

Dry biscuits

Croutons

Any sweet baked goods

Pastry pastry

Pancakes, pancakes

Fresh bread

Fried pies with any filling

Dairy

Fermented milk products of low fat content

Pickled cheese

Natural yoghurts without additives

10% sour cream

Fatty fermented milk products

Whey

Hard cheeses

Strongly salted pickled cheeses

Vegetables (preferably seasonal)

Avocado

Potatoes

Zucchini

Cauliflower

Tomatoes (only in remission and in small quantities)

Seaweed

Celery

Canned and Pickled

Mushrooms

Onions, garlic

Corn, asparagus, eggplant, radish and radish

Raw white cabbage

Berries and fruits

Apples

Bananas in limited quantities

Grenades

Prunes

Watermelon (no more than 200 g)

Nuts

Seeds

Any fresh berries

Figs

Citrus

Melon

Persimmon

Oil

Creamy - 30 g per day

Refined sunflower

Olive

Unrefined Vegetable

Salo

Margarine

Eggs

Steamed or oven-baked omelet, preferably protein

Cool or Soft

Fried eggs

Fried eggs with tomatoes

Omelet in a pan

Salads and snacks

Courgette caviar

Lightly salted herring

Vegetable salads

Sauerkraut

Ginger

Olives

Canned vegetables and snacks

Sweets and desserts

Marmalade, lollipops

Kissel, jelly

Caramel

Dry biscuit

Cookies

Cakes, pastries

Ice Cream

Chocolate

Nut desserts - kozinaki and others

After the symptoms of acute pancreatitis have been removed, the diet is expanded to include other foods, the amount of protein in the diet and the total calorie intake. At the same time, the sparing principle of nutrition is maintained for a long time to minimize the risks of relapse of the disease. All meals must be cooked or steamed; foods that are too hot or cold cannot be eaten. At the first signs of an exacerbation, you must immediately switch to the first diet option with less calories and greater restrictions.

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

Partially Restricted Products

In the second variant of the diet, you can sometimes pamper yourself with marshmallows and jam dissolved in tea. Parsley and other herbs are best used only for decorating dishes. Melon and pineapple can be eaten dried, but in small quantities.

What herbs you can drink

To relieve the condition, after consulting a doctor, you can drink decoctions of medicinal herbs.

Parsley

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

Herbal collection

The collection includes a number of plants useful for inflammation: chamomile, wormwood, field horsetail and other herbs. Collection-based decoctions 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 in the same way as in adults.

Diet for pregnant women

Pregnant women often face problems related to the digestive tract. Pancreatitis can develop due to the abuse of vitamin complexes or due to excessive pressure on the pancreas from the uterus.

The principles of the 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. The food must contain in sufficient quantities:

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

Conclusion

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 practice. Proper nutrition is as important a component of treatment as medications, so the recommendations of the attending physician should in no case be neglected.

08.01.2021