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 digestion of food depend on the normal functioning of this organ.

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

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

Causes of inflammation of the pancreas:

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

The risk group includes diabetics, people with other endocrine conditions 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 particularly sensitive to their harmful 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 gland cells die (pancreatic necrosis) and are replaced by scar tissue, the organ loses its ability to function as before.

Types of pancreatitis

The more general classification of pancreatitis is based on the nature of the course of the disease: 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 manifests itself 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 symptoms of pancreatitis:

  • Severe pain in the left hypochondrium, which radiates to other organs. A painful attack lasts about half an hour to an hour. The pain is particularly severe when lying on your back. The attack worsens after eating, especially fried and spicy foods, and any alcoholic beverages.
  • Vomiting, often uncontrollable with a mixture of bile and a bitter taste. Constant nausea that does not go away 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 medications only provide temporary relief, but they don't work on the cause of the inflammation. In the absence of qualified assistance, the risk of serious complications increases rapidly: infection of inflamed tissues, necrosis and abscesses.

Severe acute pancreatitis can lead to shock and multi-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 the cells of the pancreas. Over time, it begins to lose its main function - the production of enzymes needed to digest food. Exocrine insufficiency manifests itself:

  • diarrhea,
  • swelling,
  • changes the nature of stools: they acquire a sticky consistency due to the large amount of fat contained in them and are poorly washed off the toilet walls.

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 pain in the girdle,
  • nausea,
  • vomiting,
  • intestinal disorders.

Diagnosis is based on ultrasonography, 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 aren't 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 start, accelerate or slow down a single reaction.

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

The digestion of food starts already in the mouth. Food cut from teeth into small pieces is mixed with saliva, which contains the enzyme alpha-amylase. The better the food is chewed, 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 gastric enzyme pepsin and hydrochloric acid begin to act. 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 breaking down large protein molecules, other enzymes are produced in the stomach, for example:

  • 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: starts the digestion process of milk proteins.

Bile plays a significant role in the digestion process. Contains bile acids which stimulate the production of pancreatic secretions.

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

Functions of pancreatic enzymes:

  • protease: splitting of proteins into amino acids;
  • nuclease - affect DNA nucleic acids;
  • amylase: breaks down starch into simple sugars;
  • lipase: breaks down fats into higher fatty acids and glycerin.

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

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

What to eat with pancreatic enzyme deficiency

In pancreatitis, the process of producing 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 comprehensive examination, replacement 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 dose prescribed by the doctor!

Modern pharmacology offers a large number of different enzymatic preparations of animal and plant origin. Some of them only aim to replenish the lack of an enzyme, for example by breaking down lactose or fat. 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

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

Heavy food to be processed increases the load on the inflamed organ. After a hearty feast of fatty fried foods, the pancreas begins to energetically produce enzymes for its digestion. If the ducts of the gland are narrowed, the pancreatic juice produced in the extreme mode accumulates in the gland, exacerbating the development of the disease - the affected pancreas begins to digest.

Signs that the hardware is running in high mode include:

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

Obviously 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 what foods are allowed and how they are prepared. Especially for people with pancreatic problems, one of the founders of Russian dietetics and gastroenterology, Professor I. I. Pevzner developed a dietary table number 5.

But, before knowing 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 cut or dried;
  4. animal proteins 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. prohibited foods that increase flatulence - sweet carbonated drinks, 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 have to monitor the ratio of nutrients in the dishes. You shouldn't fool yourself that sugar can be replaced with honey, its consumption should also be controlled. You will definitely need a calculator at first. It is necessary to immediately calculate the daily calorie intake and the balance of protein, fat and carbohydrates based on the body mass index. This information is readily available on the Internet at sites dedicated to proper nutrition and a healthy lifestyle. There are various mobile applications for calculating calories and nutrients.

All these principles are taken into account in diet number 5, which exists in the 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 more stringent with many restrictions. It aims to drain the pancreas and relieve the symptoms of acute inflammation. In the first 3 days of the acute phase, the patient is advised to fast to rest the pancreas. Also, 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 reduced and the food is consumed only in pureed or semi-liquid form.

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

The diet includes cereals on water and vegetable soups with various cereals, with the exception of millet and corn, boiled or steamed mashed vegetables. From drinks, weak tea, jelly, compote of dried fruits are allowed. Only white and lightly dried bread is allowed; you can eat crackers and biscuits like cookies.

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

  • lean meat soup, it is recommended to boil the broth from veal, turkey or chicken breast, the broth meat should be minced or minced in a blender;
  • steamed omelette or soft-boiled eggs;
  • steamed cutlets of 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 phase. The foods allowed and prohibited for the basic diet are listed 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 fruits and vegetables from the allowed list. For gout, vegetable proteins or marine fish are preferred.

Table 1. Allowed and prohibited foods according to the basic variant of diet n. 5.
Category OK Not allowed
Drinks

Light tea with lemon and a little sugar

Rosehip decoction

Fruit and vegetable juices diluted with water

Compotes and sugar-free fresh fruit drinks

Strong coffee

Chocolate and cocoa

Carbonated drinks

Any alcohol, including beer

Packaged juices

Green tea

Soups (basic diet)

Vegetable soups without roasts

Cereal or noodle soup

Borscht on lean meat broth without frying

Spaghetti with milk

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 fruit

Flaxseed porridge

Cereal flans and puddings

Millet porridge

Pea puree

Pasta Any durum wheat Pasta with meat and spicy sauces, such as pasta alla carbonara
Meat and fish

Beef, veal

Skinless turkey and chicken, preferably white meat

Seafood - in limited quantities

Sea fish (2-3 times a week)

Dairy sausages - very limited

Pig

Lamb

Oily river fish

By-products

Fish and meat preserves

Smoked sausages

Sushi rolls

Semi-finished meat products

Caviar

Bread

Yesterday's white

Bread bran

Dry biscuits

Crostini

Any sweet baked product

Pastry

Pancakes, pancakes

Fresh bread

Fried cakes with any filling

Dairy

Low-fat fermented dairy products

Pickled cheese

Natural yoghurt without additives

10% sour cream

Products based on fermented fat milk

Whey

Hard cheeses

Very salty pickled cheeses

Vegetables (preferably in season)

Avocado

Potatoes

Zucchini

Cauliflower

Tomatoes (only in remission and in small quantities)

Seaweed

Celery

Canned and in brine

Mushrooms

Onions, garlic

Corn, asparagus, aubergines, radishes and radishes

Raw white cabbage

Berries and fruit

Apples

Bananas in limited quantities

Grenades

Plums

Watermelon (no more than 200 g)

Dice

Semi

Any fresh berries

Figs

Citrus fruits

Melon

Persimmon

Oil

Creamy - 30 g per day

Refined sunflower

Olive

Unrefined vegetables

Salò

Margarine

Eggs

Steamed or baked omelette, preferably protein

Cool or Soft

Fried eggs

Fried eggs with tomatoes

Omelette in a pan

Salads and snacks

Zucchini caviar

Lightly salted herring

Vegetable salads

Sauerkraut

Ginger

Olive

Canned vegetables and snacks

Sweets and desserts

Jam, lollipop

Kissel, jelly

Caramel

Dry biscuit

Cookie

Cakes, pastries

Ice cream

Chocolate

Walnut 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 thrifty principle of nutrition is maintained for a long time to minimize the risks of disease relapse. All meals must be cooked or steamed; it is not possible to eat too hot or cold food. At the first signs of exacerbation, it is necessary to immediately switch to the first diet option with fewer calories and more restrictions.

Important!When pancreatitis is particularly 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 dry, but in small quantities.

What herbs can you drink

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

Parsley

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

Collection of herbs

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

Children's diet

Chronic pancreatitis is extremely rare in children under the age of 14. 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 for the development of the fetus. Food must contain in sufficient quantities:

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

Conclusion

Adherence to 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 medication, so the recommendations of the attending physician should never be overlooked.