Diet for pancreatitis

diet in case of pancreatitis

Inflammation of the pancreas affects an important part of the gastrointestinal tract - the pancreas - which produces insulin and many enzymes in the digestive tract. Not surprisingly, diet is essential in the treatment and prevention of this disease. In case of inflammation of the pancreas, the diet should not contain alcohol, high amounts of fat and fiber.

What is inflammation of the pancreas

Inflammation of the pancreas is an acute or chronic inflammation of one of the major organs of our body's endocrine system, the pancreas. The work of the entire gastrointestinal tract and the process of digesting food depend on the normal functioning of this organ.

The pancreas is located in the immediate vicinity of the liver, just behind the stomach, and has many functions, the most important of which is the synthesis of hormones, especially insulin. It also produces digestive enzymes that provide the process of cleavage and assimilation of fats, proteins and carbohydrates. Digestion of food occurs under the influence of pancreatic juice, which flows directly into the duodenum.

In fact, inflammation of the pancreas is the self-poisoning of the pancreatic tissue by the enzymes it produces. Inflammation begins with an overproduction of certain enzymes, combined with increased pressure in the glandular ducts. 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 consumption. More than half of cases of inflammation of the pancreas involve regular consumption of high-dose alcohol.
  • Inflammation of the pancreas often develops with gallstone disease, abdominal trauma, cysts in the bile ducts, and malignant tumors of the gland.
  • The disease can be a side effect of certain medications, such as diuretics.

The risk group includes diabetics, those with other endocrine disorders, and hepatitis B or C. Sometimes, inflammation of the pancreas develops during pregnancy or after a kidney transplant.

How alcohol affects the work of the pancreas

Alcohol in the body is broken down to form acetaldehydes, which are toxic to humans. Pancreatic cells are particularly sensitive to their harmful effects. In addition, alcohol consumption can cause cramps and narrowing of the pancreatic ducts, leading to the accumulation of pancreatic juice. 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 common classification for inflammation of the pancreas is based on the nature of the course of the disease: acute attack or prolonged chronic inflammation of the pancreas with periodic relapses. These two forms differ in the severity of symptoms and require a different approach to treatment.

Acute pancreatitis

The inflammatory process of acute pancreatitis develops very rapidly and is always accompanied by severe pain. In most cases, the disease occurs in the background of alcohol consumption or after consuming large amounts of fatty foods. Sometimes exacerbation is preceded by an attack of acute hepatic colic.

Symptoms of Acute Pancreatitis:

  • Severe pain in the left hypochondria, radiating to other organs. The painful attack lasts about half an hour or an hour. The pain is especially severe when lying on your back. The seizure worsens after a meal, especially after fried and spicy foods and any alcoholic beverages.
  • Vomiting, often uncontrollable with a mixture of bile and bitter taste. Persistent nausea that does not go away even after vomiting.
  • Subfebrile or high fever.
  • Sometimes yellowing of the whites of the eyes is observed due to violation of the bile outflow, 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. Painkillers provide only temporary relief, but do not work due to inflammation. Without qualified help, the risk of serious complications increases rapidly: infection of inflamed tissues, necrosis, and abscesses.

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

Chronic inflammation of the pancreas

If, after an attack of acute pancreatitis, a person does not follow the recommendations of doctors and continues to consume alcohol and eat poorly, the disease is likely to become chronic. Chronic inflammation of the pancreas develops with significant damage to the pancreas during the first episode of the disease.

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

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

Chronic pancreatitis can be asymptomatic for a long time: acute pain occurs when significant pathological changes have already taken place in the pancreas. During an attack, chronic pancreatitis has the same symptoms as acute pancreatitis:

  • severe belt pain,
  • Nausea,
  • vomiting,
  • intestinal disorders.

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

Importance of enzymes in digestion

The functioning of the human body is ensured by a complex system of interconnected and interdependent biochemical reactions. Thanks to special protein compounds - enzymes or enzymes - these reactions are accelerated, ensuring a fast metabolism. The effect of enzymes is very selective: each of them can initiate, accelerate or slow down only one reaction.

Digestion is based on the work of digestive enzymes. Their main task is to implement the energy absorption process quickly and efficiently. Enzymes break down food ingredients (proteins, fats and carbohydrates) into absorbable substances. Moreover, the amount of enzymes produced depends on the quantity and quality of the food consumed.

Digestion of food begins in the mouth. Foods shredded by teeth into small pieces are mixed with saliva that contains the enzyme alpha-amylase. The more we chew our foods, 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 stomach enzyme pepsin and hydrochloric acid begin to function. These substances create stomach juice that:

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

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

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

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

Food residue is emptied from the stomach into the duodenum, where the main process of digesting food takes place. It is provided by more than 20 pancreatic enzymes. Enzymes are found in the pancreatic juice, which the gland produces in a volume of two liters a day.

Pancreatic enzyme functions:

  • proteases - cleavage of proteins into 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 digestive process is completed by small intestinal enzymes and beneficial bacteria in the gut. In the intestines, the processed food is absorbed into the body (Figure 1).

When the organs of the digestive system, especially the pancreas, impair the function of enzyme production, the whole body becomes unbalanced. This imbalance leads to nausea, diarrhea, bloating followed by anemia and exhaustion.

What to eat in case of pancreatic enzyme deficiency

In inflammation of the pancreas, the process of production of digestive enzymes by the pancreas is interrupted, resulting in discomfort and pain in the stomach. In this case, replacement therapy may be prescribed after a full examination.

Important!All enzyme preparations start to work 20-30 minutes after a meal, so they should be taken strictly before a meal at the dose prescribed by your doctor!

Modern pharmacology offers a number of enzyme preparations of animal and plant origin. Some of these are intended only to make up for the absence of a single enzyme, such as lactose or fats. Complex effects have been prescribed for the absence of several enzymes in various organs of the digestive system.

What is the diet for pancreatitis

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

Foods that are difficult to process increase the burden on the inflamed organ. After an abundant feast of fatty fried foods, the pancreas strongly produces enzymes for digestion. When the ducts of the gland constrict, the pancreatic juice produced in the extreme mode accumulates in the gland, aggravating the development of the disease - the pancreas involved begins to digest itself.

Signs that your hardware is running in high mode include:

  • difficulty in the abdomen after a meal,
  • heartburn,
  • belching,
  • pain attacks in the stomach.

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

Dietary Rules 5: What You Can and Can't Eat With Pancreatitis

The pancreatitis diet contains a number of restrictions on both the foods that are allowed and how they are prepared. Especially for those struggling with pancreatic problems, one of the founders of Russian dietetics and gastroenterology, Professor I. I. Pevzner developed Diet Table # 5.

However, before learning about the specific provisions of the diet, you should consider the general principles of nutrition for pancreatitis:

  1. should be eaten five times a day in small portions;
  2. excludes fried and pickled foods;
  3. in the acute stage of the disease, the food must be shredded or wiped;
  4. animal protein
  5. should be present in the diet;
  6. the daily amount of fat should not exceed 50 g;
  7. sugar is also subject to strict restrictions - up to 30 g per day;
  8. forbidden foods that increase bloating - sweet carbonated drinks, legumes, sweet apples and grapes, sweet cakes and a few others;
  9. salt intake is reduced to a minimum - up to three to five grams.

Important!In case of inflammation of the pancreas, you can consume slow carbohydrates while monitoring the proportion of nutrients in the food. You must not be deceived that sugar can be replaced by honey, its consumption must also be controlled. At first, you will definitely need a calculator. Based on your body mass index, your daily caloric intake and balance of proteins, fats and carbohydrates should be calculated immediately. This information is easy to find on the Internet on websites dedicated to proper nutrition and a healthy lifestyle. There are various mobile applications for calculating calories and nutrients.

All of these principles are taken into account in Diet No. 5, which exists in basic and advanced versions.

The basic version is indicated for the relapse of chronic pancreatitis in patients with acute illness. In the acute phase, the diet is stricter, with many restrictions. Its purpose is to unravel the pancreas and relieve the symptoms of acute inflammation. During the first 3 days of the acute stage, the patient is recommended to rest the pancreas on an empty stomach. In addition, it is permissible to consume carbohydrate foods in small portions for 3-7 days at short intervals. Nowadays, the caloric content of the diet needs to be reduced and foods are consumed only in pureed or semi-liquid form.

Important!It is widely believed that rich broth, especially chicken broth, helps with all digestive problems. With pancreatitis, gallbladder disease, and other pathologies of the gastrointestinal tract, fatty rich broths are categorically contraindicated! Excessive amounts of animal fat significantly increase the load on the pancreas and prevent the condition from normalizing.

The diet includes cereals in water and vegetable soups with a variety of cereals, except millet and corn, cooked or steamed vegetable puree. Weak tea, jelly, dried fruit compote from drinks are allowed. Only white and lightly dried bread is allowed; you can eat biscuits and biscuits such as biscuits.

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

  • lean broth, the broth should be cooked from veal, turkey or chicken breast, the meat of the broth should be minced or shredded in a blender;
  • steamed omelette or soft-boiled egg;
  • steamed slices of lean meat or lean fish;
  • cottage cheese casserole and cottage cheese souffle with minimal fat content.

Diet # 5 spares the pancreas as much as possible, which needs complete rest in the acute phase. The permitted and prohibited foods in the basic diet are shown in Table 1.

Important!Predominance of protein foods in the diet can lead to constipation. In this case, you will need to add additional raw vegetables and fruits from the whitelist. In the case of gout, vegetable proteins or sea fish are preferred.

Table 1: Foods allowed and forbidden according to the basic version of diet # 5.
Category OK Not allowed
Drinks

Light tea with lemon and little sugar

Rosehip decoction

Vegetable and fruit juices diluted with water

Fresh fruit compotes and fruit drinks without sugar

Strong coffee

Chocolate and cocoa

Fizzy Drinks

Any alcohol, including beer

Packaged juices

Green tea

Soups (basic diet)

Vegetable soups without toasting

Cereal or pasta soup

Borsch in lean broth without frying

Milk pasta

Classic borsch with fried vegetables

Pickles

Tab

Sorrel or spinach soup

Solyanka

Okroshka with kefir, kvass or whey

Porridge and Cereals

Buckwheat, oatmeal, rice in water or dilute milk

Pilaf with dried fruits

Flaxseed

Cereal bowls and puddings

Millet porridge

Pea puree

Pasta Any durum wheat Pasta with meats and hot sauces such as Carbonara pasta
Meat and fish

Beef, veal

Skinless turkey and chicken, preferably white meat

Seafood - Limited Quantity

Sea fish (2-3 times a week)

Milk sausage - very limited

Pork

Lamb

Oily river fish

By-Products

Canned fish and meat

Smoked sausage

Sushi rolls

Meat semi-finished products

Caviar

Bread

Yesterday's White

Bran bread

Dry biscuits

Bread cubes

Any sweet baked goods

Pasta

Pancakes, pancakes

Fresh bread

Baked pies with any filling

Dairy Product

Low fat fermented dairy products

Marinated cheese

Natural yoghurts without additives

10% sour cream

Fatty fermented dairy products

Whey

Hard cheeses

Highly salty cheeses

Vegetables (preferably seasonal)

Avocado

Potatoes

Zucchini

cauliflower

Tomatoes (in remission and small quantities only)

Seaweed

Celery

Canned and Marinated

Mushroom

Onions, garlic

Corn, asparagus, eggplant, radishes and radishes

Raw white cabbage

Berries and fruits

Apple

Bananas in limited quantities

Grenades

prunes

Watermelon (up to 200 g)

Nuts

Seeds

Any fresh berry

Figs

Citrus

Melon

Persimmons

Oil

Creamy - 30g per day

Refined sunflower

Olive

Unrefined vegetables

Salo

Margarine

Eggs

Steam or oven omelette, preferably protein

Cool or Soft

Fried Eggs

Fried eggs with tomatoes

Omelette in pan

Salads and snacks

Zucchini Caviar

Slightly salted herring

Vegetable salads

Sauerkraut

Ginger

Olives

Canned vegetables and snacks

Sweets and desserts

Jam, lollipops

Kissel, jelly

Caramel

Dry biscuits

Cookies

Cakes, pastries

Ice Cream

Chocolate

Walnut Desserts - Kozinaki and Others

After removing the symptoms of acute pancreatitis, the diet is supplemented with other foods, the amount of protein in the diet, and total caloric intake. At the same time, the sparing principle of nutrition is maintained for a long time to minimize the risk of relapse. All food should be cooked or steamed, food that is too hot or cold should not be eaten. At the first signs of exacerbation, you should immediately switch to the first diet option, with fewer calories and greater restrictions.

Important!When pancreatitis is particularly harmful: alcohol, chocolate, coffee, carbonated beverages.

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 food. Melons and pineapples can be eaten dried, but in small quantities.

What herbs can you drink

You can drink herbal decoctions after consulting your doctor to relieve the condition.

Parsley

Parsley has a pronounced anti-inflammatory and antioxidant effect, stimulates gastric secretion. In case of chronic inflammation of the pancreas, the infusion of fresh chopped parsley should be taken 2-3 times a day, half an hour before a meal.

Herbal Collection

The collection includes many plants useful for inflammation: chamomile, wormwood, horseradish and other herbs. Collections based on collection are prepared according to the recommendations on the packaging.

Children's diet

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 digestive problems. Inflammation of the pancreas can be caused by the abuse of vitamin complexes or by excessive pressure on the pancreas of the uterus.

The principles of diet for pregnant women are no different from the general diet for pancreatitis. However, during pregnancy, it is extremely important to provide the complete diet necessary for the fetus to develop. The food should contain enough:

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

Conclusion

Adherence to a strict diet for pancreatitis is the foundation of successful therapy. The effectiveness of diet # 5 has been proven by many years of clinical practice. Proper nutrition is as important a part of treatment as medication, so your doctor’s recommendations should never be neglected.

08.01.2021