Pancreatitis affects an important part of the gastrointestinal tract - the pancreas, which produces insulin and many of the enzymes involved in digestion. Unsurprisingly, diet is essential in the treatment and prevention of this disease. For 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 digesting food depend on the normal functioning of this organ.
Located in close proximity to the liver, just behind the stomach, the pancreas has many functions, the most important of which is the synthesis of hormones, especially insulin. It also produces digestive enzymes that enable the processes of breaking down and absorbing fats, proteins and carbohydrates. Food digestion occurs under the influence of pancreatic juice, which flows directly into the duodenum.
In fact, pancreatitis is self-poisoning of the pancreatic tissue by the enzymes it produces. The inflammation begins with the overproduction of certain enzymes combined with increased pressure in the gland ducts. Excess enzymes enter the general bloodstream and affect the functioning of the brain, kidneys, and other internal organs.
Causes of inflammation of the pancreas:
- Alcohol abuse. More than half of pancreatitis cases are associated with regular consumption of large doses of alcohol.
- Pancreatitis often develops with gallstone disease, abdominal trauma, cyst formation in the bile ducts, and malignant tumors in the gland.
- disease 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 function of the pancreas
Alcohol in the body breaks down into acetaldehydes, which are toxic to humans. Pancreatic cells are particularly vulnerable to their harmful effects. In addition, drinking alcohol can cause cramps and narrowing of the pancreatic ducts, which leads to the accumulation of pancreatic juice. As a result, digestive enzymes begin to process the gland itself, which leads to inflammation. If the disease is left untreated, cells in the gland die over time (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 type of disease progression: an acute attack or long-term chronic pancreatitis with periodic relapses. These two forms differ in the severity of symptoms and require different approaches to treatment.
The inflammatory process in acute pancreatitis develops very quickly and is always accompanied by severe pain. In most cases, the disease occurs on the background of alcohol abuse or after consuming 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 particularly felt when lying on your back. The seizure worsens after eating, especially after fried and spicy food and alcoholic beverages.
- Vomiting, often uncontrollable, with an admixture 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, very rarely a yellowing of the whites of the eyes is observed - a yellow tint of the skin.
- In some cases, the pain syndrome is accompanied by heartburn and gas.
An attack of acute pancreatitis requires immediate medical attention. Pain relievers only provide temporary relief but do not work on the cause of the inflammation. Without qualified support, the risk of serious complications increases rapidly: infections of inflamed tissues, necrosis and abscesses.
Severe acute pancreatitis can lead to shock and multiple organ failure.
If a person does not follow doctors' recommendations after an attack of acute pancreatitis 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 loses its main function - the production of enzymes that are needed to digest food. Exocrine insufficiency manifests itself:
- a change in the type of feces - they acquire a sticky consistency due to the large amount of fat and they are poorly 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 occurred in the pancreas. During a seizure, chronic pancreatitis shows the same symptoms as acute pancreatitis:
- severe belt pain,
- intestinal diseases.
The diagnosis is based on ultrasound, computed tomography or magnetic resonance tomography. As a rule, in the course of the study, narrowed pancreatic ducts are found due to the formation of stones - calcifications in them. Hardware techniques can also detect cysts on the site of atrophied tissue. Laboratory blood tests for chronic pancreatitis are not very informative.
The importance of enzymes for digestion
The function of the human body is guaranteed by a complex system of interconnected and interdependent biochemical reactions. Thanks to special protein compounds - enzymes or enzymes - all these reactions are accelerated and ensure a fast metabolism. The effect of enzymes is very selective: each of them can only trigger, accelerate or slow down one reaction.
Digestion is based on the work of digestive enzymes. Your main task is to make the process of energy absorption fast and efficient. Enzymes break down food components (proteins, fats and carbohydrates) into absorbable substances. In addition, the amount of enzymes produced depends on the amount and quality of the food consumed.
The digestion of food begins in the mouth. Food cut into small pieces by 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 reaches the stomach via the esophagus, where the gastric enzymes pepsin and hydrochloric acid begin to work. These substances produce gastric juice that:
- offers antibacterial protection to 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 proteins of connective tissue;
- lipase - an enzyme that breaks down some fat molecules into fatty acids and monoglycerides;
- Chymosin - Starts the process of digesting milk protein.
Bile plays an important role in the digestive process. It contains bile acids that stimulate the production of pancreatic secretions.
From the stomach, the lump of food is evacuated into the duodenum, where the main process of digesting food takes place. More than 20 pancreatic enzymes supply it. Enzymes are contained in pancreatic juice, which is produced by the gland in a volume of around two liters per day.
Pancreatic enzyme functions:
- proteases - cleavage of proteins by amino acids;
- nucleases - affect DNA nucleic acids;
- Amylase - breaks starch into simple sugars;
- Lipases - break down fats into higher fatty acids and glycerine.
The digestive process is completed under the influence of enzymes of the small intestine and beneficial bacteria that live in the intestine. Processed foods are absorbed by the body in the intestines (Fig. 1).
If the function of enzyme production by the organs of the digestive system, especially the pancreas, is impaired, the whole organism is thrown out of balance. This imbalance leads to nausea, diarrhea, gas, followed by anemia and fatigue.
What to eat when there is a lack of pancreatic enzymes
In pancreatitis, the process of producing digestive enzymes by the pancreas is disrupted, causing a person to experience discomfort and pain in the stomach. In this case, after a full examination, substitution therapy can be prescribed.
Important!The effects of all enzyme preparations start 20 to 30 minutes after a meal. It is therefore imperative that they be drunk in the dosage prescribed by your doctor before meals!
Modern pharmacology offers a large number of different enzyme preparations of animal and vegetable origin. Some of them just aim to make up for the lack of an enzyme, such as breaking down lactose or fats. There are also complex effects that are prescribed for a lack of several enzymes in various organs of the digestive system.
What is a diet for pancreatitis?
Diet plays no less of a role than medication in treating pancreatitis. 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 difficult to process increase the stress on the inflamed organ. After a rich feast of fatty fried dishes, the pancreas begins to intensively produce enzymes for its digestion. When the gland ducts are narrowed, the pancreatic juice produced in extreme mode accumulates in the gland, which aggravates the development of the disease - the affected pancreas begins to digest itself.
The signals that the hardware is operating in high mode include:
- Heaviness in the stomach after eating,
- attacks of stomach pain.
Of course, sticking to 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 anything fried or spicy.
Diet rules number 5: What you can and cannot eat with pancreatitis
The diet for pancreatitis has many restrictions both on what foods are allowed and how they are prepared. Especially for people with problems with the pancreas, one of the founders of Russian dietetics and gastroenterology, Professor I. I. Pevzner developed a diet table number 5.
However, before you familiarize yourself with the specific provisions of this diet, you must consider the general nutritional principles for pancreatitis:
- You need to eat in small portions 5 times a day.
- exclude fried and pickled foods;
- In the acute stage of the disease, food should be chopped or wiped.
- animal protein should predominate in the diet;
- The amount of fat per day should not exceed 50 g.
- Sugar is also strictly limited - no more than 30 g per day;
- prohibited foods that increase flatulence - sweet carbonated drinks, legumes, sweet apples and grapes, sweet pastries, and some others; The salt intake of
- is minimized - no more than three to five grams.
Important!For pancreatitis, you can eat slow carbohydrates while monitoring the nutrient ratio in the dishes. Make no mistake about the fact that honey can be substituted for sugar, its consumption should also be controlled. First of all, you 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 websites devoted to proper nutrition and a healthy lifestyle on the Internet. 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 relapses of chronic pancreatitis and with an acute nature of the disease. In the acute phase, the diet is stricter with many restrictions. It aims to take pressure off the pancreas and relieve symptoms of acute inflammation. Fasting is recommended to the patient for the first 3 days of the acute stage in order to rest the pancreas. It is also allowed to eat carbohydrate foods in small portions at short intervals for 3-7 days. The calorie content of the diet should be reduced these days, and foods are only consumed in pureed or semi-liquid form.
Important!It is widely believed that rich broths, especially chicken broth, help with digestive problems. With pancreatitis, diseases of the gallbladder and other diseases of the gastrointestinal tract, high-fat broths are categorically contraindicated! An excessive amount of animal fat significantly increases the load on the pancreas and prevents the condition from normalizing.
The diet includes cereals on water and vegetable soups with different types of grain, except millet and corn, cooked or steamed vegetable puree. From drinks, weak tea, jelly, dried fruit compote are allowed. Only white and slightly dried bread is allowed, you can eat crackers and cookies like cookies.
On the third day of the carbohydrate diet, protein foods are gradually introduced:
- lean meat soup, it is advisable to cook the broth from veal, turkey or chicken breast. Meat from the broth should be chopped or minced in a blender.
- steamed omelette or soft-boiled eggs;
- steamed schnitzel made from lean meat or lean fish;
- Quark casseroles and quark soufflé with minimal fat content.
Diet No. 5 is intended to protect the pancreas as much as possible, which in the acute stage requires a complete break. Foods permitted and prohibited for basic nutrition are listed in Table 1.
Important!The preponderance 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. Vegetable proteins or marine fish are preferred for gout.
Light tea with lemon and some sugar
Vegetable and fruit juices diluted with water
Compotes and fruit drinks made from fresh fruits without sugar
Chocolate and cocoa
Any alcohol, including beer
|Soups (diet basis)||
Vegetable soups without toast
Muesli or noodle soup
Borscht on lean meat broth without frying
Classic borscht with fried vegetables
Sorrel or spinach soup
Okroshka with kefir, kvass or whey
|Porridge and cereals||
Buckwheat, oatmeal, rice porridge in water or diluted milk
Pilaf with dried fruits
Cereal casseroles and pudding
|Pasta zx zxtd>||Any durum wheat||Noodles with meat and hot sauces such as carbonara noodles|
|Meat and fish||
Turkey and skinless chicken, preferably white meat
Seafood - in limited quantities
Saltwater fish (2-3 times a week)
Milk sausages - very limited
Oily river fish
Canned fish and meat
Semi-finished meat products
All sweet baked goods
Fried cakes with any filling
Fermented milk products with a low fat content
Natural yoghurt without additives
10% sour cream
Fat-fermented dairy products
Very salty pickled cheese
|Vegetables (preferably seasonal)||
Tomatoes (only in remission and in small quantities)
Potted and pickled
Corn, asparagus, aubergines, radishes and radishes
Raw white cabbage
|Berries and fruits||
Bananas in limited quantities
Watermelon (not more than 200 g)
All fresh berries
Creamy - 30 g per day
Steam or oven-baked omelette, preferably protein
Cool or Soft
Fried eggs with tomatoes
Omelette in a pan
|Salads and snacks||
Lightly salted herring
Canned vegetables and snacks
|Sweets and desserts||
Nut desserts - Kozaki and others
After the symptoms of acute pancreatitis are 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 gentle principle of nutrition is maintained for a long time in order to minimize the risk of the disease relapse. All meals must be boiled or steamed, food that is too hot or too cold cannot be eaten. At the first signs of an exacerbation, you must immediately switch to the first diet option with fewer calories and greater 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 indulge yourself with marshmallows and jam dissolved in tea. Parsley and other herbs are best used just to decorate dishes. Melon and pineapple can be dried, but eaten in small quantities.
Which herbs can you drink
To alleviate the disease, after consulting a doctor, you can drink decoctions of medicinal herbs.
Parsley has a pronounced anti-inflammatory and antioxidant effect and stimulates gastric secretion. With chronic pancreatitis, an infusion of freshly chopped parsley is taken 2-3 times a day, half an hour before meals.
The collection contains a number of plants useful for inflammation: chamomile, wormwood, horsetail and other herbs. Collection-based decoctions are prepared according to the recommendations on the package.
Diet for children
Chronic pancreatitis is extremely rare in children under 14 years of age. When diagnosing an acute form of the disease, the diet is organized in the same way as in adults.
Diet for pregnant women
Pregnant women often have problems with the digestive tract. Pancreatitis can develop as a result of the abuse of vitamin complexes or due to excessive pressure of the uterus on the pancreas.
The principles of nutrition for pregnant women are no different from the general diet for pancreatitis. However, during pregnancy it is extremely important to provide complete nutrition that is necessary for the development of the fetus. The composition of the food must be available 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.
Adhering to a strict diet for pancreatitis is the basis for successful therapy. The effectiveness of Diet No. 5 has been confirmed by many years of clinical practice. Proper nutrition is just as important a part of treatment as medication, so the recommendations of the attending physician should never be neglected.