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 treating and preventing this disease. With pancreatitis, the diet should not contain alcohol, large amounts of fat and fiber.
What is pancreatitisPancreatitis 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 digestive process depend on the normal functioning of this organ.
The pancreas is located near the liver, behind the stomach and has many functions, the main one being the synthesis of hormones, especially insulin. It also produces digestive enzymes that provide the processes of breakdown and assimilation of fats, proteins and carbohydrates. Digestion of food occurs under the action of pancreatic fluid, which flows directly into the duodenum.
In fact, 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 glandular ducts. Excess enzymes enter the general bloodstream, adversely affecting the functioning of the brain, kidneys and other internal organs.
Causes of pancreatitis:
- Alcohol abuse. More than half of cases of pancreatitis are associated with regular consumption of large doses of alcohol. Pancreatitis often develops with gallstone disease, abdominal trauma, the formation of bile duct cysts, 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 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 and forms acetaldehyde, which is toxic to humans. Pancreatic cells are particularly sensitive to their damaging effects. In addition, drinking alcohol can cause spasms and narrowing of the pancreatic ducts, which leads to the accumulation of pancreatic fluid 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 most general classification of pancreatitis is based on the nature of the course of the disease: an acute attack or chronic long-term pancreatitis with periodic relapses. These two forms differ in the severity of the 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 against the background of alcohol abuse or after eating a large amount of fatty foods. Sometimes a worsening is preceded by an attack of acute hepatic colic.
Acute symptoms of pancreatitis:
- Severe pain in the left hypochondrium, radiating to other organs. A painful attack lasts about half an hour or an hour. The pain feels especially strong when you lie on your back. The attack worsens after eating, especially fried and spicy food, and any alcoholic beverages.
- Vomiting, often uncontrollable with a mixture of bile and a bitter taste. Persistent nausea that does not go away after vomiting.
- Subfebrile or high temperature.
- Sometimes, due to violation of the bile duct, yellowing of the whites of the eyes is observed, very rarely - a yellow tinge to the skin.
- In some cases, 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 because of the inflammation. In the absence of qualified help, the risk of serious complications increases rapidly: infection in inflamed tissues, necrosis and abscesses.
Severe acute pancreatitis can lead to shock and multiple organ failure.
If, after an attack of acute pancreatitis, a person does not follow doctors' recommendations 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 cell structure in the pancreas. Over time, it begins to lose its main function - the production of enzymes needed to digest food. Exocrine insufficiency is manifested:
- changes in the nature of feces - they gain a sticky consistency due to the large amount of fat in them and are poorly washed off the walls of the toilet bowl.
- severe back pain,
- intestinal disorders.
Diagnosis is based on ultrasound, computed tomography or magnetic resonance imaging. During the study, narrowed channels of the pancreas 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.
Importance of enzymes in digestion
The functioning of the human body is ensured 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 capable of initiating, accelerating or slowing down only one 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 ingredients (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 already begins in the mouth. Food broken down 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 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 enzymes pepsin and hydrochloric acid begin to function. These substances create gastric juice, which:
- provides antibacterial protection to the body;
- stimulates the production of pancreatic hormones;
- regulates stomach movement;
- 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 several fat molecules into fatty acids and monoglycerides; chymosin
- - begins the process of digesting milk proteins.
It even plays an important role in the digestive process. 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 digestion takes place. Provided by over 20 pancreatic enzymes. Enzymes are found in pancreatic fluid, which is produced by the glands in a volume of about two liters per day.
Functions of pancreatic enzyme:
- proteases - the breakdown 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 ends up under the influence of small intestinal enzymes and beneficial bacteria living in the gut. 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 is unbalanced. This imbalance leads to nausea, diarrhea, gas, followed by anemia and fatigue.
What to eat with pancreatic enzyme deficiency
In pancreatitis, the process of enzyme production digested by the pancreas is interrupted, as a result of which a person suffers from discomfort and stomach pain. In this case, after a thorough examination, replacement therapy may be prescribed.
Important!The action of all enzyme preparations starts 20-30 minutes after a meal, so they should be taken strictly before meals at the dose prescribed by your doctor!
Modern pharmacology offers a large number of different enzymatic preparations of animal and plant origin. Some of them are only intended to supplement the lack of any enzymes, for example, the breakdown of lactose or fats. There are also complex effects described for a deficiency of several enzymes in various organs of the digestive system.
What is the diet for pancreatitis
Food plays no less a role in the treatment of pancreatitis than medicine. The main purpose of the prescribed diet is to restore the functions of the pancreas and normalize the production of digestive enzymes.
Highly processed foods increase the burden on the inflamed organ. After an abundant feast of fatty fatty foods, the pancreas begins to forcefully produce enzymes for its digestion. If the ducts of the gland are narrowed, the excessively produced pancreatic fluid accumulates in the gland, worsening the development of the disease - the affected pancreas begins to digest itself.
Signals that the hardware is working in high mode include:
- weight on the abdomen after eating,
- attacks of stomach pain.
Of course, following a strict diet is not easy, especially at home. People with strict dietary restrictions are forced to cook on their own and resist the temptation to eat something fried or spicy.
Diet rules number 5: what you can and can not 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 you get acquainted with the specific provisions of this diet, it is necessary to consider the general principles of nutrition for pancreatitis:
- you should eat 5 times a day in small portions;
- exclude fried foods and pickles;
- in the acute stage of the disease, food should be chopped or discarded;
- animal protein should predominate in the diet;
- the amount of fat per day should not exceed 50 g;
- sugar also falls under a strict limit - no more than 30 g per day;
- forbidden foods that increase gas - sweet carbonated drinks, legumes, sweet apples and grapes, sweet pastries and some others;
- salt intake is minimized - no more than three to five grams.
Important!With pancreatitis, you can eat slow carbs 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. In the beginning, you will definitely need a calculator. It is necessary to immediately calculate the daily calorie intake and balance of proteins, fats and carbohydrates based on body mass index. This information is easily found online on sites dedicated to proper nutrition and healthy living. There are various mobile applications for calculating calories and nutrients.
All of 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 stricter with many restrictions. It aims to discharge the pancreas and relieve the symptoms of acute inflammation. In the first 3 days of the acute phase, fasting is recommended for the patient to rest the pancreas. Further, for 3-7 days, it is permissible to eat carbohydrate foods in small portions at short intervals. The calorie content in the diet these days should be reduced, and food consumed only in a pure or semi-liquid form.
Important!It is widely believed that a rich soup, especially chicken broth, helps with any digestive problems. With pancreatitis, gallbladder diseases and other pathologies of the gastrointestinal tract, fat-rich soups 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 in water and vegetable soups with a variety of cereals, in addition to millet and corn, boiled vegetables or steamed puree. From beverages, weak tea, jellies, dried fruit compotes are allowed. Only white and slightly dried bread is allowed; you can eat crackers and biscuits as biscuits.
On the third day of the carbohydrate diet, protein foods are gradually introduced:
- lean meat soup, it is advisable to boil beef, turkey or chicken breast soup, the meat from the soup should be minced or chopped in a blender;
- steamed omelette or soft-boiled eggs;
- steam cutlets made from lean meat or lean fish;
- casserole casserole and cottage cheese soufflés with minimal fat content.
Diet Nr. 5 is known to save as much as possible the pancreas, which needs complete rest in the acute phase. The permitted 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-based proteins or sea fish are preferred.
Light tea with lemon and a little sugar
Decoction of roses
Vegetable and fruit juices diluted with water
Fruit compotes and drinks from fresh fruit without sugar
Chocolate and cocoa
Any alcohol, including beer
|Supat (basic diet)||
Vegetable soup without toast
Cereal or noodle soup
Borscht in lean broth without frying
Classic fried vegetable borsch
Sour sorrel or spinach
Okroshka with kefir, kvass or whey
|Porridge & cereal||
Buckwheat, oatmeal, rice porridge in water or diluted milk
Dried fruit pilaf
Qull fara liri
Grain Casserole and Puddings
|Macaroni||Any hard grain||Pasta with hot meats and sauces, such as Carbonara pasta|
|Meat and fish||
Turkey and skinless chicken, preferably white meat
Seafood - in limited quantities
Saltwater fish (2-3 times a week)
Dairy sausages - very limited
Oily river fish
Canned fish and meat
Semi-finished meat products
Bread from bran
Any sweet baked goods
Fried pies with each filling
Low fat fermented milk products
Natural yogurts without additives
10% sour cream
Fatty fermented milk products
Highly salted pickled cheeses
|Vegetables (preferably seasonal)||
Tomatoes (only in apologies and in small quantities)
Canned and pickled
Corn, asparagus, eggplant, radish and radish
Raw white cabbage
|Berries and fruits||
Bananas in limited quantities
Watermelon (not more than 200 g)
Any fresh berries
Creamy - 30 g per day
Steam or oven omelette, preferably protein
Cold or mild
Tomato fried eggs
Omelet in a pan
|Salads & Meals||
Lightly salted herring
Canned vegetables and meals
|sweets and confectionery||
Sweets with nuts - kozinaki and others
Once the symptoms of acute pancreatitis have been removed, the diet is expanded to include other foods, the amount of protein in the diet, and total calorie intake. At the same time, the prudent principle of nutrition is maintained for a long time to minimize the risks of disease recurrence. All meals should be cooked or steamed; very hot or cold foods cannot be eaten. At the first signs of a deterioration, you should immediately switch to the first diet option with fewer calories and greater restrictions.
Important!When pancreatitis is particularly 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 for decorating dishes. Melon and pineapple can be eaten dried, 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 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.
The collection includes a number of herbs useful for inflammation: chamomile, wormwood, horsetail and other herbs. Collection-based decoctions are prepared according to the recommendations on the packaging.
Diet for childrenChronic pancreatitis is extremely rare in children under 14 years of age. When you diagnose an acute form of the disease, food 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 abuse of vitamin complexes or due to excessive pressure on the pancreas by the uterus.
Dietary principles 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 fetal development. The composition of the food should be present in sufficient quantities:
- protein (lean meat and fish, dairy products, eggs, legumes),
- complex carbohydrates (cereals, pasta, fruits and vegetables), fats
- (vegetable oils),
- vitamins and minerals.
Compliance with a strict pancreatitis diet 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 neglected.