Detailed list of permitted products for pancreatic necrosis. How to eat properly for patients with pancreatic necrosis

The disease pancreatic necrosis is a severe lesion of the pancreas. It is impossible to cure the disease without timely surgical intervention. Therefore, doctors often recommend that patients do not rely too much on drug treatment, but immediately resort to the help of a surgeon and undergo surgery. Proper nutrition for pancreatic necrosis of the pancreas after the period of surgery will help to shorten and speed up the rehabilitation period.

It is worth remembering that the disease more often appears in people suffering from pancreatitis and who do not adhere to the diet prescribed by their doctor. If there are disturbances in the functioning of the pancreas, it becomes difficult for the body to digest food. This applies even to light foods. Therefore, it is so important to follow all doctor’s recommendations regarding diet.

And although the treatment of this disease involves surgery, this does not mean that you can ignore other doctor’s recommendations.

A few days before the operation, the patient is strictly forbidden to eat food. And it is during this period, as statistics show, that many succumb to the temptation to secretly have a little snack from the doctor. Such behavior will have very serious consequences. After all, restrictions are introduced with the aim of causing the pancreas to stop producing certain enzymes. It is these enzymes that destroy the nerve endings, tissues and blood vessels of the organ that has been affected by the disease. The patient is also prohibited from drinking. In the preoperative period, normal functioning of the body is maintained by administering intravenous solutions. The solutions used contain all the necessary nutrients (fats, glucose, amino acids).

After the operation, the patient’s nutrition is completely controlled by the doctor. In the first few days, the patient cannot eat or drink water on his own. The vital functions of the body are maintained in the same way that was used before the operation. And only on the 5th day the patient is allowed to start drinking liquid. This can be not only ordinary water, but also a rosehip decoction. You can drink about 4 glasses per day.

One of the main prerequisites for the development of pancreatic necrosis is non-compliance with the diet - consumption of fried, spicy, fatty foods and alcohol, therefore, a necessary condition for effective therapy of necrotizing pancreatitis is a balanced diet and avoidance of strong drinks.

Principles of nutrition for necrotizing pancreatitis

Properly selected nutrition for pancreatic necrosis is an important component of the complex treatment of the disease.

The diet is divided into several stages:

• fasting, which involves abstaining from food during an exacerbation of pancreatic necrosis, before and after surgery;
• diet No. 5P (1st option), prescribed after fasting for a period of 3 days to a week;
• diet No. 5P (2nd option), used after relieving acute symptoms and reducing pain.

Both options have different goals:

1. the first of them does not provoke the secretion of digestive juice, which helps relieve pain and ensure maximum rest of the pancreas during pancreatic necrosis;
2. the second aims to prevent relapses and progression of the disease, while the diet excludes dishes that increase the secretory activity of both the pancreas and stomach.

Parenteral nutrition and fasting

In the first days of the disease, for a certain period before and after surgery, the patient is assigned a zero table, which leads to enzymatic rest of the pancreas: at this stage, the organ rests without producing juice that is harmful to it during pancreatic necrosis.

To avoid exhaustion, the patient receives parenteral nutrition, in which the beneficial substances necessary for the body are injected directly into the blood.

The composition of the injection solution, calculated based on energy needs by a nutritionist, most often consists of a 20% glucose solution with the addition of solutions of amino acids, fat emulsions, insulin and other components.

Diet after pancreatic necrosis

After surgical treatment, when the symptoms of pancreatic necrosis subside, the diet is expanded. On the fifth day after surgery, the patient is allowed to drink a glass of rosehip decoction or alkaline mineral water without gas no more than 4 times a day.

If the condition does not worsen within two days, the patient is transferred to diet No. 5P, according to which a split diet is prescribed up to 6 times a day with three main meals. Products should be warm, boiled or steamed without salt or spices.

Diet No. 5P completely excludes the consumption of fatty, salty, spicy, fried foods and alcohol in case of pancreatic necrosis. The first courses are prepared from cereals and pureed vegetables - carrots, potatoes, pumpkins, zucchini. For side dishes cooked in water from rice, buckwheat, oatmeal or noodles, you can serve low-fat fish, poultry or meat.

In addition, you can take the following foods as the basis of your diet:

• stale baked goods made from 1st or 2nd grade flour;
• unsweetened cookies and crackers;
• soft and ripe fresh fruits;
• baked apples, jellies, mousses;
• low-fat fermented milk products;
• egg white omelet;
• butter and vegetable oil in dishes;
• rosehip decoction, weak tea, dried fruit compotes and juices without sugar or preservatives.

Taboo products

In case of pancreatic necrosis, the following products are completely prohibited:

• alcohol;
• carbonated drinks;
• cocoa and coffee;
• fresh bread;
• broth-based soups;
• fatty fish, poultry and meat;
• smoked meats and sausages;
• marinades and canned food;
• beans, radishes, turnips, garlic, onions, sorrel, mushrooms, sweet peppers, cabbage, eggplants, radishes;
• bananas, grapes, figs;
• chocolate, jam, confectionery, ice cream;
• lard and cooking fats;
• whole egg dishes;
• high fat dairy products;
• pearl barley, barley, millet and corn crumbly porridges.

It is necessary to adhere to the diet for a long time (from 6 to 9 months), until laboratory parameters are completely normalized and the symptoms of pancreatic necrosis disappear. Ideally, a special eating regimen becomes habitual for the patient. If its functional insufficiency has not developed, you can diversify your diet in the future, listening to the doctor’s recommendations and your own feelings.

Useful video about nutrition for pancreatitis

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The diet for pancreatic necrosis must be strictly followed by the patient before surgery. The person should not eat or drink anything for 3 days. The diet for pancreatic necrosis of the pancreas after surgery is the same as before surgery. What is included in this diet will be discussed below.

Postoperative restrictions for patients

If an operation is performed to eliminate pancreatic necrosis, the patient’s diet will be very strict. For example, after eliminating necrosis on the pancreatic tissue, he is prohibited from eating or drinking any liquid (even water) for 4 days. To prevent the situation from worsening, the person is injected intravenously with solutions of various amino acids, glucose and fats.

For the first time after pancreatitis surgery, the patient is given water or rosehip decoction to drink only on the fifth day. But the amount of liquid is limited to 4 glasses per day.

If, after starting constant fluid intake, the patient’s situation does not worsen for 4-5 days, then he is prescribed the 5-P diet.

To stabilize the patient’s situation, the diet for pancreatic damage consists of a variety of low-fat foods, and it should be bland, since a person is prohibited from consuming table salt after pancreatic necrosis.

The duration of a strict diet is from 20 to 30 days. If there are positive trends in the patient’s health, the doctor will allow you to expand the diet.

Once new products are added, the patient should take them in minimal quantities. If pain occurs, he must inform the doctor, after which new foods will be removed from the diet.

Pancreatic necrosis is considered one of the most serious diseases affecting the pancreas. Both women and men are equally susceptible to this disease. Pancreatic necrosis is most often diagnosed in young people under 30 years of age.

In this article you can read about what you can eat if you have a disease such as pancreatic necrosis of the pancreas, as well as what dishes are included in the diet. It will also describe which products are strictly prohibited for this disease.

What is pancreatic necrosis of the pancreas?

The development of this disease occurs as a result of disruption of the functioning of the local protective mechanism of the pancreas. A provoking factor can be the consumption of junk food and alcoholic beverages in large quantities. As a result, the production of external secretion increases and the outflow of pancreatic juice is disrupted, which provokes a significant stretching of the pancreatic ducts.

The further process of destruction of the acini of the gland and the formation of edema provoke massive tissue necrosis. The penetration of tissue breakdown products and enzymes into the blood causes toxic poisoning of the entire body. As a result, the liver, heart, kidneys and brain can become foci of intoxication.

If conventional treatment methods fail to produce positive results and total and subtotal tissue necrosis does not stop, then the patient is prescribed surgery. Surgical intervention is carried out after the exacerbation of the disease.

General rules of nutrition before and after surgery

The patient must follow a diet for pancreatic necrosis of the pancreas, both after and before surgery. 24 hours before the start of the intervention, the patient is strictly prohibited from consuming food or any liquid. Thus, the pancreas will not produce enzymes involved in the digestion of its parenchyma.

Despite a strict diet for pancreatic necrosis, before the procedure the patient must have the strength to endure the operation, so he is injected intravenously with various substances that support the body.

After surgery, the patient is allowed to feed only on the sixth or seventh day. Before this, it is maintained with warm medicinal water (Narzan, Borjomi) or weak tea without sugar. The volume of fluid consumed should not exceed 800 milliliters per day. If the patient's condition after surgery is considered too severe, drinking any liquid is again prohibited. Nutrition occurs through intravenous injections. Only when a person’s condition returns to normal will foods that promote the regeneration of the digestive system be included in his diet.

The postoperative diet menu for pancreatic necrosis is based on the elimination of negative factors that destroy the pancreas. It is also aimed at reducing the excitability of the gallbladder and eliminating pathogens of pancreatic secretion.

Previously, it was believed that a diet after pancreatic necrosis in the form of prolonged fasting without drinking (about three days) promotes postoperative recovery. However, modern medicine has decisively abandoned this concept.

Recent scientific studies have proven that if the patient is not allowed to drink warm medicinal water after surgery, lipolysis and hypodysproteinemia may develop. Thus, the duration of a fasting diet for pancreatic necrosis of the pancreas does not exceed one day, and in extremely difficult cases it is abandoned altogether. Then the patient, after parenteral nutrition, is gradually transferred to eating dietary food. This postoperative recovery regimen has been proven to be the most effective. It is worth remembering that liquid, even in small quantities, will benefit the patient after surgery.

The diet menu for pancreatic necrosis of the pancreas includes low-calorie foods. The daily mass fraction of proteins in products should not exceed sixty grams. However, you are allowed to consume no more than fifty grams of fat per day. The main element of the diet should be carbohydrate foods with a semi-liquid or viscous consistency.

Authorized Products

The diet for pancreatic necrosis of the pancreas should include vegetables (zucchini, carrots, potatoes). It is recommended to prepare lean first courses from them or to use them boiled and chopped. Porridges based on ground cereals (buckwheat, rice) are prepared in the same way.

First and second courses are allowed to be salted, but only if the total amount of salt per day does not exceed two grams. In a slightly stale form, you can use baked goods made from first-grade flour.

For fruits, we recommend non-acidic apples baked or as part of a mousse. In addition, you can eat apricots and peaches, but only in small quantities and peeled. It is recommended to drink medicinal water, rosehip decoction, jelly or weak tea.

Partially limited products

For pancreatic necrosis, the diet may include a minimal amount of fermented milk products, such as low-fat fermented baked milk, kefir or sour cream. Milk soup is allowed, but only when diluted with water.

It is recommended to eat chicken or quail eggs only soft-boiled. Dietary meat or fish can be consumed in the form of puree or steamed cutlets.

Prohibited Products

It is strictly forbidden to include in the diet for pancreatic necrosis smoked products (meat or sausages), fatty and rich broths from fish or meat, fresh milk and fermented milk products with a high fat content. In addition, you should exclude fresh baked goods, scrambled eggs and hard-boiled chicken or quail eggs.

It is strongly recommended not to drink alcohol, any carbonated drinks, coffee, or strong tea. You will have to give up vegetables that contain coarse fiber, as well as hot spices, salt and sugar. Failure to comply with these prohibitions directly leads to relapse of the disease.

Features of the diet for children

An approximate diet menu for pancreatic necrosis for children has some differences with the diet of adults. For example, for children under three years of age, it is necessary to completely exclude freshly squeezed juices, berries with seeds, all citrus fruits, as well as any vegetables and fruits.

Otherwise, the diet for adults and children is absolutely identical. It is worth paying attention to the fact that in kindergartens and schools the nutrition is unified and that the staff must be notified in advance that a particular child requires a separate dietary meal.

Example menu

Experts advise including certain dishes in the diet for pancreatic necrosis. Recipes will be presented below.

Sample menu for the day:

1. For breakfast, an omelette made from whites, viscous porridge made from chopped buckwheat and tea are suitable.
2. For an afternoon snack, you can make a soufflé of dried apricots.
3. Lunch can consist of rice broth along with a soufflé of low-fat boiled pollock and jelly from permitted fruits.
4. In the break between lunch and dinner, it is recommended to have a snack with low-fat cottage cheese and unsweetened rosehip compote.
5. For dinner, steamed cutlets made from dietary meat or fish, as well as a soufflé made from freshly squeezed carrot juice, are perfect.

Diet recipes

It is important to remember that it is quite possible to eat tasty and healthy food in case of this disease. However, it is worth remembering some rules when preparing dishes, namely:

1. Salt and sugar should be added in minimal quantities.
2. All food preparations must be thoroughly washed.
3. You should carefully study the composition of products before purchasing. Preference should be given only to natural ingredients.

Below are several interesting recipes for dishes with a pancreatic necrosis diet.

Milk soup with buckwheat

To prepare this first dish, you need to carefully sort out three tablespoons of cereal, chop it, rinse it with running water and cook, adding a little salt, until half cooked. After that, you need to add one glass of low-fat milk, a teaspoon of sugar and bring until ready.

Steamed chicken cutlets

To begin with, twenty grams of stale bread are soaked in two tablespoons of low-fat milk, and then mixed with one hundred and fifty grams of minced chicken. If desired, you can add a pinch of salt to the resulting mixture. Medium-sized cutlets are formed from the minced meat, placed in a double boiler and steamed in olive oil for about half an hour.

Pumpkin and Apple Casserole

This dish can be a replacement for your usual desserts. In order to prepare a casserole of pumpkin and apple, you need to finely chop one hundred and fifty grams of pumpkin pulp and half a medium apple. After that, the mixture must be placed in a saucepan, simmered with the addition of water and using a blender to obtain the consistency of puree.

Next, pour a tablespoon of hot milk, half a teaspoon of melted butter into the resulting puree, add a teaspoon of sugar and two tablespoons of semolina. After which, you need to give the mixture time to cool. Meanwhile, whisk the egg white until foamy and add to the puree. The resulting mass must be placed on a baking sheet and baked in the oven at 170 degrees for about half an hour.

Semolina soufflé

This and all other soufflé recipes are considered most useful if steamed. Three tablespoons of semolina are boiled as for making porridge, only instead of milk, three glasses of dried fruit compote are used. Beat the resulting mixture with a mixer and gradually add the whites from three chicken eggs. If desired, add a little sugar, place in molds and steam.

Dietary vinaigrette

Some salads are also not prohibited for pancreatic necrosis. So a vinaigrette can be quite useful. To prepare it, you need to leave two hundred and fifty grams of sauerkraut and one pickled cucumber in water for half an hour in advance. Then cook two medium-sized potatoes and one beet in their skins until tender.

Next, all that remains is to cut all the components into equal cubes, mix and season with a small amount of vegetable oil. The second salad approved by nutritionists is beet salad. Two or three beets are boiled in their skins until fully cooked, after which they are grated or finely chopped, salted and flavored with vegetable or olive oil.

Cream of broccoli soup

The most popular and useful recipes from the diet after pancreatic necrosis are the first courses. A special place among them is occupied by cream of broccoli soup. To prepare cream soup correctly, first you need to bring half a liter of water to a boil, throw two or three peeled potatoes and about five broccoli florets into it.

Cook vegetables for about twenty minutes over medium heat. Next, pour the broth into a separate container, and grind the potatoes and broccoli in a blender to a puree consistency. Next, dilute the resulting puree with previously drained broth, return to the stove and cook until thickened.

Cottage cheese pudding

This recipe for curd pudding will not leave anyone indifferent. To prepare the pudding, four hundred grams of low-fat cottage cheese and three hundred grams of peeled, non-acidic apples are crushed in turn in a blender to a puree consistency. Then mix them together, adding the whites of six chicken eggs. If desired, you can add a little sugar, place in molds and bake in the oven.

Complications due to non-compliance with the diet

If you ignore the rules of diet, patients can and will expect a number of complications. In addition to the fact that failure to follow a diet will provoke a relapse of the disease, it can also become a direct cause of the appearance of symptoms of diabetes mellitus in the patient.

According to the results of a survey among patients, proper adherence to a diet for pancreatic necrosis can significantly reduce clinical symptoms. However, patients will have to get used to therapeutic nutrition, since the diet will have to be followed almost for life.

Conclusion

Patients with pancreatic necrosis of the pancreas must unconditionally listen to the instructions of their attending physician and follow the therapeutic diet in every detail. Consumption of prohibited products even in minimal quantities can lead to irreversible consequences. In this case, neither expensive drug treatment nor radical surgery will give positive results.

A complication of pancreatitis, such as pancreatic necrosis, is treated with conservative therapy and surgery. At the same time, a prerequisite for the recovery of a person of any age is a diet for pancreatic necrosis, which is prescribed by a doctor.

General rules

A diet for the treatment of pancreatic necrosis involves eating steamed or mashed dishes with a high protein content and a reduced level of carbohydrates and fats. The patient should avoid overeating, which has a negative effect on the body, overloading the digestive tract and pancreas. In case of enzyme deficiency, cold and hot dishes are also excluded, the optimal food temperature is 20...50°C. Failure to follow the rules and an inappropriate diet leads to dangerous consequences, including the development of pathologies and death.

Authorized Products

Pancreatic necrosis involves the consumption of the following foods:

• soups with noodles, vegetables and cereals;
• porridge with water and with added milk;
• boiled vermicelli;
• lean meats: baked, steamed, in the form of cutlets, meatballs, meatballs and casseroles;
• hard cheese and low-sour cottage cheese;
• dry and dietary cookies;
• dried white bread or crackers;
• baked apples;
• dried fruit compote, jelly;
• tea with milk;
• rosehip decoction;
• water without gas.

Prohibited Products

With pancreatic necrosis, a person must adhere to a diet that excludes the consumption of fatty, salty, spicy, canned and smoked foods.

The list of prohibited foods for a patient with pancreatic necrosis includes: fresh bread, lamb, pork and goose meat, sausages, rich broths, legumes, fresh garlic and onions, tangerines and oranges, peppers and hot spices, cream, sour juices, coffee and alcohol.

Dish recipes

The therapeutic diet for a lack of enzymes in the digestive system involves the use of dietary foods.

Soups

1. Boil the chicken meat and cut it into small pieces, cover with cold water.
2. Add finely chopped potatoes and carrots, add a little salt.
3. Place the peeled whole onion in the soup and remove it after cooking.
4. Remove the soup from the heat after the vegetables are completely boiled.

For patients with pancreatic necrosis, nutritionists advise adding buckwheat to the soup, which is easily absorbed by the body and contains useful substances. The diet also provides for the introduction of dietary puree soups into the diet.

Second courses

A diet for pancreatic necrosis involves the inclusion of carefully crushed food products in the menu.

The cutlets are prepared as follows:

1. Dilute the minced meat with a piece of bread soaked in water or milk.
2. Form into balls and place in a slow cooker, steamer or frying pan with water added.

Chicken or beef soufflé:

1. Boil the meat until half cooked.
2. Scroll through a meat grinder.
3. Add milk (not whole milk) and egg whites.
4. Beat the mixture with a mixer.
5. Place in a preheated oven for 30 minutes.

Fish dumplings:

1. Grind the white fish fillet and mix with the pulp of the bread.
2. Add sliced ​​onion.
3. Grind the mixture through a sieve.
4. Stir in the egg and a pinch of salt.
5. Form into balls and place in boiling water.

Salads

During remission, the diet allows the use of vinaigrette, salad with apples and squid, or with chicken and Adyghe cheese.

Method for preparing vinaigrette for feeding patients with pancreatic necrosis:

1. Boil beets and potatoes.
2. Soak sauerkraut in cool boiled water to remove excess salt and acid.
3. Soak the pickled cucumber in cold water.
4. Cut the vegetables into cubes, pour in sunflower oil.
5. Add peeled cucumber to vegetables.
6. Wash and squeeze the cabbage.
7. Mix all ingredients.

A portion of vinaigrette can be present in the diet of a patient with pancreatic necrosis 1 or 2 times a week. However, the introduction of salad into the menu is carried out gradually, and in case of acute pancreatic necrosis, the diet excludes vinaigrette from the diet.

1. Boil frozen squid in boiling water and cut into rings.
2. Grate the cheese on a coarse grater.
3. Chop boiled eggs.
4. Grate the apple.
5. Mix the ingredients and season with low-fat sour cream.

One serving of salad for pancreatic necrosis can be eaten once every two weeks.

Easy to prepare protein salad with chicken and Adyghe cheese:

1. Boil the chicken breast, add water again and keep on low heat for half an hour.
2. Grind the cheese.
3. Finely chop the meat.
4. Season the salad with a minimal amount of sour cream or kefir.

Dessert

The diet for pancreatic necrosis allows the use of fruit purees and jellies from fruits that are easily digestible (melon, apricot, watermelon). In some cases, the patient is allowed marshmallows and marshmallows, in strictly limited quantities.

A patient with pancreatic necrosis is allowed to introduce dietary carrot cookies prepared according to the following recipe into the diet:

1. Grind butter with sugar.
2. Mix with beaten egg, apples, grated carrots, flour and baking powder.
3. Bake in the oven.

Sample diet menu for pancreatic necrosis

A diet with a weekly menu helps a person maintain a diet and diversify their diet during pancreatic necrosis. The menu described below can be customized by combining acceptable products.

Monday

• steamed meat and rosehip decoction;
• cottage cheese and tea with milk;
• pumpkin-carrot soup, white fish and drink;
• omelette with a little salt, cheese and rosehip infusion;
• beet salad, oatmeal, baked apple, still mineral water;
• cottage cheese and jelly before bed.

Tuesday

• omelette and steamed cutlets;
• oatmeal with milk, compote;
• buckwheat porridge and fish dumplings, drink;
• baby food;
• meatloaf stuffed with omelet, salad with permitted products, tea with milk;
• kefir and carrot cookies.

Wednesday

• steamed meat, oatmeal with milk and still water;
• an omelette with a small piece of bread and a drink;
• soup with sour cream and jelly;
• cottage cheese and tea;
• salad, boiled chicken;
• cottage cheese and jelly before bed.

Thursday

• biscuits with cheese;
• omelette, baked apple, compote;
• beef soufflé with pasta, dry biscuits and rosehip infusion;
• pureed apple;
• carrot and zucchini stew, tea with milk.

Friday

• oatmeal with bread, still mineral water;
• curd pudding, vinaigrette, tea;
• cream soup, buckwheat porridge, cottage cheese, drink;
• meatloaf, cottage cheese casserole, jelly;
• cottage cheese, tea with milk.

Saturday

• mashed potatoes with meatballs, tea;
• cottage cheese and jelly, drink;
• pumpkin porridge, a piece of dietary meat, salad and compote;
• egg white omelet;
• fish roll and drink;
• curdled milk with dry biscuits.

Sunday

• oatmeal porridge, meat soufflé and drink
• cottage cheese and tea;
• oatmeal soup, steamed cutlets with carrot and potato puree, baked apple;
• egg white omelette;
• meatballs with carrot puree and milk sauce, rosehip infusion;
• kefir before bed.

Diet 5b

The Pevzner diet has several options. 5b (or 5P No. 1) is a treatment method for diagnosing chronic pancreatic necrosis, prescribed during the recovery period, but not during an exacerbation of the disease.

The rules of diet 5b are similar to those already mentioned above. The difference lies in greater sparing of the stomach and the most frequent consumption of food.

It is better to steam vegetables and fruits or in the oven, and serve them in grated, crushed, peeled form.

If pancreatic necrosis is acute, then the child is required to fast for three days. Then steamed and boiled dishes, as well as alkaline mineral water, are introduced into the diet. A therapeutic diet for children lasts 1-6 months and is prescribed to the child by a doctor along with the use of medications and procedures.

Diet after pancreatic necrosis

After surgery and during rehabilitation, the patient adheres to a strict diet. So, after removal of necrotic formations, food and liquid intake is strictly prohibited for 4 days. Glucose, fats and amino acids are administered to the patient intravenously. In the next 5 days, the amount of liquid does not exceed 4 glasses per day. Then the 5P diet is prescribed, the duration of which is 20-30 days.