Gallbladder removal (cholecystectomy) is done for a number of reasons, but the most common reason is gallbladder stones. After the operation, the problem was solved: there is no gallbladder and no stones, however, these patients must follow a diet throughout their lives.
Basic dietary rules after cholecystectomy.
The objectives pursued by clinical nutrition after removal of the gallbladder are:
- creation of the maximum chemical savings of the liver;
- improvement of bile separation;
- ensuring the normal functioning of the liver, biliary tract and the entire gastrointestinal tract.
According to the order of the Ministry of Health, dietary nutrition after cholecystectomy in medical institutions corresponds to the main version of the standard diet (ATD). According to the classification, the diet after removal of the gallbladder is treatment table No. 5.
Despite some restrictions in treatment table No. 5, the diet must be physiologically balanced, that is, contain the required amount of vitamins and minerals.
Daily nutrient content:
- protein - 85-90 g, of which 45-50 g is protein of animal origin;
- fats - 70-80 g, of which up to 25-30% are vegetable fats;
- carbohydrates - 300-330g, and simple sugars - no more than 30-40g.
The daily caloric content of the treatment table after removal of the gallbladder is 2170-2400 kilocalories.
Basic principles of nutrition.
- diet. Meals should be divided: up to 4-6 times a day, in small portions. Although there is no gallbladder, the bile ducts are preserved and therefore must be emptied in time so that bile does not stagnate in them. In addition, small portions of food do not overload the liver and other digestive organs, which helps prevent inflammation. It is especially important to eat at the same time: thus, the work of both the liver and the biliary tract is normalized. Small portions of food prevent the development of obesity, which is of great importance.
- food processingFood can be steamed, baked or boiled. Microwave cooking should be avoided; multicookers and double boilers are not prohibited. Occasionally stewing food is allowed. In the first 45 days after the operation, when cutting, the products are crushed and rubbed. This type of culinary processing of food provides maximum mechanical preservation of the liver and stomach, and also has a beneficial effect on the entire digestive tract.
- food temperature Dishes are served only warm (15-60 degrees Celsius). Excessively hot and cold foods cause spasm of the biliary tract, irritate the stomach and duodenum.
- salt and liquid. The use of sodium chloride corresponds to the physiological norm (8-10 grams per day). Salty foods that irritate the gastrointestinal tract and cause stagnation of fluids, and therefore bile in the body, are excluded. Liquids should be consumed up to 2 liters per day. 30 minutes before meals, it is recommended to drink 1 glass of non-carbonated alkaline mineral water, which stimulates the flow of bile.
- alcohol. Alcohol consumption will have to be abandoned (with rare exceptions). Ethyl alcohol causes spasm of smooth muscles and increases the tone of the bile ducts. Also, in the absence of the gallbladder, the liver only breaks down alcohol and increases the load. The systematic use of alcoholic beverages is dangerous not only because of the recurrence of previous problems with the gallbladder, but also because of the development of liver cirrhosis.
- we eat delicious. Each meal should be beautifully arranged: on a table covered with a tablecloth, with flowers, in a calm atmosphere. It is necessary to eat slowly, carefully chewing each piece. This will allow you to get enough very moderate servings, which will have a beneficial effect on weight and provide minimal stress on the GI tract.
Prohibited Products
First of all, from the diet after removal of the gallbladder, it is necessary to exclude foods with a high content of cholesterol. It is he who provokes the thickening and stagnation of bile and promotes the formation of stones.
Second, since most of the enzymes that break down fats are absent in the composition of bile after removal from the bladder, the consumption of animal (refractory) fats should be limited.
You should also avoid products that favor the formation of bile and the secretion of gastric and duodenal juices (extractive substances, spicy dishes, marinades and others). It is contraindicated to eat food that remains in the intestines for a long time, causing putrefaction and fermentation, stimulating the formation of gases.
It is also necessary to limit the consumption of simple carbohydrates - they break down easily, raise the level of "bad" cholesterol and are deposited in the form of fatty layers.
The list of prohibited products includes:
- bread made from top-quality flour, all baked goods and fried dough (pancakes, pancakes, tarts, as well as tarts and cakes);
- cooking oil, margarine, lard any:
- rich broths and soups from them (meat, fish, poultry);
- fatty meats and poultry (goose, duck, pork, lamb), sinewy meat;
- fatty fish (mackerel, sturgeon, catfish, burbot, salmon);
- canned meat and fish;
- all sausages;
- liver (kidneys, liver, brain);
- fish caviar;
- sour and bitter vegetables (radish, radish, green onions, spinach, sorrel, daikon);
- fried eggs, egg yolks;
- marinades and pickles;
- smoked meats;
- spices - pepper, mustard, horseradish, vinegar, coriander and others;
- berries and sour fruits;
- ice cream, chocolate, cream products;
- strong tea, coffee, cocoa, sweet carbonated drinks, sparkling mineral waters;
- vegetables;
- dishes from food outlets to the public (pizzas, hamburgers).
approved products
The dishes that are recommended to be consumed by a person who has undergone a cholecystectomy should not be irritating and unnecessarily stimulate the gastrointestinal tract.
It is necessary to use when cooking foods rich in pectins and lipotropic substances. Lipotropic substances break down cholesterol, prevent its deposition on the walls of blood vessels (atherosclerosis) and its accumulation in bile, which causes its thickening. Pectins, in turn, gently envelop the mucous membranes of the digestive tract, prevent the absorption of harmful substances, stimulate intestinal motility and have a healing effect.
Also, in the clinical nutrition of the patient after removal of the gallbladder, vegetable fiber should be included in large quantities. It not only contains vitamins, but also stimulates intestinal motility, preventing flatulence, constipation and the retention of food masses in it.
We should not forget about fermented milk products, as they are sources of valuable animal protein and calcium, they contain live bacteria that have a beneficial effect on the intestinal microflora.
The list of permitted products includes:
- yesterday or dry bread, crackers, biscuits, crackers;
- soups on secondary broths, soups on vegetable broths;
- lean meats and poultry (turkey, chicken, beef, rabbit, veal);
- ham of salt-free and low-fat varieties;
- cereals, both crumbly and semi-viscous (buckwheat, oatmeal);
- all shellfish, as a source of cholesterol-neutralizing iodine;
- lean fish (pike, trout, salmon) as a source of polyunsaturated fatty acids;
- steamed protein omelette;
- vegetable oils, butter in dishes;
- cottage cheese, kefir, curdled milk, "live" yogurt, salt-free and low-fat cheeses;
- fruits and berries (very sweet and sour in processed form: kisses, mousses, jelly, compotes);
- jam, marmalade, chalk;
- fresh vegetables, tomatoes, cucumbers, sweet peppers, pumpkin, beets, zucchini, potatoes, carrots;
- tea with milk or lemon, weak coffee, alkaline mineral waters, juices and fruit drinks;
- salted salmon, jellied fish, vinaigrette, soaked herring, fresh vegetable salads.
The need for a diet.
Following a diet after cholecystectomy allows you to maintain the condition of the liver and bile secretion in the optimal mode, normalizes the functioning of the entire digestive tract, prevents the occurrence of such unpleasant moments that often occur after removal of the gallbladder, such as swelling. , constipation and bitterness in the mouth.
Also, therapeutic nutrition after removal of the gallbladder prevents the development of atherosclerosis, improves the appearance of patients and stabilizes their weight.
Consequences of not following the diet
If the diet is not followed after removal of the gallbladder, it will not be long before the post-cholecystectomy syndrome, which is a collective concept and includes the exacerbation of previous diseases of the digestive tract and the appearance of new ones.
In addition, people who neglect their diet after surgery put at risk not only their appearance (obesity, hypovitaminosis), but also the health of other body systems.