Removal of the gallbladder (cholecystectomy) is performed for a number of reasons, but the most common cause is the presence of stones in the gallbladder. After the operation, the problem was solved: there is no gallbladder or stones in it, however, such patients should keep a diet for the rest of their lives.
Basic dietary rules after cholecystectomy
Objectives of clinical nutrition after gallbladder removal:
- creation of maximum chemical reserves of the liver;
- improving bile secretion;
- ensuring the normal functioning of the liver, bile ducts and the entire gastrointestinal tract.
According to the order of the Ministry of Health, the diet after cholecystectomy in medical institutions corresponds to the main variant of the standard diet (ATD). According to the classification, diet after removal of the gallbladder is the number 5 treatment schedule.
Despite some limitations in the treatment schedule No. 5, the diet should be physiologically balanced, ie it should contain the necessary amount of vitamins and minerals.
Daily Food Ingredients:
- proteins - 85-90 g, of which 45-50 g are of animal origin;
- oils - 70-80 g, of which up to 25-30% are vegetable oils;
- carbohydrates - 300-330 g, simple sugars - no more than 30-40 g.
After removal of the gallbladder, the daily caloric intake of the treatment schedule is 2170-2400 kcal.
Basic principles of nutrition
- diet. Meals should be in fractions: 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 the bile does not stay in them. In addition, small portions of food do not burden the liver and other digestive organs, which helps prevent inflammation. At the same time, eating is especially important: thus, the function of both the liver and bile ducts is normalized. Small portions of food prevent the development of obesity, which is of great importance.
- Food processing. Food can be steamed, baked or boiled. Avoid cooking in the microwave, multivariates and double boilers are not prohibited. Sometimes cooking is allowed. In the first 45 days after the operation, the products are crushed and rubbed during cutting. Culinary processing of this type of food provides maximum mechanical savings of the liver and stomach, as well as has a beneficial effect on the entire digestive system.
- cooking temperature. Meals are served only hot (15-60 degrees Celsius). Excessive hot and cold foods cause spasms of the bile ducts, irritate the stomach and duodenum.
- salt and liquid. The use of sodium chloride is in accordance with the physiological norm (8-10 grams per day). Salty foods that irritate the gastrointestinal tract and cause fluid retention and therefore bile in the body are eliminated. Up to 2 liters of fluid should be consumed per day. It is recommended to drink 1 glass of alkaline mineral water without gas, which stimulates bile flow, 30 minutes before meals.
- alcohol. Alcohol should be avoided (with rare exceptions). Ethyl alcohol causes smooth muscle spasms and increases the tone of the bile ducts. In addition, in the absence of the gallbladder, the liver breaks down alcohol on its own, increasing the load on it. Systematic use of alcohol is dangerous not only with the return of previous problems with the gallbladder, but also with the development of cirrhosis of the liver.
- we eat delicious. Every meal should be beautifully arranged: on a table covered with tablecloths, with flowers, in a calm atmosphere. You need to chew each piece carefully and eat it slowly. This will allow you to get enough of the very medium parts, which has a beneficial effect on weight and provides minimal stress on the gastrointestinal tract.
First, after the gallbladder is removed, foods high in cholesterol should be excluded from the diet. It causes the bile to thicken and stagnate and helps stones to form.
Second, the consumption of animal (refractory) fats should be limited because bile does not contain most of the enzymes that break down fats after bladder removal.
You should also avoid products (extractives, spicy foods, marinades, etc. ) that increase the formation of bile and the secretion of gastric and duodenal juices. It is contraindicated to eat foods that remain in the intestines for a long time, causing putrefaction and fermentation, and stimulating the formation of gas.
Consumption of simple carbohydrates should also be limited: they are easily broken down, raise the level of "bad" cholesterol and accumulate in the form of fatty layers.
The list of banned products includes:
- bread made from premium flour, all pastries and fried pastries (pancakes, pancakes, pies, as well as cakes and pastries);
- cooking oil, margarine, lard any:
- rich broths and soups from them (meat, fish, poultry);
- fatty meat and poultry (goose, duck, pork, lamb), meat;
- oily fish (mackerel, sturgeon, catfish, burbot, salmon);
- canned meat and fish;
- whole sausage;
- liver (kidneys, liver, brain);
- fish caviar;
- sour and bitter vegetables (radishes, radishes, green onions, spinach, sorrel, daikon);
- fried eggs, egg yolks;
- marinades and pickles;
- smoked meat;
- spices: pepper, mustard, horseradish, vinegar, coriander and others;
- sour berries and fruits;
- ice cream, chocolate, cream products;
- strong tea, coffee, cocoa, sweet carbonated drinks, mineral carbonated waters;
- meals from public places (pizzas, hamburgers).
Foods recommended for consumption by a person who has undergone cholecystectomy should not be irritating and should not stimulate the gastrointestinal tract unnecessarily.
It should be used when cooking foods rich in pectins and lipotropic substances. Lipotropic substances break down cholesterol, preventing it from sinking into the walls of blood vessels (atherosclerosis) and accumulating in the bile, which leads to its thickening. Pectins, in turn, gently cover the mucous membranes of the digestive system, prevent the absorption of harmful substances, stimulate intestinal motility and have a therapeutic effect.
In addition, large amounts of plant fiber should be included in the patient's clinical diet after gallbladder removal. It contains not only vitamins, but also stimulates intestinal motility, prevents flatulence, constipation and storage of nutrients there.
We should not forget about fermented dairy products, because they are a source of valuable animal protein and calcium, contain live bacteria that have a beneficial effect on the intestinal microflora.
The list of allowed products includes:
- yesterday's or dried bread, crackers, biscuits, crackers;
- soups in secondary broths, soups over vegetable broth;
- lean meat and poultry (turkey, chicken, veal, rabbit, beef);
- ham from unsalted and low-fat varieties;
- both crushed and semi-viscous cereals (buckwheat, oatmeal);
- all seafood as a source of iodine, which neutralizes cholesterol;
- lean fish (sturgeon, trout, salmon) as a source of polyunsaturated fatty acids;
- steamed protein omelet;
- vegetable oils, butter in containers;
- cottage cheese, kefir, cottage cheese, "live" yogurt, unsalted and low-fat cheeses;
- fruits and berries (very sweet and sour in processed form: kissels, mousses, jellies, compotes);
- jam, marmalade, chalk;
- fresh herbs, tomatoes, cucumbers, sweet peppers, squash, beets, zucchini, potatoes, carrots;
- milk or lemon tea, weak coffee, mineral alkaline waters, juices and fruit drinks;
- salted salmon, jelly fish, vinaigrette, soaked herring, fresh vegetable salads.
Adherence to the diet after cholecystectomy allows to maintain the condition of the liver and bile secretion in an optimal mode, normalizes the functioning of the entire digestive system, prevents such unpleasant moments that often occur after removal of the gallbladder, such as edema. , constipation and bitterness in the mouth.
Also, therapeutic nutrition after gallbladder removal prevents the development of atherosclerosis, improves the appearance of patients and stabilizes their weight.
Consequences of not following a diet
If the diet is not followed after removal of the gallbladder, postcholecystectomy syndrome will not last long, it is a collective concept and includes the exacerbation of previous diseases of the digestive system and the emergence of new ones.
In addition, people who neglect their diet after surgery risk not only their appearance (obesity, hypovitaminosis), but also the health of other body systems.