Gallbladder removal (cholecystectomy) is performed for a variety of reasons, but the most common reason is the presence of stones in the gallbladder. After the operation, the problem was solved: there is no gallbladder and no stones in it, but such patients have to follow a diet all their lives.
Basic dietary rules after cholecystectomy
The goals of clinical nutrition after gallbladder removal are:
- creating maximum chemical sparing of the liver;
- improve the separation of bile;
- Ensuring the normal functioning of the liver, bile ducts 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, post-gallbladder removal diet is treatment chart #5.
Despite some limitations in treatment table No. 5, the diet should be physiologically balanced, that is, contain the required amount of vitamins and minerals.
Daily nutrient content:
- proteins - 85-90 g, of which 45-50 g are proteins of animal origin;
- fats - 70-80 g, of which up to 25-30% vegetable fats;
- Carbohydrates - 300-330 g, and simple sugars - no more than 30-40 g.
The daily calorie content of the treatment table after removal of the gallbladder is 2170-2400 kilocalories.
basic principles of nutrition
- Diet. Meals should be fractional: 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 stagnate in them. Also, small portions of food do not put a strain on the liver and other digestive organs, which helps prevent inflammation. It is especially important to eat at the same time: this will normalize the work of the liver and bile ducts. Small portions of food prevent the development of obesity, which is of great importance.
- food processing. Food can be steamed, baked or boiled. Microwave cooking should be avoided, multi-cookers and double-cookers are not prohibited. Occasionally braising food is permitted. In the first 45 days after the operation, the products are crushed and grated when cutting. This type of culinary processing of the food ensures maximum mechanical protection of the liver and stomach and also has a beneficial effect on the entire digestive tract.
- food temperature. Food is only served warm (15-60 degrees Celsius). Excessively hot and cold food causes spasms in the bile ducts and irritates the stomach and duodenum.
- salt and liquid. The use of sodium chloride corresponds to the physiological norm (8-10 grams per day). Excluded are salty foods, which irritate the gastrointestinal tract and cause fluid and bile to build up in the body. Fluids should be consumed up to 2 liters per day. 30 minutes before meals it is recommended to drink 1 glass of alkaline mineral water without flatulence, which stimulates bile flow.
- Alcohol. Alcohol must be avoided (with rare exceptions). Ethyl alcohol causes smooth muscle spasms and increases bile duct tone. In addition, in the absence of the gallbladder, the liver breaks down alcohol on its own, the load on it increases. Systematic consumption of alcoholic beverages is dangerous not only from the return of previous problems with the gallbladder, but also from the development of cirrhosis of the liver.
- we eat delicious. Each meal should be beautifully arranged: at a table with a tablecloth, with flowers, in a calm atmosphere. It is necessary to eat slowly, carefully chewing each piece. This allows you to get enough from very moderate portions, which has a positive effect on weight and minimal stress on the gastrointestinal tract.
Prohibited Products
First, foods high in cholesterol must be eliminated from the diet after gallbladder removal. It causes thickening and stagnation of bile and promotes stone formation.
Second, since most lipolytic enzymes are absent from the composition of bile after removal of the bladder, consumption of animal (refractory) fats should be limited.
Also avoid products that promote bile formation and the secretion of gastric and duodenal juices (extractives, spicy dishes, marinades and others). It is contraindicated to eat foods that remain in the intestines for a long time, causing putrefaction and fermentation, stimulating gas formation.
The consumption of simple carbohydrates must also be limited: they are broken down easily, increase "bad" cholesterol levels and are deposited in the form of layers of fat.
The list of prohibited products includes:
- Bread made from fine flour, all baked goods (pancakes, pancakes, pies and cakes and pastries);
- cooking oil, margarine, lard all:
- rich broths and soups from it (meat, fish, poultry);
- fatty meat and poultry (goose, duck, pork, lamb), stringy 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, radishes, green onions, spinach, sorrel, daikon);
- fried eggs, 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, carbonated mineral waters;
- Legumes;
- Food from public catering establishments (pizza, hamburgers).
Approved Products
Dishes recommended for consumption by a person after a cholecystectomy should not irritate 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 deposit on the walls of blood vessels (atherosclerosis) and accumulation in the bile, which leads to its thickening. Pectins, in turn, gently envelop the mucous membranes of the digestive tract, prevent the absorption of harmful substances, stimulate intestinal movement and have a healing effect.
In addition, in the clinical diet of the patient after removal of the gallbladder, plant fibers should be included in large quantities. It contains not only vitamins, but also stimulates intestinal motility, prevents flatulence, constipation and the accumulation of food masses in it.
We should not forget about fermented milk products, since they are sources of valuable animal protein and calcium, and contain live bacteria that have a beneficial effect on the intestinal microflora.
The list of approved products includes:
- Yesterday's bread or dried, crackers, biscuits, crackers;
- secondary broth soups, vegetable broth soups;
- lean meat and poultry (turkey, chicken, veal, rabbit, beef);
- Ham of unsalted and low-fat varieties;
- Cereals, both crumbly and semi-viscous (buckwheat, oatmeal);
- all seafood as a source of iodine that neutralizes cholesterol;
- lean fish (pike, trout, salmon) as a source of polyunsaturated fatty acids;
- steam protein omelet;
- vegetable oils, butter in dishes;
- Cottage cheese, kefir, curds, "live" yogurt, unsalted and low-fat cheese;
- Fruits and berries (very sweet and sour in processed form: kissels, mousses, jellies, compotes);
- jam, marmalade, chalk;
- fresh vegetables, tomatoes, cucumbers, peppers, squash, beets, zucchini, potatoes, carrots;
- tea with milk or lemon, weak coffee, mineral alkaline waters, juices and fruit drinks;
- salted salmon, fish jelly, vinaigrette, soaked herring, fresh vegetable salads.
The need for a diet
Following a diet after cholecystectomy allows you to maintain the state of the liver and bile secretion in the optimal mode, normalizes the functioning of the entire digestive tract and prevents the occurrence of such unpleasant moments that often occur after gallbladder removal, such as: B. Bloating, 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 non-compliance with the diet
If the diet is not followed after the removal of the gallbladder, then postcholecystectomy syndrome does not last long, 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 post-operative nutrition risk not only their appearance (obesity, hypovitaminosis), but also the health of other body systems.