Removal of the gallbladder (cholecystectomy) is done for a number of reasons, but the most common reason is the presence of stones in the gallbladder. After the operation, the problem was solved: there are no gallbladders and stones, however, such patients have to follow a lifelong diet.
Basic dietary rules after a cholecystectomy
The objectives pursued by clinical nutrition after removal of the gallbladder are:
- creation of maximum chemical sparing of the liver;
- improvement of bile separation;
- ensure 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, the diet after removal of the gallbladder is treatment table No. 5.
Despite some restrictions in treatment table No. 5, the diet should be physiologically balanced, that is, contain the required amount of vitamins and minerals.
Daily Nutrient Content:
- protein - 85-90g, of which 45-50g is protein of animal origin;
- fats - 70-80g, of which up to 25-30% are vegetable fats;
- carbohydrates - 300-330g and simple sugars - no more than 30-40g.
The daily calorie content of the treatment table after removal of the gallbladder is 2170-2400 kilocalories.
Nutrition Basics
- 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 they must be emptied in time so that the bile does not stagnate there. In addition, small portions of food do not burden the liver and other digestive organs, which helps to avoid inflammation. It is especially important to eat at the same time: thus the work of the liver and bile ducts is normalized. Small portions of food prevent the development of obesity, which is of great importance.
- food preparation. Foods can be steamed, baked or boiled. Microwave cooking is to be avoided, multicookers and double boilers are not prohibited. Sometimes food stew 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 sparing of the liver and stomach, and also has a beneficial effect on the entire digestive tract.
- food temperature. Dishes are served only lukewarm (15-60 degrees Celsius). Excessively hot and cold foods cause spasms of the bile ducts, 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. 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 gas, which stimulates the outflow of bile.
- alcohol. Alcohol consumption will have to be abandoned (with rare exceptions). Ethyl alcohol causes smooth muscle spasms and increases the tone of the bile ducts. In addition, in the absence of a gallbladder, the liver breaks down alcohol on its own, its load increases. The systematic use of alcoholic beverages is dangerous not only by the return of previous problems with the gallbladder, but also by the development of cirrhosis of the liver.
- we eat delicious. Each meal must be beautifully laid out: at a table covered with a flowered tablecloth, in a calm atmosphere. Eat slowly, chewing each piece carefully. This will allow you to get enough very moderate portions, which will have a beneficial effect on weight and provide minimal stress on the gastrointestinal tract.
Prohibited products
First of all, from the diet after the removal of the gallbladder, it is necessary to exclude foods with a high content of cholesterol. It is he who causes the thickening and stagnation of bile and promotes the formation of stones.
Second, since most fat-breaking enzymes are absent from the composition of bile after bladder removal, consumption of (refractory) animal fats should be limited.
You should also avoid products that promote the formation of bile and the secretion of gastric and duodenal juices (extractive substances, spicy dishes, marinades and others). It is contraindicated to eat foods that linger in the intestines for a long time, causing putrefaction and fermentation, stimulating gas formation.
The consumption of simple carbohydrates should also be limited: they break down easily, increase the rate of "bad" cholesterol and are deposited in the form of fatty layers.
The list of prohibited products includes:
- bread made from premium flour, all pastries and fried dough products (crepes, pancakes, pies, as well as cakes and pastries);
- cooking oil, margarine, lard
- rich broths and soups from them (meat, fish, poultry);
- fatty meat and poultry (goose, duck, pork, lamb), tender meat;
- fatty fish (mackerel, sturgeon, catfish, monkfish, salmon);
- canned meat and fish;
- all sausages;
- liver (kidneys, liver, brains);
- fish caviar;
- sour and bitter vegetables (radish, radish, green onion, spinach, sorrel, daikon);
- fried eggs, egg yolks;
- pickles and pickles;
- smoked meats;
- 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;
- collective catering dishes (pizzas, hamburgers).
Approved products
Dishes recommended for consumption by a person who has undergone cholecystectomy should not be irritating and unnecessarily stimulate the gastrointestinal tract.
It is necessary to use it 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, plant fibers should be included in large quantities. It not only contains vitamins, but also stimulates intestinal motility, preventing flatulence, constipation and retention of food masses.
We should not forget about fermented milk products, since they are valuable sources of animal protein and calcium, contain live bacteria that have a beneficial effect on the intestinal microflora.
The list of authorized products includes:
- day old or dried bread, crackers, cookies, crackers;
- soups on secondary broths, soups on vegetable broths;
- lean meats and poultry (turkey, chicken, veal, rabbit, beef);
- ham of unsalted and low-fat varieties;
- crumbly and semi-viscous cereals (buckwheat, oatmeal);
- all seafood, as a source of iodine which neutralizes cholesterol;
- lean fish (pike, trout, salmon) as a source of polyunsaturated fatty acids;
- steamed protein omelette;
- vegetable oils, butter in dishes;
- cottage cheese, kefir, curd, "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 greens, tomatoes, cucumbers, peppers, pumpkin, beets, zucchini, potatoes, carrots;
- tea with milk or lemon, light coffee, alkaline mineral waters, juices and fruit drinks;
- salted salmon, fish jelly, vinaigrette, soaked herring, fresh vegetable salads.
The need for a diet
Dieting after cholecystectomy allows you to maintain the state of 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 afterremoval of the gallbladder, such as bloating, constipation and bitterness in the mouth.
In addition, therapeutic nutrition after gallbladder removal 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 the removal of the gallbladder, the postcholecystectomy syndrome will not take long, which is a collective concept and includes the exacerbation of previous diseases of the digestive tract and the emergence of new ones.
In addition, people who neglect the diet after surgery risk not only their appearance (obesity, hypovitaminosis), but also the health of other bodily systems.