Gallbladder removal (cholecystectomy) is done for several 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 stones in it, but such patients have to follow a diet all their lives.
Basic rules of nutrition after cholecystectomy
The goals of the clinical diet after gallbladder removal are:
- creating maximum chemical sparing of the liver;
- improving bile secretion;
- ensures 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 version of the standard diet (ATD). According to the classification, the diet after gallbladder removal is the treatment table no. 5.
Despite some limitations in the treatment table no. 5, the diet should be physiologically balanced, ie contain the required amount of vitamins and minerals.
Daily nutrient content:
- proteins - 85-90g, of which 45-50g are proteins 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 content of calories in the treatment table after gallbladder removal 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, so they must be emptied in time so that the bile does not stagnate in them. 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: this normalizes the work of both 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 cooked. Microwave cooking should be avoided; multicookers and steam 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 food processing enables maximum mechanical savings of the liver and stomach, and has a beneficial effect on the entire digestive tract.
- food temperature. Meals are served only hot (15-60 degrees Celsius). Too hot and cold food causes spasm of the biliary tract, irritates the stomach and duodenum.
- salts and liquids. The use of sodium chloride corresponds to the physiological norm (8-10 grams per day). Salty foods that irritate the gastrointestinal tract and cause fluid stagnation, and thus bile in the body, are excluded. Fluid should be consumed up to 2 liters per day. 30 minutes before eating it is recommended to drink 1 glass of alkaline mineral water without gas, which stimulates bile flow.
- alcohol. Drinking alcohol will have to be abandoned (with rare exceptions). Ethyl alcohol causes smooth muscle spasms and increases the tone of the biliary tract. In addition, in the absence of the gallbladder, the liver itself breaks down alcohol, the load on it increases. Systematic use of alcoholic beverages is dangerous not only with the return of previous problems with the gallbladder, but also with the development of liver cirrhosis.
- we eat delicious. Every meal should be nicely arranged: at a table covered with a tablecloth, with flowers, in a peaceful atmosphere. It is necessary to eat slowly, carefully chewing each piece. This will allow you to get enough in very moderate portions, which will have a beneficial effect on weight and ensure minimal stress on the gastrointestinal tract.
Prohibited products
First of all, it is necessary to exclude from the diet after the removal of the gallbladder foods high in cholesterol. It is the one that causes thickening and stagnation of bile and stimulates the formation of stones.
Secondly, since most enzymes that break down fats are missing in the composition of bile after the removal of the bladder, the consumption of animal (refractory) fats should be limited.
Products that promote the formation of bile and the secretion of gastric and duodenal juices (extracts, spicy foods, marinades, etc. ) should also be avoided. It is contraindicated to eat food that stays in the intestines for a long time, causing putrefaction and fermentation, stimulating the formation of gases.
Consumption of simple carbohydrates should also be limited: they are easily broken down, raise the level of "bad" cholesterol, and are deposited in the form of fat deposits.
The list of prohibited products includes:
- bread made from premium flour, all pastries and toasted products (pancakes, pancakes, pies, as well as cakes and pastries);
- edible oil, margarine, lard of any kind:
- rich soups and soups thereof (meat, fish, poultry);
- fatty meat and poultry (goose, duck, pork, lamb), tough 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 onion, 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, mineral carbonated water;
- legumes;
- dishes from public places (pizzas, burgers).
Approved products
Dishes that are recommended for people who have undergone cholecystectomy should not be irritating and unnecessarily stimulate the gastrointestinal tract.
It is necessary to use when cooking foods that are rich in pectins and lipotropic substances. Lipotropic substances break down cholesterol, prevent its deposition on the walls of blood vessels (atherosclerosis) and accumulation in bile, which causes it to thicken. Pectins, in turn, gently envelop the mucous membrane of the digestive tract, prevent the absorption of harmful substances, stimulate intestinal motility and have a healing effect.
In addition, in the clinical diet of patients after removal of the gallbladder, plant fiber should be included in large quantities. It not only contains vitamins, but also stimulates intestinal motility, preventing bloating, constipation and retention of food masses in it.
We should not forget fermented dairy products, because they are sources of valuable animal proteins and calcium, they 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 on secondary broth, soups on vegetable broth;
- lean meat and poultry (turkey, chicken, veal, rabbit, beef);
- unsalted and lean ham 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, sour milk, "live" yogurt, unsalted and low-fat cheeses;
- fruits and berries (very sweet and sour in processed form: pickles, foams, jellies, compotes);
- jam, marmalade, chalk;
- fresh greens, tomatoes, cucumbers, sweet peppers, pumpkins, beets, zucchini, potatoes, carrots;
- tea with milk or lemon, weak coffee, alkaline mineral waters, juices and fruit drinks;
- salted salmon, fish jelly, vinaigrette, soaked herring, fresh vegetable salads.
The need for a diet
Adherence to a diet after cholecystectomy allows you to maintain the condition of the liver and bile secretion in the optimal mode, normalizes the work of the entire digestive tract, prevents the occurrence of such unpleasant moments that often occur after removal of the gallbladder, such as bloating. , constipation and bitterness in the mouth.
Also, a therapeutic diet after gallbladder removal 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, the post-cholecystectomy syndrome will not last long, which is a collective term and includes the worsening of previous diseases of the digestive tract 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.