Removal of the gallbladder (cholecystectomy) is performed 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 is no gallbladder and no stones in it, however, such patients must follow a diet throughout their lives.
Basic dietary rules after cholecystectomy
The goals pursued by clinical nutrition after removal of the gallbladder are:
- creation of maximum chemical sparing of the liver;
- improvement of the separation of bile;
- 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 the treatment table No. 5, the diet should be physiologically balanced, that is, contain the required amount of vitamins and minerals.
Daily Nutrient Content:
- proteins - 85-90g, 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 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, they must be emptied in time so that 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: thus, the work of both the liver and the 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. Microwave cooking should be avoided; multicookers and double boilers are not forbidden. Occasionally, food stewing 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 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 fluid stagnation, and hence 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 alkaline mineral water without gas, which stimulates the flow of bile.
- alcohol. Drinking alcohol will have to be abandoned (with rare exceptions). Ethyl alcohol causes spasms of smooth muscles, and increases the tone of the biliary tract. In addition, in the absence of the gallbladder, the liver alone breaks down alcohol, the load on it 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 should be beautifully arranged: at 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 of 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 removal of the gallbladder, it is necessary to exclude foods with a high content of cholesterol. It is he who causes thickening and stagnation of bile and promotes stone formation.
Secondly, since most of the enzymes that break down fats are absent in the composition of bile after removal of the bladder, the consumption of animal (refractory) fats should be limited.
You should also avoid products that enhance bile formation and 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 also needs to be limited: they are easily broken down, increasing the level 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 (pancakes, pancakes, pies, as well as cakes and pastries);
- 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, brains);
- fish caviar;
- sour and bitter vegetables (radish, radish, green onion, spinach, sorrel, daikon);
- fried eggs, egg yolks;
- marinades 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, mineral sparkling waters;
- legumes;
- dishes from public food outlets (pizzas, hamburgers).
Approved Products
Dishes that are recommended to be consumed by a person who has 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 its thickening. Pectins, in turn, gently envelop the mucous membranes of the digestive tract, prevent the absorption of harmful substances, stimulate the intestinal motility and have a healing effect.
In addition, in the clinical nutrition of the patient after removal of the gallbladder, plant fiber should be included in large quantities. It not only contains vitamins, but also stimulates intestinal motility, preventing flatulence, constipation and retention of food masses in it.
We should not forget about fermented milk products, because they are sources 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 on secondary broths, soups on vegetable broth;
- lean meats 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, curdled milk, "live" yogurt, unsalted and low-fat cheeses;
- fruits and berries (very sweet and sour in processed form: kissels, mousses, jelly, compotes);
- jam, marmalade, chalk;
- fresh greens, tomatoes, cucumbers, sweet peppers, pumpkin, beets, zucchini, potatoes, carrots;
- tea with milk or lemon, weak coffee, mineral alkaline 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 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 not following the diet
If the diet is not followed after the removal of the gallbladder, postcholecystectomy syndrome will not take long, which is a collective concept and includes 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 body systems.