Removal of the gallbladder (cholecystectomy) is done 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 or stones, however, such patients have to follow a diet for life.
Basic dietary rules after cholecystectomy
The objectives pursued by clinical nutrition after the removal of the gallbladder are:
- creation of the maximum chemical savings of the liver;
- improved separation of bile;
- ensuring the normal functioning of the liver, biliary tract and the entire gastrointestinal tract.
According to the ordinance 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 the 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:
- proteins - 85-90 g, of which 45-50 g are proteins of animal origin;
- fats - 70-80 g, of which up to 25-30% are vegetable fats;
- carbohydrates - 300-330 g, and simple sugars - no more than 30-40 g.
The daily calorie content of the bed after the 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. 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 is to be avoided, multi-cooking and double boilers are not prohibited. Food stew is occasionally 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 saving of the liver and stomach, and also has a beneficial effect on the entire digestive tract.
- food temperature. Dishes are served only hot (15-60 degrees Celsius). Excessively hot and cold foods cause spasms 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 stagnation of fluids, and therefore 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. Alcohol consumption 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 alone breaks down alcohol, the load on it increases. Systematic use of alcoholic beverages is dangerous not only for the return of previous problems with the gallbladder, but also for the development of cirrhosis of the liver.
- we eat delicious. Every meal should be beautifully organized: 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 take in 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 removing the gallbladder, it is necessary to exclude foods with a high cholesterol content. It is he who causes thickening and stagnation of bile and promotes the formation of stones.
Second, since most of the fat-breaking enzymes are absent in the bile composition after bladder removal, the consumption of (refractory) animal fats should be limited.
You should also avoid products that improve 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 for a long time in the intestines, causing putrefaction and fermentation, stimulating the formation of gas.
Even the consumption of simple carbohydrates must be limited: they break down easily, raising the level of "bad" cholesterol, and are deposited in the form of layers of fat.
The list of prohibited products includes:
- bread made with first quality flour, all pastries and fried dough products (pancakes, pancakes, pies, as well as cakes and pastries);
- cooking oil, margarine, any lard:
- rich broths and soups from them (meat, fish, poultry);
- fatty meats and poultry (goose, duck, pork, lamb), muscular meats;
- 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, 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, carbonated mineral waters;
- legumes;
- dishes from public food establishments (pizzas, hamburgers).
Approved products
The 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 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 the bile, which causes it to thicken. 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.
In addition, in the clinical nutrition of the patient after the removal of the gallbladder, vegetable 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 inside.
We must not forget about fermented milk 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 dry bread, crackers, biscuits, crackers;
- soups on secondary broths, soups on vegetable broth;
- lean meats and poultry (turkey, chicken, veal, rabbit, beef);
- unsalted and lean variety ham;
- cereals, both crumbly and semi-viscous (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;
- ricotta, kefir, curdled milk, "live" yogurt, unsalted and low-fat cheeses;
- fruit and berries (very sweet and sour in transformed form: kisses, mousse, jelly, compotes);
- jam, jam, chalk;
- fresh vegetables, tomatoes, cucumbers, sweet peppers, squash, beets, zucchini, potatoes, carrots;
- milk or lemon tea, weak coffee, alkaline mineral 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 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 swelling , constipation and bitterness in the mouth.
In addition, therapeutic nutrition after the 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, the postcholecystectomy syndrome will not take long, which 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 the diet after surgery risk not only their appearance (obesity, hypovitaminosis), but also the health of other body systems.