Removal of the gallbladder (cholecystectomy) is performed for a number of reasons, but the most common reason is the presence of gallstones. After the operation the problem is solved: there is no gallbladder and stones in it, but such patients must follow a diet throughout their lives.
Basic dietary rules after cholecystectomy
The goals pursued by clinical nutrition after gallbladder removal are:
- creating maximum savings of liver chemicals;
- improving bile secretion;
- ensuring 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 basic version of the standard diet (ATD). According to the classification, the diet after removal of the gallbladder is a healing mass №5.
Despite some limitations in the healing mass No. 5, the diet must be physiologically balanced, ie contain the necessary 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 removal of the gallbladder is 2170-2400 kilocalories.
Basic principles of nutrition
- diet. Food should be partial: 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: in this way 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. The food can be steamed, baked or cooked. Microwave cooking should be avoided; multicookers and double boilers are not prohibited. Food suffocation is sometimes allowed. During 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. Meals are served only warm (15-60 degrees Celsius). Excessively hot and cold foods cause spasm 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 fluid retention, and hence bile in the body, are excluded. The liquid should be consumed up to 2 liters per day. 30 minutes before a meal it is recommended to drink 1 glass of alkaline mineral water without gas, which stimulates the outflow of bile.
- alcohol. Drinking alcohol 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 the gallbladder, the liver itself breaks down alcohol, the load on it increases. Systematic use 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: on a table covered with a tablecloth, with flowers, in a relaxed atmosphere. It is necessary to eat slowly, carefully chewing each piece. This will allow you to enjoy very moderate portions, which will have a beneficial effect on weight and will provide a minimum load on the gastrointestinal tract.
Prohibited products
First of all, it is necessary to exclude foods high in cholesterol from the diet after removal of the gallbladder. It causes thickening and stagnation of bile and promotes the formation of stones.
Second, because most of the enzymes that break down fats are missing from the bile after removal of the bladder, the consumption of animal (refractory) fats should be limited.
You should also avoid products that increase the formation of bile and the secretion of gastric and duodenal juices (extractives, spicy dishes, marinades, etc. ). It is contraindicated to eat foods that stay in the intestines for a long time, causing putrefaction and fermentation, stimulating the formation of gas.
Consumption of simple carbohydrates should also be limited: they are easily broken down, increasing the level of "bad" cholesterol and deposited in the form of fat layers.
The list of prohibited products includes:
- first-class flour bread, all pastries and fried pasta (pancakes, pancakes, pies, as well as pastries and cakes);
- oil, margarine, lard of all kinds:
- rich broths and soups thereof (meat, fish, poultry);
- fatty meats and poultry (goose, duck, pork, lamb), tough meat;
- oily fish (mackerel, sturgeon, catfish, mime, salmon);
- canned meat and fish;
- all sausages;
- liver (kidneys, liver, brain);
- fish caviar;
- sour and bitter vegetables (radishes, radishes, green onions, spinach, sorrel, daikon);
- fried eggs, egg yolks;
- pickles and pickles;
- smoked meats;
- spices: pepper, mustard, horseradish, vinegar, coriander and others;
- sour fruits and berries;
- ice cream, chocolate, cream products;
- strong tea, coffee, cocoa, sweet carbonated drinks, mineral carbonated water;
- legumes;
- dishes from public catering establishments (pizzas, hamburgers).
Approved products
Meals that are recommended for a person who has undergone a cholecystectomy should not irritate or stimulate the gastrointestinal tract unnecessarily.
It is necessary to use in 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 the 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.
In addition, after the removal of the gallbladder, plant fibers should be included in large quantities in the patient's clinical diet. It not only contains vitamins, but also stimulates intestinal motility, preventing the formation of gas, constipation and retention of nutrients in it.
We should not forget about fermented dairy products, as they are sources of valuable animal proteins and calcium, contain live bacteria that have a beneficial effect on the intestinal microflora.
The list of permitted products includes:
- yesterday's or dried bread, crackers, biscuits, crackers;
- soups of secondary broths, soups of vegetable broth;
- lean meat and poultry (turkey, chicken, beef, rabbit, beef);
- unsalted and low-fat ham;
- cereals, both crumbly and semi-viscous (buckwheat, oats);
- all seafood, as a source of iodine, which neutralizes cholesterol;
- lean fish (pike, trout, salmon) as a source of polyunsaturated fatty acids;
- a pair of protein omelets;
- vegetable oils, butter in dishes;
- cottage cheese, kefir, fermented milk, "live" yogurt, unsalted and low-fat cheeses;
- fruits and berries (very sweet and sour in processed form: kisses, mousses, jellies, compotes);
- jam, marmalade, chalk;
- fresh vegetables, tomatoes, cucumbers, sweet peppers, pumpkin, beets, zucchini, potatoes, carrots;
- tea with milk or lemon, weak coffee, alkaline mineral waters, juices and fruit drinks;
- salted salmon, jelly fish, vinaigrette, soaked herring, fresh vegetable salads.
The need for diet
Adherence to a diet after cholecystectomy allows you to maintain the condition of the liver and bile secretion in optimal mode, normalizes the functioning of the entire digestive tract, prevents the appearance of such unpleasant moments that often occur after removal of the gallbladder, such as bloating, constipationand 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 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.