Removal of the gallbladder (cholecystectomy) is performed for several reasons, but the most common reason is the presence of stones in the gallbladder. After the operation, the problem was resolved: there is no gallbladder and no stones in it, however, these patients must follow a lifelong diet.
Basic dietary rules after cholecystectomy
The goals pursued by clinical nutrition after gallbladder removal are:
- creating maximum liver chemical economy;
- improvement of bile separation;
- ensuring 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 classification, diet after gallbladder removal is treatment table #5.
Despite some restrictions in treatment table #5, the diet must be physiologically balanced, that is, 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 calorie content of the treatment table after gallbladder removal is 2170-2400 kilocalories.
Basic nutrition principles
- 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 must be emptied in time so that bile does not become stagnant in them. In addition, small portions of food do not put a strain on the liver and other digestive organs, which helps to prevent inflammation. It is especially important to eat at the same time: in this way, 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 processing. Food can be steamed, baked or boiled. Microwave cooking should be avoided; multicooker and bain-marie are not prohibited. Occasionally, stewing of 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 provides maximum mechanical economy of the liver and stomach, and also has a beneficial effect on the entire digestive tract.
- food temperature. Dishes are only served hot (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 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 non-carbonated alkaline mineral water, 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. Also, in the absence of the gallbladder, the liver alone breaks down alcohol, the load 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 liver cirrhosis.
- we ate delicious. Every meal should be beautifully arranged: on a table covered with a tablecloth, with flowers, in a calm environment. It is necessary to eat slowly, carefully chewing each piece. This will allow you to get enough of very moderate servings, 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 content of cholesterol. It is he who causes thickening and stagnation of bile and promotes the formation of stones.
Second, since most of the enzymes that break down fats are absent from the composition of bile after removal from the bladder, consumption of animal (refractory) fats should be limited.
You should also avoid products that improve the formation of bile and secretion of gastric and duodenal juices (extractive substances, spicy dishes, marinades and others). It is contraindicated to eat foods that remain in the intestine for a long time, causing putrefaction and fermentation, stimulating the formation of gases.
The consumption of simple carbohydrates also needs to be limited: they are easily broken down, raising the level of "bad" cholesterol, and are deposited in the form of layers of fat.
The list of prohibited products includes:
- bread made from premium flour, all pastries and fried dough (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), vigorous 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, chives, spinach, sorrel, daikon);
- fried eggs, egg yolks;
- marinades and pickles;
- smoked meats;
- spices: pepper, mustard, horseradish, vinegar, coriander and others;
- berries and sour fruits;
- ice cream, chocolate, cream products;
- strong tea, coffee, cocoa, sweet carbonated drinks, sparkling mineral waters;
- legumes;
- dishes from public restaurants (pizzas, hamburgers).
approved products
Dishes that are recommended to be consumed by a person who has had a 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 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 patient's clinical nutrition after gallbladder removal, plant fiber should be included in large amounts. It not only contains vitamins, but also stimulates intestinal motility, preventing flatulence, constipation and pasta retention.
We must not forget about fermented dairy products, because they are sources of valuable animal protein 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 in secondary broths, soups in vegetable broth;
- lean meats and poultry (turkey, chicken, veal, rabbit, beef);
- ham of unsalted and low-fat varieties;
- cereals, both friable and semi-viscous (buckwheat, oats);
- all seafood, as a source of iodine that neutralizes cholesterol;
- lean fish (pike, trout, salmon) as a source of polyunsaturated fatty acids;
- steamed 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: kissels, mousses, jellies, jams);
- jam, marmalade, chalk;
- fresh greens, tomatoes, cucumbers, peppers, squash, beets, zucchini, potatoes, carrots;
- tea with milk or lemon, weak coffee, alkaline mineral waters, juices and fruit drinks;
- salted salmon, fish gelatine, 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 an optimal way, normalizes the functioning of the entire digestive tract, prevents the occurrence of unpleasant moments that usually occur after the removal of the gallbladder, such as swelling , constipation, belly and bitterness in the mouth.
In addition, therapeutic nutrition after gallbladder removal prevents the development of atherosclerosis, improves the patients' appearance and stabilizes their weight.
Consequences of not following the diet
If the diet is not followed after removing the gallbladder, then the post-cholecystectomy 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 their diet after surgery risk not only their appearance (obesity, hypovitaminosis) but also the health of other body systems.