What foods are not allowed with cholelithiasis. Features of nutrition in the presence of stones in the gallbladder

Gallstone disease refers to those ailments that require drastic changes in lifestyle. The patient must not only give up bad habits and completely eliminate heavy physical exertion, but also rebuild his diet, limiting the use of some "forbidden" foods.

A diet for gallstone disease is a complete treatment method: it will help reduce acute pain, stop inflammation and stimulate bile secretion. A certain type of nutrition should be prescribed only by a specialist after a comprehensive examination of the patient.

The composition of bile can vary depending on the state of human health and lifestyle. Oversaturation with elements such as calcium salts, certain types of amino acids, low density lipoproteins, etc., leads to the fact that they precipitate, accumulate, thereby forming dense formations - stones. This can also lead to stagnation or infection of bile, inflammatory processes, lipid metabolism disorders.

Stones in the bile ducts or bladder cause serious discomfort in the patient: severe pain in the right side, jaundice, deterioration in general well-being. Without proper treatment, gallstone disease can lead to complications. A neglected ailment cannot be cured by medical and other non-invasive methods; surgical intervention will be required here.

Causes of the disease and risk factors

The main reasons for the accumulation of stones in the gallbladder include:

• increased lithogenicity of bile. This property denotes its ability to settle into stones;
• stagnation of bile;
• infectious and inflammatory processes.

What groups of people are most susceptible to such changes? Risk factors include:

• female (women are most susceptible to diseases of the bile ducts and bladder);
  
• high levels of sugar and cholesterol in the blood;
• period of pregnancy and lactation;
  
• a sharp decrease in body weight;
• elderly age;
  
• prolonged parenteral breathing;
• taking hormonal drugs.
  

Clinical manifestations

The most important reason for the increase in the number of advanced gallbladder diseases is that patients often ignore side pain and do not seek help from specialists. The following reasons indicate the presence of an ailment:

• biliary colic. This manifestation is a sharp, but often short-term pain in the right side. It can radiate, subside in places, but then reappear with greater force;
  
• dull, aching pain in the region of the liver. It is associated with an increase in the size of this organ due to a violation of the excretion of bile. May be accompanied by heaviness and bloating;
• nausea, vomiting;
  
• a sharp rise in temperature.

If at least one of the symptoms listed above is observed, it is better not to take risks and consult a specialist for a comprehensive examination.

Important! When observing one of the symptoms of the disease, you should not look on the Internet or old notebooks for traditional medicine recipes against gallstones. Do not self-medicate, as this can lead to a loss of time that could be spent on effective therapy under the supervision of a specialist, and cause an exacerbation of the disease.

Dietary Risk Factors

The general risk factors that can lead to the formation of gallstone disease have been described above. But there are also dietary, that is, directly related to nutrition. The formation of stones can lead to:

• binge eating;
  
• lack of polyunsaturated fatty acids in the diet. Many believe that in order to lose weight and get rid of health problems, it is necessary to exclude “fatty” foods (pork, butter and vegetable oils, nuts, avocados, lard, etc.) from the diet. But this is a serious misconception. Without an adequate content of fatty foods in the diet, it is impossible to imagine a stable level of cholesterol and blood sugar, vascular health, normal weight;
• a large amount of gluten, starch in the diet (pasta, sweet pastries, bread, cereals);
  
• lack of vitamin A;
• a small amount of vegetables in the diet. Vegetables are the best source of fiber. In addition, they fill the stomach well and eliminate the feeling of hunger. It is recommended to make your plate so that half of its contents are vegetables;
  
• a large number of refined and deodorized foods in the diet. It is worth giving preference to whole foods (extra virgin oils, farm meat, full-fat dairy products).
  

Mistakes in nutrition can lead not only to obesity, but also to serious diseases. This once again confirms gallstone disease.

Diet Basics

As mentioned above, the diet is prescribed only by a specialist after a comprehensive examination of the patient. An individual nutrition plan is selected for him, which depends on the content of important macro- and micronutrients in his body. But there are also universal principles of diet for gallstone disease.

1. Frequent meals. It is advisable to eat 4-5 times a day in small portions. Firstly, with such fractional nutrition, the patient will never feel hungry, and consequently, overeat. Secondly, each meal is a kind of impetus to the release of bile, which opposes its stagnation. Finally, small portions help to avoid feelings of heaviness and pain in the stomach.
   
2. Lots of water. At least 2 liters of water per day is important even for healthy people. The more water the patient drinks, the weaker the concentration of bile becomes. And it resists the formation of stones.
   
3. Restriction in the consumption of fried foods or their complete exclusion from the diet. It is advisable not to fry, but to boil, bake, steam. This is much more useful, since during frying in vegetable oil, dangerous carcinogens are formed.
   
4. Exclusion of foods high in low-density lipoprotein. These include fast food, pastries, some convenience foods.
   
5. The exclusion of fast carbohydrates (cereals, pastries, some fruits, sugar, etc.) They contribute to an increase in blood sugar and "bad" cholesterol, do not eliminate the feeling of hunger and cause stagnation of secretion.
   
6. Enrichment of the diet with fresh vegetables rich in fiber. The benefits of vegetables have been discussed above.
   
7. Consuming whole foods that have undergone minimal processing.
8. Consumption of foods that are rich in calcium (fatty cottage cheese, cheese, varenets, kefir, etc.) They contribute to a change in the environment to a more alkaline side.
   
9. Limiting the consumption of cold foods and drinks, as they can cause discomfort in the stomach.
10. Exclusion of spicy, highly salty, that is, everything that can irritate the gallbladder.
    

These are the basic rules that even healthy people can follow if they want to protect themselves from ailments. But for patients with gallstone disease, these principles are necessary conditions that cannot be avoided.

This is interesting! For the last 15-20 years, nutritionists from all over the world have been actively complaining about fats and calling them the cause of high blood cholesterol levels, thrombosis, obesity and other diseases. Now a large pool of studies is being conducted that prove that healthy polyunsaturated fats, which are found in meat, fish, eggs, dairy products, vegetables, not only do not have a negative effect on human health, but also contribute to weight loss, improve well-being, etc. .

Ration by points

Let's consider a diet on several main points in order to most accurately answer the question of what it is.

Diet

As mentioned above, the patient eats fractionally (4-5 times a day) and in small portions. It is advisable to eat at the same time, develop a system.

This regimen does not require calorie reduction. Frequent meals contribute to a more active excretion of bile, prevent constipation. In addition, the risk of overeating, unpleasant bloating, is significantly reduced.

food processing

food temperature

Food temperature should be optimal and not cause discomfort. It is recommended to exclude very hot or very cold dishes.

Salt

Ideally, many doctors recommend that you stop salting your food completely. Salt promotes fluid retention in the body, the formation of edema. But not everyone can eat fresh food every day. That is why it is necessary to introduce some restrictions - no more than 10 g per day.

Water

The minimum amount of water that you need to drink daily is 1.5-2 liters. This amount does not include juices, tea, coffee and other drinks. It is recommended to completely eliminate sugary sodas, some fruit juices, in order to reduce blood sugar and stop excessive insulin production.

It is difficult to drink such an amount of water, it can be diversified with a small amount of lemon juice or ginger.

Alcohol

Alcohol is one of the forbidden products, which will be discussed below. It should be abandoned even in the absence of ailments. With cholelithiasis, alcoholic beverages can provoke colic, bloating and spasms. This, in turn, leads to severe pain and discomfort.

In addition, alcoholic drinks are often served with ice, which can also negatively affect well-being.

Note! The use of alcoholic beverages is not the only bad habit that must be abandoned in case of gallstone disease. It is strongly recommended to give up tobacco, overeating, eating late in the day.

"Forbidden" and "permitted": what can and cannot be eaten on a diet

The diet for gallstone disease involves the introduction of quite serious restrictions. Therefore, each patient needs to know the lists of allowed and prohibited products.

	Grocery list
What can you eat	Whole meats (pork, beef, turkey, chicken, etc.); cheese; full-fat dairy products (kefir, sour cream, varenets, cottage cheese, etc.); sea ​​or river fish; eggs (up to 3-4 pieces per day); butter; cereals (in limited quantities); vegetables (with every meal); rye whole grain bread, bran or crispbread; nuts; tea, coffee, fruit juices (the latter - in limited quantities); fruits; berries; ham, sausages without the addition of starch and sunflower oil; mushrooms; vegetarian or meat soups; olive oil; whole grain pasta (preferably low gluten); sweet potato; seaweed.
What not to eat	Salo; fast food; fried foods; excessively salty, peppery and spicy foods and dishes; legumes; vegetables with a high content of essential oils (radishes, garlic, onions, etc.); refined sunflower and other vegetable oils; pastries, bakery products, white bread; high starch vegetables (potatoes); semi-finished products; sugar; sorrel; spinach; alcohol; carbonated sweet drinks; smoked products (sausages, fish); spices; sushi rolls; white or Brussels sprouts; offal.

This is a basic list of foods that can or cannot be consumed on such a diet. Only a specialist will make the exact diet for you.

Compliance with the diet is the main condition for successful treatment

Diet number 5 - an emergency measure?

Diet number 5 - a certain style of nutrition, which is used for exacerbation of gallstone disease for 5-7 days. Longer adherence to such a diet is dangerous to health: serious food restrictions can lead to a lack of macro- and micronutrients.

Diet Principles #5

Diet number 5 can really be called an emergency measure, since it is used only in extreme cases: with increased symptoms of gallstone disease, increased pain in the right side, severe nausea and vomiting. The main principles of this nutrition are the following points:

• fractional multiple meals. The number of meals per day should be increased to 5-6. The mass of a serving should not exceed 200 grams. So there is a much lower load on the digestive tract;
  

  Food should preferably be consumed in a grated form.

• exclusion from the diet of dishes and foods high in low-density lipoproteins - "bad" cholesterol and trans fats;
• periodic fasting days. As a rule, they represent 1-2 days of complete fasting. The patient drinks warm water, herbal teas and decoctions, sometimes broths;
  
• reducing the amount of salt. It retains water in the body, contributes to the stagnation of bile. If it is not possible to completely eliminate salt, you can salt already prepared dishes, but not in the process of their preparation.

Important! Diet number 5 - only a temporary measure, which is intended to dull the symptoms of the disease. It is not worth sticking to such a diet for more than 2-3 weeks if you feel worse - it is better to resort to surgery or serious therapy.

Menu examples

Below are examples of menus that you can focus on when compiling a diet. But the list of products, dishes and their volume is determined only by a specialist.

1 menu option

Meals	Types of dishes
1st breakfast	100 g of fresh cottage cheese 9%, 150 g of oatmeal in water with a small amount of olive oil, tea without added sugar.
2nd breakfast	An apple or a glass of kefir.
Dinner	Medium bowl of vegetable soup, 150 g boiled cauliflower, boiled chicken breast or beef fillet.
afternoon tea	A glass of herbal tea with 1-2 whole grain breads.
Dinner	2-3 medium boiled potatoes, 150 g baked in the oven or boiled fish, vegetable salad (tomatoes, cucumbers, herbs, avocados).

2nd menu option

3 menu option

Meals	Types of dishes
1st breakfast	150 g of semolina with a little olive oil, scrambled eggs or scrambled eggs from 2 proteins and 1 yolk, tea without added sugar.
2nd breakfast	A glass of kefir or milk, a slice of rye bread.
Dinner	150 g buckwheat porridge with a little olive oil, steamed meat or chicken cutlets, sauerkraut and carrot salad.
afternoon tea	Cottage cheese pudding (grind cottage cheese in a blender or rub through a sieve).
Dinner	2-3 potato puree, 100 g boiled chicken fillet, milk or tea

Meals	Types of dishes
1st breakfast	150 g carrot casserole without oil, 1 protein, milk tea or herbal tea
2nd breakfast	150 grams of buckwheat or oatmeal with a little olive oil.
Dinner	Lean borscht (you can add lean beef) tea.
afternoon tea	A glass of kefir, 1-2 loaves.
Dinner	Boiled beef or chicken breast, vegetable salad (tomatoes, cucumbers, avocados, greens).

Carrot casserole - both healthy and very tasty!

On a note! Olive oil often appears on the menu. It is important to choose a high quality, unrefined, undeodorized olive oil. Only this can normalize the level of cholesterol in the blood, increase vascular tone.

The need for a diet

Diet is a system that must be disciplined to adhere to. Any violations in the menu will nullify all efforts. However, if you follow the diet conscientiously, it can seriously improve your health.

The positive effects of dietary restrictions include:

• stop the formation of new stones;
• normalization of digestion;
• solution of the problem of constipation, nausea and vomiting;
• lowering the level of cholesterol and sugar in the blood;
• liquefaction and excretion of bile;
• activation of the growth of beneficial intestinal microflora;
• weight loss;
• normalization of sleep;
• dulling of pain in the right side, etc.

This explains the need to follow a diet for gallstone disease. If the therapeutic style of nutrition is not adhered to, this can result in the following consequences:

• ulcer;
• pancreatitis;
• colic and abdominal pain;
• frequent nausea and vomiting;
• the formation of new stones, etc.

The role of magnesium

The role of magnesium in the human body cannot be belittled: it normalizes metabolism, increases vascular tone, takes an active part in the transmission of nerve impulses to internal organs, has a positive effect on insulin secretion, etc. It is especially important to monitor the magnesium content in the blood in cholelithiasis.

Foods with the highest magnesium content

You should not abuse these products: for example, many cereals contain a large amount of starch, which can negatively affect blood cholesterol levels and weight gain trends. But it is necessary to include a small amount of buckwheat, almonds or beans. The procedure for gastroscopy of the stomach, preparation for the examination, study the link.

Video - With cholelithiasis, diet

Inna Lavrenko

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Fractional nutrition for calculous cholecystitis should be with a portion limit of up to 250-300g, the caloric content of the diet per day is limited to 2.5 thousand kcal, of which there should be 80g of fat, the same amount of protein, 400g of carbohydrates. Salt should be no more than 10g per day, clean water should be drunk at least 2 liters. Cooking should also be mostly steamed, but you can bake in the oven until crispy. Vegetables should be grated and saturated with fiber, you can eat tough meat.

Allowed products for chronic inflammation in the gallbladder

Chronic cholecystitis without an acute stage of inflammation in the gallbladder is treated with a diet that reduces the irritating mucous membranes of the organs of the products. You can eat the following food:

• vinaigrette and vegetable salad with oils (unrefined, cold pressed);
• berries, fruits and various vegetables;
• in the presence of constipation, the introduction of fresh vegetable salads will help;
• eggs in the amount of one per day. Yolks actively stimulate the outflow of bile. If bitterness appears in the mouth in the morning, it is necessary to make dishes only from proteins.

Prohibited foods for chronic inflammation in the gallbladder

• Citrus fruits and garlic, other products that contain essential oils;
• a decoction of cabbage, broths;
• sorrel or spinach containing oxalic acid;
• puff pastry, sweet pastries;
• offal, fatty cuts of meat. The kidneys, brains and liver contain a lot of cholesterol;
• alcohol of any strength;
• honey, sugar, sweets and jam. Milk with high fat content, sour cream and cream, fermented baked milk.

Cholecystitis is often accompanied by various diseases. In case of exacerbation of this disease, a dietary table No. 5A is necessary. Nearby organs of the gastrointestinal tract, intestines and gastroduodenal system with pathology in the gallbladder suffer through a common innervation and blood supply.

If pancreatitis is present, then a No. 5P diet is needed. The treatment table provides for an increase in carbohydrates and fats, proteins up to 120g. This ratio of nutrients stimulates the pancreas. It is forbidden to use coarse fiber and concentrated broths. Cook only in the oven or steam, you can stew or boil food. Within three months, dietary nutrition without violations should be observed.

With concomitant inflammation in the gallbladder, gastroduodenitis, nutrition should be based on dietary table No. 1. The diet should be without stimulating bile synthesis dishes, excessively hot or cold foods. It is best to take food in the form of gruel or in liquid form. It is forbidden to consume all legumes, asparagus and radishes, as well as fruits with a peel - currants, grapes, dates or gooseberries. Under the ban are sinewy meat products and bird skin, bread and pastries made from whole grain flour.

Diet and drug treatment do not always lead to improvement and recovery. With frequent and too pronounced exacerbations of cholecystitis with the release of pus, as well as with cholelithiasis in some types, it is necessary not to delay the surgical intervention.

Cholelithiasis

Gallstone disease (GSD) in a patient is different, but always differs in viscous bile with a changed chemical composition, as well as an intensive process of stone formation. In addition to treatment with medicines, physiotherapy and surgical operations, experts recommend constantly following a diet that can not only alleviate the condition, but also prevent relapse. There are several stages of the disease, nutrition in which differs.

Chemical stage of gallstone disease

At this stage, there is a failure in the production of bile by the liver and its release from the gallbladder. The substance increases concentration, accumulates in the gallbladder, becomes viscous and contains many bile acids, cholesterol and phospholipids. If the disease is detected at this stage and there is no treatment, the process of formation of suspensions, flakes may begin, and a bile precipitate may precipitate. Without the manifestation of symptoms, this continues for a long time, moving to the second, latent stage.

At the latent stage of the development of the disease, bile stagnates and active formation of stones begins. This usually occurs with inflammatory foci on the mucous membranes of the bile organ, thickening of its walls. With instrumental diagnostics, doctors detect “silent” stones. The stage can last for decades without the manifestation of stone activity, there are no symptoms, and the patient is unaware of the disease.

Clinical stage of gallstone disease

The most dangerous stage of gallstone disease, when the stones begin to move along the ducts. This process is accompanied by pain in the right side of the peritoneum in the hypochondrium, the appearance of biliary colic is possible. Each patient has an individual course of pathology - from sluggish to acute with frequent relapses. It is important to consider the size of the stones and their localization.

How to eat with an exacerbation of gallstone disease?

With an exacerbation of cholelithiasis, it is necessary to use a dietary table No. 5A. They adhere to his rules for a couple of weeks until the condition stabilizes, after which they switch to diet number 5. A sample menu for the day might be as follows:

• breakfast of semolina or a steam protein omelette, tea with the addition of low-fat milk;
• snack - buckwheat with olive oil, steamed meat cutlets, stale white bread, weak tea;
• lunch - vegetarian soup with rice and vegetables, steamed chicken fillet, buckwheat with unrefined butter, dessert in the form of milk jelly;
• dinner - boiled fish and mashed potatoes, tea with low-fat milk;
• Before going to bed, you can drink a glass of kefir.

During an exacerbation, strict adherence to the rules of dietary nutrition may prevent surgery and eliminate or suspend the formation of stones by normalizing the viscosity of bile and its chemical composition.

The reasons for the development of gallstone disease are called poor nutrition, metabolic disorders, infection, bile stasis, and genetic predisposition. When these factors interact, the physicochemical characteristics of bile change, it becomes lithogenic (capable of forming stones).

Stones are formed due to the fact that there are not enough bile acids that retain cholesterol, as a result, cholesterol precipitates and calculus formation begins. Undissolved cholesterol joins the formed stone and the calculus gradually increases (by 1-4 mm per year). When the stone moves, the patient feels pain.

Nutrition is important in the development of pathology (lack of a meal schedule, high energy value of dishes, eating food with "bad" cholesterol), so the diet during an exacerbation of cholelithiasis is an important component of therapy. Therapeutic nutrition accelerates the recovery of impaired functions of the hepatobiliary system.

If during the study stones were found in the gallbladder, then the patient should refuse to eat food, which includes "bad" cholesterol, a lot of fats and carbohydrates, and you also need to adhere to the meal schedule. In the early stages of the disease, a therapeutic diet can completely correct the physicochemical parameters of bile and prevent the growth of calculi, and medicines can dissolve stones.

Even if the disease is running, then adhering to a diet can minimize the risk of a stone entering the ducts (biliary colic). In case of violation of the functions of the hepatobiliary system, a dietary table N o 5 and its variations are prescribed. Which diet will be recommended for cholelithiasis (GSD) depends on the stage of the disease and the composition of the stones.

Cholesterol stones, as a rule, appear in people who overeat, consume a lot of animal fats, in particular, fatty meats, eggs, caviar. Foods high in cholesterol, spicy and fatty foods should be excluded from the diet, the use of vegetable oils is limited (but not excluded), since they have choleretic properties and can cause an exacerbation of cholelithiasis.

For gallstone disease, dietary recommendations are as follows:

• limit the intake of fats to 70–80 g (of which 75% should be of animal origin) and carbohydrates to 350–400 g;
• eat a lot of vegetables and fruits, as it is necessary to increase the amount of dietary fiber in the diet;
• add foods rich in magnesium salts to the diet;
• use alkaline mineral waters ("Borjomi", "Polyana Kvasova", "Essentuki") so that the cholesterol in the bile is in dissolved form;
• adhere to fractional nutrition (eat every 3 hours in small portions so that bile is released evenly);
• exclude alcohol;
• if there is obesity, then it is necessary to adhere to a hypocaloric diet, since weight loss improves the functions of all body systems;
• to eliminate the lithogenicity of bile, it is necessary to take chenodeoxycholic and ursodeoxycholic acid for a long time.

At the initial stage of the development of the disease, there are no restrictions on the use of any products, but it is recommended to eat food at regular intervals in order to stimulate the separation of the liver secretion and the contraction of the gallbladder.

During the period of remission, a moderate sparing of the hepatobiliary system is required, therefore, a dietary table N o 5 is prescribed. This therapeutic diet replenishes the physiological needs of the body in chemical elements, therefore it can be recommended for a long period of time. A patient can consume no more than 2400-2600 kcal per day. The diet should be limited to 80 g of protein, 80 g of fat and 400 g of carbohydrates, salt should not exceed 10 g.

All dishes are cooked in a double boiler or boiled

In case of illness, it is necessary to ensure that there is a regular moderate outflow of bile, which means that you need to adhere to fractional nutrition, avoid foods that stimulate bile secretion, as well as containing cholesterol.

What foods are allowed and prohibited for calculous cholecystitis

• products containing fiber. The most fiber-rich vegetables (cabbage, green peas, asparagus, carrots, corn, pumpkin), fruits (bananas, peaches, pears, apples), dried fruits (prunes, dried apricots, dates), nuts (almonds, cashews), cereals (buckwheat , oatmeal, white rice), bran, legumes;
• salads dressed with unrefined vegetable oil (olive, sunflower, linseed). Oil promotes bile secretion and prevents the development of fatty hepatosis;
• dairy products. Kefir, fermented baked milk, curdled milk help to increase the pH of the liver secretion;
• cereals with a high content of magnesium (buckwheat, millet, barley, oats). They improve the work of the cardiovascular, endocrine, digestive systems, help to absorb B vitamins, which are necessary for the liver to work. Magnesium improves the condition of blood vessels and blood flow, therefore, prevents vasospasm. A lot of magnesium in sesame, bran, cocoa, halva, soy, pistachios, seeds;
• protein products (low-fat varieties of fish, cottage cheese, chicken protein) and vegetable oil, since they contribute to the synthesis of endogenous bile acids, which do not allow cholesterol to crystallize;
• foods rich in vitamin A (milk, cottage cheese, cream, sour cream, butter). Retinol normalizes metabolism in the body, strengthens the immune system, accelerates tissue regeneration;
• products with lecithin (butter, sour cream, cream). They prevent the crystallization of cholesterol;
• free liquid at least 2 liters. It prevents stagnation of bile and affects its consistency.

A magnesium diet is recommended if cholelithiasis provokes constipation or there are stagnant processes in the gallbladder

At the heart of medical nutrition with a high content of magnesium is the dietary table No. 5, to which the consumption of a large amount of food rich in magnesium is additionally prescribed. The trace element stimulates bile secretion, enhances the motor activity of the gallbladder and intestines, which accelerates the excretion of cholesterol.

A magnesium diet is contraindicated for inflammation in the tissues of the stomach and intestines, in which fermentation is increased and diarrhea occurs, and it cannot be observed during an exacerbation.

In diseases of the liver and gallbladder, it is required to limit the use of:

• products containing essential oils (citrus fruits, garlic, onions, parsley, dill, celery);
• dishes with a high content of extractive substances (broth, cabbage-based decoction, crust formed during roasting meat, tea);
• rich, puff, shortcrust pastry;
• fatty meat and offal that contain a lot of cholesterol, as well as all fried foods;
• alcohol;
• easily digestible carbohydrates (jam, sugar, confectionery, sweets, honey).

With cholelithiasis, biliary colic is likely, which can be triggered by negative emotions, the use of fatty foods, spices, spicy seasonings, so you need to follow the diet and eat only permitted foods.

Nutrition during an exacerbation of the disease

If the disease has worsened, then a more strict diet is required, which must be followed until the disappearance of clinical manifestations (pain, nausea, vomiting, stool disorders). The diet for cholelithiasis during the period of exacerbation on the first day recommends giving up food in order to provide functional rest to the inflamed gallbladder. It is allowed to drink weak tea, rosehip broth, juices diluted in equal proportions with water.

48-72 hours after the onset of the exacerbation, the patient is transferred to the N o 5B diet, which provides mechanical and chemical sparing. According to the recommendations, the patient should limit the intake of carbohydrates to 200 g and protein to 80 g. Salt should not be added to dishes and they should be served pureed (it is better to cook meat souffle, mucous soups, mashed potatoes).

The treatment table is prescribed taking into account concomitant diseases and the stage of pathology

You need to eat in small portions at least 5 times a day. The daily diet should not exceed 1600 kcal. You need to drink about 2-2.5 liters of free fluid per day. With an exacerbation of gallstone disease, the first five days, the diet should consist of the following dishes:

• slimy soups made from oatmeal, rice or semolina prepared without adding oil;
• liquid pureed cereals (rice, oatmeal). Porridge can be cooked in milk;
• jelly, vegetable juices and compotes (fruits must be grated);
• low-fat cottage cheese;
• boiled fish and meat;
• crackers or yesterday's wheat bread.

The diet is not complete, so you can’t stick to it for a long time. On the 5th-8th day after the onset of the exacerbation, the patient is transferred to the dietary table N o 5A, which is recommended until the onset of remission. Diet N o 5A with an exacerbation of gallstone disease allows you to use:

• stewed and boiled vegetables;
• porridge cooked in water;
• pasta;
• milk soups and soups with vegetable broth, borscht;
• milk, cottage cheese, low-fat sour cream;
• lean meat and fish (stewed or boiled);
• marshmallow, honey, marmalade, marshmallows;
• non-acidic berries and fruits;
• greens (with the exception of spinach and sorrel);
• juices from pomegranate, blueberry, quince, bird cherry;
• salads with vegetable oil (oil after heat treatment should not be consumed);
• weak tea, coffee with milk.

After the disease subsides, the patient should again adhere to the basic diet N o 5

It is impossible to eat fatty meats and fish, dishes with seasonings and spices, fresh pastries, cakes, muffins, chocolate, vegetables with coarse fiber (white cabbage, radish, radish) and essential oils (garlic, fresh onions), pies, caviar, offal.

In cholelithiasis, pathological processes affect not only the liver and gallbladder, but also other organs of the digestive system, especially the stomach, intestines, pancreas, so therapeutic nutrition is recommended taking into account the secondary disease. So, with the development of pancreatitis, the N o 5P diet is shown, which involves an even greater restriction of fats and carbohydrates and is designed to stimulate the pancreas.

Unlike the diet prescribed for cholelithiasis, it limits the intake of dietary fiber. Depending on the concomitant disease, a dietary table N o 5A or N o 5B may be prescribed. Both diets involve the exclusion from the diet of "bad" cholesterol, dietary fiber, essential oils or extractives, and do not recommend eating foods that promote fermentation processes.

These tables require that everything be consumed in a pureed or chopped form, and vegetables and fruits, meat and fish must be cooked (boiled or baked). Diets differ in calorie content and proportion of proteins, fats and carbohydrates.

If gallstone disease is not amenable to conservative treatment, then gallbladder removal is prescribed.

After the operation, a diet of N o 5Sch or N o 5G is indicated. With the treatment table No. 5Sh, the intensity of bile secretion decreases, and with the diet No. o 5G, the bile separation increases due to the introduction of complete proteins and polyunsaturated fatty acids. A diet during exacerbation of gallstone disease provides sparing of the digestive system and relieves the burden on the gallbladder, thereby reducing the severity of pain and improving the condition of the inflamed organ.

Dietary nutrition should be followed for a long time, since eating heavy foods (fatty, fried, spicy) can lead to an exacerbation of the disease and the movement of stones. In addition to a therapeutic diet, patients are prescribed long-term drug therapy, which contributes to the dissolution of cholesterol stones, but if the patient does not begin to adhere to a healthy diet, then there is a high probability of the formation of new stones.

Gallstone (the correct name is gallstone) disease refers to diseases of the hepatobiliary system, which includes organs involved in the formation of bile and its excretion: the gallbladder, liver, bile ducts, located inside the hepatic tissue and beyond. Pathology develops against the background of a violation of lipid metabolism and the exchange of bile pigments and is characterized by the formation of calculi of various sizes inside the gallbladder or ducts, through which concentrated bile comes from the liver. Calculi outwardly look like dense yellow or green stones (brown stones are less common), and their number can reach 100 or more pieces.

The tactics of treating patients with cholelithiasis of varying severity is determined by the number of calculi, their size and location (in the lumen of the gallbladder or in the ducts), the general well-being of the patient and his lifestyle. Surgical treatment may be indicated when the gallbladder is filled by 50% or more. If the number of calculi is less than this indicator, organ-preserving therapy is applied, the basis of which is drug treatment and a therapeutic diet. This is especially true for women, as they are diagnosed with gallstone disease 4 times more often than men.

Timely diagnosis of pathology is of great importance for patients with cholelithiasis. The sooner the patient learns about his disease, the sooner he will be able to take the necessary measures to correct the diet and habits. Statistics show that almost half of patients learn that they have cholelithiasis during a routine examination of the abdominal organs, prescribed against the background of concomitant diagnoses and pathologies. This is due to a blurred clinical picture and the absence of typical signs, many of which appear only during an exacerbation.

Many symptoms of cholelithiasis, for example, dyspeptic pain and digestive disorders, can be interpreted by patients as the result of improper or abundant nutrition: no more than 7-8% of patients go to doctors at this stage. The patient may also be disturbed by periodic pulling pains in the area of ​​localization of the projection of the gallbladder (right hypochondrium), nausea, heartburn, bad breath. In cholelithiasis complicated by dyskinesia (obstruction) of the bile ducts, changes can also be observed on the part of the skin: they become too pale and dry, and as the disease progresses, they acquire a yellowish tint.

Other symptoms of the disease include:

• belching with a putrid odor;
• stool instability (non-infectious diarrhea or spastic constipation);
• bitter or metallic taste in the mouth;
• bloating and heaviness in the abdomen, occurring at any time of the day and aggravated after eating.

Note! A periodic increase in body temperature to 37°-37.4° against the background of other symptoms of cholelithiasis can also be considered as an indirect sign of pathology. This is due to the accumulation of bile acids and their entry into the bloodstream, as well as the intoxication that develops against this background.

The role of diet in the treatment of cholelithiasis and the main points

Therapeutic nutrition for the accumulation of calculi in the gallbladder or ducts must be followed from the moment of diagnosis (ideally, after the appearance of suspicions of possible disorders in the digestive tract). The diet for patients with gallstone disease is based on reducing the consumption of fats and foods rich in cholesterol, as well as replacing refined foods with complex carbohydrates that require slow digestion and breakdown. Compliance with a therapeutic diet can improve the patient's condition, reduce the manifestations of the disease, eliminate pain, improve the chemical composition of bile and normalize the metabolism of lipids and pigment components.

It is important that the daily diet is balanced not only in terms of the main nutritional components, but also in terms of the content of vitamins, omega acids, mineral salts and other useful substances. The amount of sugar per day should not exceed 70 g, and it is better to limit the amount of liquid you drink to 2.5 liters.

To speed up recovery and reduce the risk of exacerbations, it is important to follow the recommendations of experts in cooking and compiling a daily menu, listed below.

1. Patients with any form of cholelithiasis are forbidden to eat too cold or hot food. All dishes should have a temperature comfortable for the stomach - about 30 ° -36 °.
2. The volume of one serving should not exceed 250 g. The exception is first courses - they are allowed to eat up to 350 ml at a time.
3. For the entire period of treatment, fried foods, canned food, marinades and dishes with the addition of a large amount of fat, such as salads dressed with mayonnaise, are excluded.

Note! It is important for women diagnosed with gallstones to consume enough magnesium. This element is found in various cereals, Brussels sprouts, nuts, peas, beans and peanuts. If the disease is complicated by chronic enterocolitis or gastritis, you should consult a specialist, since an excess of magnesium in these pathologies is contraindicated and can lead to a deterioration in well-being.

Diet for gallstone disease: what foods can women eat?

The basis of nutrition for the accumulation of stones in the gallbladder and ducts is boiled meat and various vegetables. Meat is better to choose low-fat varieties, and before cooking, carefully remove all films from it and cut off fat. Especially useful for women are veal, lamb and lamb - these types of meat contain a lot of iron and help prevent anemia, especially in women prone to menorrhagia (long and heavy periods) or uterine bleeding. Women who are overweight should choose rabbit meat, turkey, chicken or chicken fillets - this is a dietary meat that not only enriches the body with the necessary elements, but also contains little fat, allowing you to control body weight.

You can cook casseroles from boiled meat by adding various vegetables, soufflé or mashed potatoes. From vegetables, all types of cabbage, carrots, zucchini, pumpkin are especially useful. Pumpkin puree soup with the addition of a small amount of cream can be an excellent dish for lunch or for a hearty, but at the same time light, dinner. Despite all the benefits of vegetables, not all of them can be used in various forms of gallstone disease. Women with this diagnosis should stop eating the following types of vegetables:

• radish;
• radish;
• onions and green onions;
• garlic;
• spinach.

Greens with gallstone disease are not contraindicated, but you should not use spices with a high content of essential acids, such as sorrel, cilantro and parsley. Before adding greens to ready-made dishes, it must be scalded with boiling water or kept in hot water for at least 2 minutes.

What kind of fish can you eat?

You should also choose low-fat fish, but with a gentle and dietary cooking method (without adding oil), several times a month you can afford fatty sea and river fish, such as herring, mackerel, trout or salmon. Cod, hake, pollock, tuna and halibut are perfect for everyday nutrition. It is necessary to cook fish with the addition of a small amount of salt, herbs. As a side dish, it is better to choose stewed or grilled vegetables.

From seafood 2-3 times a month, you can afford a small amount of boiled shrimp, mussels or oysters. Smoked delicacies (for example, smoked squid) should be excluded from the diet.

Bread: is it possible or not?

Bread in the diet should be present daily, as it is a good source of magnesium and B vitamins that regulate the functioning of the nervous system and heart rate. Butter buns, loaf, bread made from wheat flour of the first and highest grade, gingerbread, pies - all this is contraindicated for patients with cholelithiasis. You should also refuse bread with bran and seeds, as it stimulates contractions of the intestinal walls and can create an extra burden on the gastrointestinal tract.

The best choice for women with cholelithiasis would be whole grain buns made from wholemeal flour, as well as rye crackers - they can be replaced with regular bread or added to first courses to improve taste characteristics.

What else can you eat?

Some people think that women with gallstone disease should avoid eggs because they are high in cholesterol. This is not true: eggs can be included in the menu, but not more than 1-2 times a week. It is even better to replace chicken eggs with quail eggs: they have 3 times less cholesterol, and the content of vitamins and minerals (including the necessary magnesium) is almost 50% more.

Fruits (bananas, apples, peaches, pears) are best consumed baked, as raw fruits contain a lot of coarse vegetable fiber, which irritates the walls of the digestive tract and provokes pain in the abdomen. The menu can also include all fermented milk products, with the exception of whole cow's milk, which is difficult to digest and can cause constipation. Butter for patients with cholelithiasis should be bought only natural, made from cream, with a fat content of at least 82.5%. The maximum allowable daily intake of oil for women is 12 g.

Sample menu for the day: two options for women with gallstones

Option 1

meal	What and how much to eat?	Image
Breakfast	Buckwheat porridge on pasteurized milk, diluted with boiled water in a ratio of 1: 1 (200 g); A piece of black bread with a thin layer of butter; Black tea with sugar (180 ml)
Lunch	Baked apple in caramel glaze (200 g)
Dinner	Cauliflower puree soup with meatballs (250 ml); Cod with a side dish of stewed vegetables (170 g); Fig compote (150 ml)
afternoon tea	Cookies "Maria" (2 pieces); Ryazhenka 4% (200 ml)
Dinner	Cottage cheese casserole with canned peaches (240 g); Cowberry kissel (190 ml)
Before bedtime	Natural yogurt without additives (100 g)

Option 2

meal	What and how much to eat?	Image
Breakfast	Omelet from two eggs with tomatoes and boiled chicken; Black bread sandwich with low-fat pate; Cranberry juice (180 ml)
Lunch	Curd soufflé with pear (210 g)
Dinner	Fish soup with vegetables (250 ml); Mashed potatoes with steamed beef (220 g); Dried plum compote (150 ml)
afternoon tea	Brown bread croutons (70 g); Curdled milk (140 ml)
Dinner	Cabbage, bell pepper and chicken casserole with low-fat cheese (240 g); Weak tea with milk or cream (200 ml)
Before bedtime	Kefir 1% (100 ml)

Nutrition after surgery: what you need to know so as not to harm yourself?

One of the newest methods of treating gallstone disease is lithotripsy. The method is the crushing of stones through the skin. It is less traumatic, not very painful, but not effective enough for the treatment of cholelithiasis due to the peculiarities of the localization of calculi, which can be located deep under the skin. If drug therapy, lithotripsy and other methods of conservative treatment were ineffective, cholecystectomy is used - a surgical treatment of cholelithiasis, which consists in removing the gallbladder. The operation does not apply to complex types of surgical intervention, but requires certain recommendations to be followed during the preparation period and after the removal of the organ.

Within 24 hours after the operation, any foods and liquids are completely excluded from the patient's diet. If a woman is very thirsty, you can moisten her lips with water. In exceptional cases, a small amount of drinking water is allowed, but the daily volume should not exceed 200 ml. Starting from the second day, vegetable and meat purees (can be bought in baby food departments), as well as low-fat broths from fish or poultry meat, can be gradually introduced into the woman's diet. On the third day, you can add liquid porridge, jelly and cottage cheese soufflé to the menu. You will need to adhere to such a diet for 5-7 days.

On the tenth day after the operation, a woman can eat dishes recommended for patients with cholelithiasis. It is recommended to adhere to such a diet constantly in order to eliminate unnecessary stress on the digestive tract and maintain a constant chemical composition of bile, which becomes more concentrated after removal of the gallbladder.

Video - Nutrition for gallstone disease

Video - Diet for gallstone disease

There was an exacerbation: how to eat?

Even if a woman strictly complies with all doctors' prescriptions regarding nutrition and lifestyle, the likelihood of exacerbations can be quite high. Contribute to the recurrence of gallstone disease can drink alcohol, smoking, increased physical activity, stress. The attack is characterized by intense pain, vomiting, nausea, refusal to eat, diarrhea. In some cases, during an exacerbation, the patient may experience constipation, but diarrhea occurs 3 times more often.

As an emergency medical aid, a three-day fast is used to unload the digestive tract and relieve pain. During this period, a woman can drink spring and mineral water without gas, herbal tea, unsweetened compote. Fruit drinks during this period are contraindicated, since almost all berries contain a large amount of acids that irritate the walls of the stomach and intestines and increase the manifestations of pain.

After that, the patient is assigned treatment table No. 5 with certain adjustments, for example:

• within a month, strong meat and chicken broths are contraindicated;
• bread can be consumed starting from the eighth day after the arrest of the attack;
• the amount of salt is reduced to 7-8 g per day;
• meat, fruits and vegetables can be eaten boiled or baked.

Important! Some patients ignore doctors' prescriptions for nutrition and continue to consume prohibited foods. Such frivolity can lead to serious consequences, such as peptic ulcer, colitis or obstructive jaundice. More serious complications are perforation and necrosis of the gallbladder, as well as inflammation of the peritoneum (peritonitis) and abscesses in the abdominal cavity.

Diet is an important and integral part of the complex therapy of gallstone disease in women and men. By itself, it cannot cure the disease, but by following the recommendations for organizing a diet, a woman can significantly reduce the risk of exacerbations and alleviate general well-being by normalizing digestive processes and relieving stomach pain. read on our website.

If a patient has been diagnosed with cholelithiasis (acute or chronic cholecystitis) and gallstones have been found, an important component of treatment is the observance of a special diet. It must be followed after the treatment of the disease or surgery. During a period of exacerbation, the diet should be especially sparing.

Gallstone disease almost never manifests itself separately. Therefore, inflammation in the gallbladder is accompanied by other pathologies that affect the following organs:

Diet number 5 is prescribed for the following diseases:

• Gallstone disease.
• Hepatitis.
• Stones in the gallbladder.

What is included in this diet, what are its features and how it should be observed during an exacerbation of the disease, we will find out further.

With cholelithiasis or stones in the gallbladder, you need to follow the following rules in terms of nutrition:

In the presence of stones in the gallbladder and cholecystitis, you need to follow a diet that, although it allows you to eat fruits, but not all. With diet number 5 you need eliminate from the diet the following sour fruits and berries:

Acceptable fruits for gallstones are:

• Bananas.
• Sweet apples;
• Melon.
• Watermelon.
• Avocado.
• Strawberry.
• Papaya.

But it is better to cancel the grapes for now. The fact is that against the background of cholelithiasis and gallstones, the patient may experience diseases of the digestive system in the form of pancreatitis or gastritis. Therefore, it is necessary remove foods from the diet, which can provoke inflammation and fermentation of organs. These include grapes, black bread, kvass, cabbage and others.

Listen to yourself, if after this or that fruit you feel discomfort in your stomach, you need to either refuse it, or reduce the dose of consumption.

Vegetables for gallstone disease

But as for vegetables, with cholecystitis and gallstones, they have no restrictions. But you need to be careful about white cabbage in its raw form. If pancreatitis does not appear against the background of cholelithiasis, it can be consumed.

And when you suffer from pancreatic disorders, cabbage need to boil or bake. Even sauerkraut is allowed, but not too sour.

Eat the following vegetables without worry:

1. Carrot.
2. Zucchini.
3. Potato.
4. Beet.
5. Pumpkin.
6. Green pea.

Tomatoes are possible, but not during the period of exacerbation, the skin must be cut off and do not overeat them. Excluded tomatoes salted and marinated. Legumes are excluded from this diet, but they can be eaten in small portions during remission.

So, you found out that with gallstone disease, you need to follow a diet that excludes spicy, canned, fatty and fried foods. What can you drink? The following drinks are allowed during this period:

Mineral water should be drunk half an hour before meals, drink natural tea, not packaged. But coffee, especially instant, with cholelithiasis dangerous, like chicory. It has an equally harmful effect on the gastric mucosa.

It is best to refuse coffee, even natural, if you suffer from diseases of the stomach and pancreas against the background of stones in the gallbladder. If this is not possible, then limit the concentration of the drink, mix it with milk and do not drink on an empty stomach.

Strictly prohibited with this diet cold drinks, especially with ice; alcohol in any form. If there is no exacerbation and pain, then up to 50 grams of dry quality wine is allowed, but only when you yourself want to drink it.

List of allowed and prohibited foods for a diet

When dieting against the background of gallstone disease, it is advisable to introduce such healthy foods and dishes into your diet:

The following products are prohibited:

• meat and fish of fatty varieties;
• salo;
• animal fats and products that contain them (for example, butter);
• fatty sauces (for example, mayonnaise);
• egg yolk;
• fried foods;
• smoked meats;
• canned food (meat and fish);
• fish and meat broths;
• mushroom soup;
• sweet flour products;
• sour berries and fruits;
• cocoa and cocoa-containing products (chocolate);
• coffee;
• alcoholic drinks;
• hot spices and seasonings;
• vinegar marinades;
• sour and carbonated drinks.

Menu for gallstone disease

Diet menu number 5 during the day might look something like this:

The course of treatment with a diet is from one and a half years. All ingredients and composition of dishes can be changed, but follow general guidelines diet is necessary.

If there is a period of exacerbation of gallstone disease, then they practice a special diet, which is called diet number 5a. The duration of its observance is up to two weeks, then the patient must return to a normal diet. The diet menu for exacerbation can be something like this:

• Breakfast - semolina porridge, protein-based omelet, tea with milk.
• Second breakfast - buckwheat porridge seasoned with olive oil, steamed meat cutlets, stale white bread, tea.
• Lunch - half a serving of soup on vegetable broth with rice, boiled chicken fillet, buckwheat porridge in vegetable oil, jelly dessert with milk.
• Dinner - mashed potatoes, boiled fish, tea with milk.
• 2 hours before going to bed - kefir.

As you can see, with cholelithiasis, to improve the condition, you need to follow a fairly strict diet, which involves the rejection of many foods. Of course, it will be extremely difficult to limit yourself. But this is the only way you will prevent the formation of stones in the gallbladder or stop a running process and reduce the risk of surgery.