Diet For Bowel Diseases: Menu, Allowed And Prohibited Foods

The basic principles of the diet for intestinal diseases

Pathologies and diseases of the intestines occupy a leading place in the list of the most common diseases of our time. What is the reason? Large and dynamic cities dictate their own living conditions. The result of this is a fundamentally wrong approach to their own nutrition: constant “snacks”, fast food and other harmful, as well as poor-quality food, eternal diets and starvation of girls who believe that the secret of beauty is painful thinness, frequent and uncontrolled use of antibiotics, regardless whether they are needed or not.

As a result, the intestinal microflora suffers greatly, inflammation of the intestinal mucosa occurs.

Inflammatory bowel diseases according to the nature of the course can be divided into acute, when the disease is severe, usually short-term in time, and chronic, characterized by a sluggish course of the disease with periods of exacerbation.

An inflammatory process that causes a disorder in the function of the intestine can affect either the entire intestine or any specific part of it. Localization of inflammatory bowel disease can be divided as follows:

• Enteritis is an inflammatory process that is localized in the small intestine and can capture both a separate part of it and the entire organ.

• Duodenitis is an inflammation of the duodenum, in most cases the disease begins with the first section, where the stomach passes into the intestines.

• Mesadenitis is an inflammation of the lymph nodes, which can provoke various pathologies of the mucous membranes.

• Colitis is an inflammation of the mucous membrane of the large intestine, which in most cases affects the entire organ, but there is also inflammation of its individual parts.

Inflammatory phenomena occurring in the intestines have quite serious consequences. They lead not only to violations of its function, but also to organic pathology.

As a result of intestinal diseases, the natural process of digestion of food entering the body is disrupted. Violations are accompanied by inadequate absorption of water and nutrients for the normal functioning of the human body. In addition, serious problems begin in the form of a violation of the process of removing toxic metabolic products. The main symptoms of the appearance and development of intestinal diseases are:

1. Pain in the abdomen - often a person cannot accurately indicate the localization of pain, but characterizes it as bursting or squeezing, pills bring only a temporary restriction, the condition resembles irritable bowel syndrome.

2. The appearance of nausea after eating - often this sign indicates inflammation of the duodenum or small intestine.

3. Bloating - most often indicates a lack of enzymes involved in the digestion process.

4. Weight loss - which most often indicates insufficient absorption of nutrients by the intestinal walls.

It is important to note that any inflammatory bowel disease requires immediate treatment, and a diet for gastrointestinal diseases is an essential adjunct to treatment. Compliance with certain dietary restrictions can significantly improve well-being, speed up recovery and prevent new relapses of the disease.

There are several principles of nutrition that should be followed in case of inflammatory diseases of the gastrointestinal tract:

• it is necessary to provide the patient with a complete, varied and balanced diet in accordance with the physiological needs of the body and the characteristics of the course of the pathological process, do not cut the daily calorie intake too much;

• it is important to provide mechanical sparing of the mucosa of the gastrointestinal tract;

• it is necessary to provide chemical sparing of receptors and mucosa of the gastrointestinal tract

• In the acute stage, functional rest of the stomach, intestines, pancreas, liver and biliary system is necessary;

• thermal sparing of the mucosa and receptor apparatus of the gastrointestinal tract is necessary.

And now let's take a closer look at each of the above principles, how to put it into practice correctly.

In diseases of the digestive system, as in any other diseases, nutrition should be complete, balanced and provide the physiological needs of the body for essential nutrients. However, it must be emphasized that this is a nutritional treatment method, so the diet is made up of specially selected and prepared products that affect individual pathogenetic links of the disease.

First of all, when prescribing a particular diet, changes in the organs that are primarily affected in each specific disease are taken into account. For example, the gastroduodenal region with peptic ulcer, the pancreas with pancreatitis, etc. Next, the state of the organs and systems most often involved in the pathological process is taken into account. For example, the intestines, the biliary system in case of peptic ulcer: pancreas, liver, biliary system in case of intestinal diseases, etc. Be sure to pay attention to the degree of metabolic disturbance and its possible correlation, as well as the state of the body as a whole.

Most diets used in gastroenterological practice contain the physiological norm of all nutrients per kilogram of human body weight:

• 1.5-2.0 g of proteins;

• 1.5-2.0 g of fat;

• 5.0-6.0 g of carbohydrates.

When prescribing a particular diet, it is necessary to take into account the local effect of food on the mucous membranes and the receptor apparatus of the gastrointestinal tract, in particular, its mechanical, chemical and thermal effects. The mechanical effect of food on the mucosa and receptor apparatus of the gastrointestinal tract is determined by the volume of food, its consistency, the degree of grinding, the nature of the heat treatment, the amount of substances in food that irritate the receptor apparatus and the mucous membranes of the stomach and intestines. Mechanical stimuli include fiber, cell membranes, connective tissue. All diets used in gastroenterological practice have different requirements in terms of mechanical effect on the gastrointestinal tract.

With peptic ulcer of the stomach and duodenum in the stage of a sharp exacerbation with symptoms of an irritable stomach, chronic enterocolitis to the stage of a sharp exacerbation with profuse diarrhea, exacerbation of chronic pancreatitis, diseases of the operated stomach and some other diseases of the digestive system, in which strict mechanical sparing is necessary, the daily amount of food decreases up to and is divided into 5-6, and sometimes even 8-10 doses (early after gastric surgery).

In some cases, the patient is given liquid and solid food separately with an interval of 1.5-2 hours (moderate or severe dumping syndrome). Dishes of a liquid and mushy consistency have a lesser mechanical effect on the stomach, they leave it faster than solid and compact dishes.

Another method of mechanical sparing is grinding food by passing it through a meat grinder.

And, finally, another way to implement mechanical sparing of receptors and the mucosa of the gastrointestinal tract is the selection of products containing a smaller amount of connective tissue. For example, rabbit meat, turkey, white chicken meat, veal, etc. Connective tissue sources are meat fascia and tendons, fish and poultry skin.

In diets with pronounced mechanical sparing, meat should be carefully cleaned from fascia and tendons in its raw form before minced meat is cooked, fish and poultry should be skinned. It is also necessary to limit all those products that contain fiber and cell membranes, which are strong mechanical irritants of the mucosa and receptor apparatus of the gastrointestinal tract.

In any inflammatory diseases of the gastrointestinal tract, special importance is attached to the chemical sparing of the secretory apparatus, receptors and mucosa of the gastrointestinal tract. The chemical action of food is determined by a number of factors. First of all - the amount of nutrients that affect the secretory processes in the gastrointestinal tract, the motor function of the stomach, intestines, gallbladder. These are organic acids, extractives, essential oils, etc.

Organic acids enhance the secretion of gastric juice and intestinal peristalsis, extractives accelerate the secretory process in the stomach, intestines, pancreas, liver, biliary system as a whole. When frying, aldehydes and acroleins are formed, which are products of incomplete breakdown of fats. They, in turn, irritate the parenchyma of the liver and pancreas, so frying is rarely used in diet therapy for diseases of the digestive system.

Another type of chemical sparing is a significant or complete restriction of table salt.

The temperature factor has an impact immediately, as soon as food comes into contact with the mucous membrane of the gastrointestinal tract, this is especially important for its upper sections - the esophagus and stomach. Contrasting temperatures have a reflex effect on the underlying sections of the gastrointestinal tract, as well as on the functional state of the liver and pancreas.

Diet for bowel disease

Any diet for gastrointestinal diseases is designed to prevent any irritation of the intestinal mucosa. Although they are not able to influence the disease as such, with the right choice of food, its processing does not aggravate the already significant discomfort of the patient. A proper diet with specially selected products can speed up the healing process of the intestinal mucosa and alleviate the symptoms of the disease.

Most often, doctors of classical medicine for acute intestinal diseases and digestive disorders prescribe a therapeutic diet No. 4, developed by professor-gastroenterologist Manuil Pevzner. This nutrition system has several variations, depending on the patient's condition.

Diet No. 4 is a therapeutic diet, the main purpose of which is to reduce the load on the gastrointestinal tract and is prescribed for acute and chronic bowel diseases, which are accompanied by diarrhea, bloating and other digestive disorders. The diet is prescribed for a fairly short period of time (from 3 to 7 days), in extreme cases, the diet can be extended up to 14 days.

In addition, the diet is used for colitis and exacerbations of chronic diseases of the gastrointestinal tract (ulcer, gastritis, dysphagia). Under such conditions, the patient develops dyspepsia, which is characterized by stool disorder, abdominal pain, nausea, and spasms. Therefore, therapeutic nutrition should fully provide the patient during this period not only with nutrients, but also help reduce inflammatory reactions from the gastrointestinal mucosa.

Also, the diet is aimed at restoring microflora, relaxing muscles, improving intestinal motility. The goal of the therapeutic diet is to provide maximum relief of the digestive process, and as a result, the restoration of the entire gastrointestinal tract. Table No. 4 provides for the observance of a special menu with strict control of food consumed. But the main attention in this diet is paid precisely to sparing and restoring the mucous membrane of the gastrointestinal tract.

The basic principles of the 4th table diet are as follows:

1. Compliance with the calorie content of the diet (about 2050 kcal per day), in case of exhaustion or diarrhea, the daily calorie content can be increased to 2500-3000 kilocalories.

2. Eating 100 g of protein per day, including 70% animal origin, 250 g of carbohydrates, 70 g of fat.

3. Restriction of salt, sugar.

4. Daily consumption of 1.5 liters of water.

5. Cooking only by stewing and boiling.

6. Eating liquid and pureed food.

7. Fractional meals (4-5 times a day).

In order to improve the general condition, improve the functioning of the intestines and reduce inflammation in it, you should follow certain rules for cooking:

1. In the process of preparing soups, you can use vegetable and weak meat broths.

2. Porridge is allowed to cook only on water and broths. They prefer slimy and frayed cereals.

3. Meat dishes can consist of whole cuts of meat, fish or minced meat (meatballs, meatballs), prepared by stewing and steaming.

4. Vegetables are consumed after heat treatment in soups or as mashed potatoes in limited quantities. With constipation, the amount of vegetables consumed can be increased to 300 grams per day.

5. It is recommended to consume 1 egg per day mainly in the composition of meals.

6. It is forbidden to cook fried and baked dishes.

7. It is necessary to observe the principle of thermal sparing, which provides for the temperature of dishes in the range from 15 to 45 degrees.

Lists of allowed and prohibited products

Diet helps to reduce inflammation in the gastrointestinal tract, normalize stools, whether it be diarrhea or constipation, by eliminating certain foods that cause excess bile and digestive enzymes. When compiling a treatment menu, it is recommended to exclude from the diet:

• rich broths, first courses with pasta and whole grains;

• flour products (you can only crackers from white bread);

• fatty meat, fish;

• dairy;

• all legumes;

• vegetables (only for decoctions)

• fresh and dried berries and fruits;

• carbonated water, coffee, strong tea;

• sauces and spices, marinades and preserves, sausages.

You can include in the menu:

• soups from low-fat fish, meat and vegetables;

• wheat crackers (100-200 g per day);

• white meat of turkey, rabbit, chicken, lean veal and beef;

• oatmeal, rice and buckwheat (we are talking about pureed cereals);

• cocoa without milk, decoctions of herbs;

• butter (5 g per meal);

• soups of slimy consistency, cooked in fat-free meat, fish broth or vegetable broth, with well-cooked cereals, noodles or noodles, meatballs are allowed.

Breakfast options that can be prepared:

• oatmeal (ground) in water with butter, soft-boiled egg;

• oatmeal and boiled chicken in the form of a pate with a little oil;

• casserole of buckwheat and fresh (homemade) cottage cheese in breadcrumbs with an egg;

• casserole (soufflé) of rice without milk with eggs and butter, cracker;

• steamed chicken cutlets with butter and egg, rice on the water.

Dinners:

• low-fat chicken broth with semolina, grated buckwheat on the water, chicken steam cutlets;

• soup with meatballs and rice, buckwheat with steam cutlets;

• light broth with rice and chicken soufflé with eggs and butter in the oven, toasted bread;

• fish steam cutlets, buckwheat porridge, light vegetable broth with semolina;

• steam turkey cutlets, rice on the water, broth based on turkey fillet with breadcrumbs;

• soup on a light broth with mashed beef and buckwheat, rice with a steam cutlet.

Dinners:

• steamed omelet;

• buckwheat casserole with egg;

• rice, egg and chicken soufflé;

• baked fish fillet and rice porridge;

• steam cutlets from turkey (or fish), buckwheat porridge;

• buckwheat porridge and two soft-boiled eggs.

Varieties of diets for various diseases of the gastrointestinal tract

Another interesting and working type of diet is the FODMAP diet, which is used for complaints of severe flatulence, abdominal pain, alternating diarrhea and loose stools - all manifestations of IBS (irritable bowel syndrome), as well as inflammatory bowel diseases.

The essence of the diet is to exclude groups of carbohydrates that contain a large amount of fructose, lactose, fructans, galactans and sugar polyols. These carbohydrates are poorly absorbed in the intestines and contribute to the growth of bacterial and fungal flora, which leads to symptoms such as bloating, gas, pain and discomfort in the gastrointestinal tract.

FODMAP содержатся в широком спектре продуктов, и большинство людей ежедневно употребляют в пищу продукты с высоким FODMAP без проблем. Когда FODMAP употребляются в пищу, они медленно движутся по тонкому кишечнику, притягивая воду. Когда они достигают толстой кишки, кишечные бактерии используют FODMAP в качестве источника топлива для выживания. Бактерии быстро ферментируют FODMAP, в результате чего образуется газ.

Below are food groups containing FODMAP substances. Oligosaccharides (fructans and galactooligosaccharides) are found in foods such as wheat, rye, onions, garlic, and legumes. Disaccharides (lactose) - found in dairy products such as milk, soft cheeses, yoghurts. Monosaccharides (fructose) - found in honey, apples, corn syrups, etc. Polyols (sorbitol and mannitol) are found in some fruits and vegetables and are used as artificial sweeteners.

The FODMAP diet allows you to:

1. Reduce pain and discomfort.

2. Reduce bloating and distension.

3. Improve bowel function (reduce diarrhea or constipation).

4. Improve the quality of life.

The diet shows its effectiveness in eliminating the symptoms of diarrhea, bloating, and abdominal pain. Of course, strict adherence to all restrictions is required, however, with their proper observance, many people feel an improvement in the first week of the diet.

In addition to diet, it is also important to reduce the overall level of stress, increase the digestive capacity of the gastrointestinal tract, use nutritional supplements and medications if necessary.

The transition to a low FODMAP diet usually occurs in several stages.

Stage 1. Exclusion of prohibited products. The period of exclusion of prohibited products is usually 3-6 weeks.

Stage 2. Elimination. The duration of a low FODMAP diet is usually 2 to 6 weeks or until symptoms improve. In the presence of SIBO (bacterial overgrowth syndrome), diet alone is not enough to reduce pathogenic or opportunistic flora.

Stage 3. Expansion of the diet. In order to establish a response to a specific FODMAP carbohydrate, it is wise to first expand the diet with foods containing only one of the listed carbohydrates. For example, start with dairy products to rule out lactose intolerance. Then - from honey (a source of fructose). Mannitol is found in mushrooms, sorbitol in fresh avocados and peaches. Fructans, besides some fruits (melon, etc.), are the only FODMAP carbohydrate in fresh onions, red onions, and garlic. Galactans are present in significant amounts in almonds. 3 days are allotted for the introduction of one product.

On the first day, a small portion of the product is consumed. It is usually recommended to start with half a serving (for example, 100 ml of yogurt). If symptoms appear after eating even a small amount of this product, this may indicate lactose intolerance. You should try another product with the same carbohydrate after 3 days. If there are no symptoms with a small serving, continue to assess the tolerance of the usual serving of the product on the 2nd day.

The next day, you can use a standard portion of the product. If unpleasant symptoms and sensations appear, the test on the third day is not carried out, but a break is made for another three days. If all is well, on the third day you can consume a large portion of the product. The presence of symptoms will indicate that such a large amount should not be eaten. In the absence of symptoms after three days, the tolerance of other products from the same group should be assessed. Each new product is evaluated according to the above scheme (day 1-2-3). Between samples with two different products, 3 days must pass in order to completely eliminate the influence of the previous test on the next.

After analyzing the tolerance of various foods within the same group (for example, the group of milk and sour-milk products), you can move on to assessing other carbohydrates. Try a fructose tolerance test with honey and mango. The next group of foods to evaluate are, for example, lentils, hazelnuts and almonds (containing only galactans). Pomegranate, grapefruit, melon and some other fruits, garlic and onions will help assess the tolerance of fructans. Sorbitol is found in peach, apricot, avocado, blackberry. Mannitol is found in large quantities in mushrooms (champignons, porcini mushrooms), as well as in cauliflower.

Diet for intestinal diseases in children

The child may also have bowel disease. Dyspeptic syndrome is quite common: diarrhea, bloating. In such cases, pediatricians, gastroenterologists and nutritionists even recommend that children adhere to the same therapeutic diet No. 4, since it is not dangerous for the child's body, and the choice of products is really large, so people with allergies have the opportunity to replace allergenic products. And, of course, with digestive disorders, the diet is really effective.

If doctors have prescribed a fourth diet, which is therapeutic, this should not be neglected, it is advisable to consider a quality diet that the child will like. For moral support, you can diet with him. Parental support is always extremely important for a child, especially since treatment table No. 4 is, in principle, a fairly suitable and sparing option for a child's incompletely formed gastrointestinal tract.

Consequences of not following the diet

With spontaneous refusal of therapeutic nutrition, especially at the acute stage of the disease, appear:

• pain symptoms, spasms;

• nausea, vomiting;

• diarrhea, to dehydration;

• disorders of bile flow, hepatic colic;

• intoxication of the body with intestinal infections, hepatitis C.

Errors in the diet cause a recurrence of chronic pathology of the gastrointestinal tract.

diet recipes

For cooking you will need:

• 4 tbsp chia seeds

• 150 ml coconut milk

• fresh or frozen berries to taste

In the evening, in a separate container, pour the chia seeds with coconut milk, mix well. Cover with a lid and place in the refrigerator overnight. In the morning, take out the pudding and mix, take out and rinse the berries, chop in a blender. We spread the pudding in layers in a bowl / glass / deep container: 1 layer of berry puree, 2 layer - chia. And so on, until the ingredients run out. Top with a mint leaf.

For cooking you will need:

• 30 gr buckwheat

• 200 ml coconut milk

• 1 handful of berries (fresh or frozen)

• vanilla to taste

Rinse buckwheat, add 150 ml of water and cook for 10 minutes. At the end of the time, add coconut milk, spices and berries and cook for another 5 minutes.

For cooking you will need:

• 70 gr pumpkin

• 100 ml water

• 50 ml coconut milk

• 2 tbsp rice

• 5 gr butter

• 1 tsp poppy

• 20 gr walnuts

• salt

For cooking you will need:

• 150 gr rice risotto

• 200 gr chicken fillet

• 1 tbsp ghee butter

• 1 piece bell pepper

• green onion

• 1 carrot

• 100 ml coconut cream

• salt/pepper to taste

Wash, clean and cut the chicken fillet into cubes. Fry in melted butter for 5-7 minutes. We wash, clean, cut the vegetables, send to the chicken and fry for another 7 minutes. Rinse rice, add to vegetables and chicken, add salt/pepper and fill with water 2 fingers above rice. Leave to cook over medium heat until cooked. Turn off the heat, add coconut cream, stir.

For cooking you will need:

• 500 g cod fillet

• half a small zucchini

• 5 small potatoes

• 1 medium sized carrot

• salt to taste

All listed vegetables must be peeled and washed thoroughly. Cut the zucchini into thin strips, and the potatoes into small cubes. Grate carrots on a coarse grater. Next, you need to boil 1.5 liters of water and add chopped potatoes to it. After the water boils again, it is necessary to reduce the heat, add the fish fillet, pre-washed and diced. As the soup boils, it is necessary to carefully remove the resulting foam. When the broth boils, add chopped zucchini and grated carrots, 1 tablespoon of sunflower oil and salt to taste. After that, the fire is reduced and the soup is boiled for 20 minutes. The finished dish is covered with a lid and insisted for half an hour.

For cooking you will need:

• 1 tbsp coconut oil

• 1 tbsp grated fresh ginger

• 1 red bell pepper

• 200 gr pumpkin

• 3 tbsp tomato paste

• 1 tsp curry powder

• ½ tsp turmeric

• 250 ml coconut milk

• 1 tbsp lemon juice

• salt/pepper to taste

We wash, clean, cut vegetables. Heat coconut oil in a frying pan, add vegetables and simmer for 15 minutes. Add milk, tomato paste, spices and simmer until tender (soft) pumpkin. Serve with herbs and pumpkin seeds.

For cooking you will need:

• 300 gr fresh cabbage

• 200 gr chicken fillet

• 1 carrot

• 2 eggs

• 30 gr walnuts

• herbs: dill, basil, thyme

• spices, salt, pepper

• 1 tbsp ghee

Rinse the fillet, cut into cubes. Fry in a hot pan for 5-7 minutes. Wash, peel and chop the vegetables. Fry with chicken for another 7 minutes. At this time, beat the eggs with a fork or whisk in a separate bowl. Add spices, salt, pepper to taste, herbs. Mix. We take a baking dish and put the chicken fillet and vegetables in it and pour the mixture of eggs. Sprinkle chopped walnuts on top. Send to a preheated oven to 180 degrees for 25-30 minutes.