Dietary Nutrition In Diseases Of The Liver And Bile Ducts

Time for reading: ~24 minutes Last Updated: August 09, 2022
Dietary nutrition in diseases of the liver and bile ducts

In diseases related to the bile and liver, diet therapy is the basis of treatment.

Varieties of diet therapy


Diet therapy has two varieties - for acute and chronic conditions affecting the liver and bile ducts. Acute viral hepatitis, chronic active hepatitis and liver cirrhosis in the process of exacerbation are referred to acute conditions, for all diseases with manifestations of liver failure, a state of pre hepatic coma, acute cholecyst and acute cholangiohepatitis, in conditions after surgical interventions of the liver and bile ducts. Chronic conditions include chronic active hepatitis and liver cirrhosis outside of exacerbations, chronic cholecyst and cholangiohepatitis, gallstone disease, etc.

In the liver, the exchange of all basic and additional nutrients takes place - proteins, fats, carbohydrates, vitamins, macro and microelements. In it, the exchange of bile acids, bilirubin, and porphyrins takes place. It plays an important role in the synthesis of structural, plasma and enzyme proteins. Serum albumins, prothrombin, fibrinogen, and some globulins are produced in the hepatic Kupffer cells. It is estimated that half of the body's proteins are produced in the liver. In the liver, amino acids are hydrolyzed to their final breakdown products – ammonia and urea. Complex proteins are also formed here - lipoproteins, glycoproteins, etc., which play an important role in the structure and functions of a number of organs and systems. All this requires the inclusion of sufficient proteins in the diet.( 1 :1) animal and vegetable.


Dietary requirements

Food sources of complete protein are cottage cheese, meat, fish, oatmeal, soy, egg white, fresh and sour milk, cheese, lean meats, etc. The use of these products ensures the import into the body of lipotropic factors valuable for liver function - choline, methionine, betaine, cysteine, cystine, inositol, vitamin E, etc. A diet with 100-110 g per day supports the recovery of liver cells and the functional ability of the liver by increasing the so-called labile protein in the protoplasm of liver cells, improving the content of ribonucleic acids, the activity of enzymes, the functions of mitochondria. Limiting proteins to 20-30 gis required in liver failure, accompanied by damage to the processes of deamination and transamination of amino acids and a decrease in the urea synthesizing function of the liver, which leads to hyperammonemia and can cause hepatic coma. Proteins are completely excluded in massive hepatic necrosis with cerebral manifestations, precoma and coma. Proteins are increased to 120-140 g in liver steatosis, especially in exhausted people, in order to counteract fatty infiltration of liver cells and enrich them with amino acids for the synthesis of their own structural proteins, including proteins of the hepatocytes themselves.

Fat reduction

Another important requirement for diets in hepatobiliary diseases is the reduction of fat. It is determined by the role of the liver and bile ducts. Bile is formed and secreted in the liver, which is a colloidal solution of bile salts and acids, phospholipids, cholesterol, bilirubin, etc. substances. The outpouring of vesicular bile ("B") into the duodenum emulsifies the fats from the food and forms a significantly large total surface area of ​​the fat droplets, and facilitates the action of lipases. In case of impaired function of the hepato-biliary system, the formation and release of bile is impaired. This requires limiting fat. In severe liver failure, fats are excluded. Fats are a specific irritant of bile secretion, so they are sharply limited to 30-50 g daily for cirrhosis in decompensation or subcompensation, for acute hepatitis, cholecystitis and cholangiohepatitis, for initial renal failure. During periods of remission, the fat content in the food of patients with chronic liver and biliary diseases should correspond to the physiological norms - 80-90 gdaily, with a normal 2:1 ratio of animal to vegetable fats. This is necessary for several reasons. Above all, ensuring an optimal amount of animal proteins in the diet is possible only when importing an adequate amount of animal fats. On the other hand, the taste qualities of high-protein food are ensured only with the corresponding presence of fat. The fact that fats (especially animal fats) supply the body with a whole series of fat-soluble vitamins is also important, and together with this they support their resorption and exchange in the body. Vegetable fats are also important for the activation of lipolysis enzymes. This function of sunflower, olive, corn, soybean, etc. oils is associated with highly unsaturated (polyenoic) fatty acids. Vegetable oils have a powerful choleretic effect and therefore in hypotonic-hypokinetic dyskinesia, in bile stasis, etc. their share in the diet increases, and the ratio of plant to animal can reach 1:1, 1.5:1.

For liver and biliary diseases, cow butter, cream, fish oil and all dairy products are also used. Pork, sheep, beef fat is maximally limited. With a prolonged diet with a significant restriction, they can lead to vitamin deficiency. This requires the food to be rich in vitamins and minerals, due to the disturbed digestive and resorptive function of the gastrointestinal tract and due to damage to the biological activation of vitamins, i.e. their conversion into coenzymes (phosphorylation) and enzymes (binding them to proteins). The energy value of food in these diseases is normal. It is reduced only in severe liver failure - prehepatargia and in obesity. The carbohydrate content of the food is rich. Simple carbohydrates (glucose, sucrose, fructose) are a valuable energy source and enrich the liver with glycogen. Daily needs of simple carbohydrates are up to 80-100 g. Too high a content of disaccharides and monosaccharides disrupts the colloid stability of bile, which leads to the formation of concretions, enhances the fermentation processes in the intestines and is easily converted into tissue fat. Simple carbohydrates are important in acute processes - they increase glycogen, which improves the function of hepatocytes and prevents fatty infiltration. The diet also requires a rich content of vitamins and minerals. They participate in the regulation of the exchange and in the redox processes of the tissues and the liver. Animal fats in these diseases are reduced, but it is necessary to provide long-chain fatty acids that are not cholesterol-forming. The proportion of unsaturated and polyene fatty acids (vegetable oils) should be increased. Unsaturated fatty acids have a pronounced lipotropic effect, by activating lipases and accelerating cholesterol metabolism, forming labile esters. Due to the risk of a shortage of fat-soluble vitamins (A, K, E), it is necessary to additionally include them in the therapy. Particularly important for the regeneration of hepatocytes is vit. A, but since its formation from carotenes in the liver is impaired, and its resorption in the intestines is impaired, it must be administered parenterally.


Culinary processing of food

The food should be mechanically gentle on the digestive tract, due to the frequent gastrointestinal disturbances that accompany diseases of the liver and bile ducts. This is achieved when the food is prepared by boiling, in a water bath, or steaming. Soups are prepared pureed and uncooked, and dishes with grated meat and vegetables. Broths, irritating spices and fried dishes, chemical irritants, etc. are excluded.



Dietary requirements in acute conditions (PREMIUM)

« Limited fats and proteins, optimal amount of carbohydrates, hypoenergetic and imbalanced food intake (B:M:B= 1:0,8:10);

« The first 7 days – no animal fats, only vegetable proteins, then – cottage cheese, egg white, more fluids in the form of juices and teas;

« Second week – lean meat and fish, 5g vegetable fat per serving, sugar 20g  per serving, no fiber (no cabbage, beets, beans, peas, lentils, etc.);

« Sugars help restore hepatocytes, form and deposit glycogen, counteract fatty degeneration;

« The liver is "bathing" in sugars! 

«  Multivitamins, polyminerals are given additionally;

« In the beginning, three days of rest, giving weak, slightly sweetened teas, a decoction of rose hips. Then it is passed on to slimy and pureed soups, porridges, cottage cheese, grated meat, and fish;

« Increased fluid intake - 2-3 l/d for excretion of bilirubin, cholesterol, bile salts;

« NaCl- little.  


Dietary requirements for chronic conditions (PREMIUM)

« Proteins are in an optimal amount;

« Fats are slightly increased, compared to those in acute conditions, but below the "norm";

« Sweet carbohydrates are in increased quantity (B:M:B=1:0.5:4);

« Normoprotein, normocarbohydrate, hypofat, hypoenergy diet;

« Excluded: animal fats, animal offal, egg yolk, canned food, legumes and nut foods, onions, eggplants, pickles, strong spices and broths, teas and coffees, alcohol and cigarettes;

« suitable foods are: protein foods with lipotropic factors - cottage cheese, yogurt, soy flour, concentrates and isolates, oat and rice products, etc. Fats (vegetable) - rich in PNMK with lipotropic and choleretic action, a little milk fat for delivery of vit. A. Carbohydrates - white bread, pasta, rice, oatmeal, honey, jams, fresh and processed fruits and vegetables, juices.

« zigzags are suitable:

- fruit regime 1-2 days;

- then fruit-milk for 1-2 days;

- sugar compote 1-2 days;

- complete protein 1-2 days.

Diet therapy lasts from 1 to 1.5 years.


Principles of diet therapy in cirrhosis (PREMIUM)

The principles are the same as in other diseases of the liver and biliary tract, but here we have salt reduction, fluid reduction, even more fat reduction, protein reduction - disturbed synthesis of urea from ammonia and risk of encephalopathy. A contrasting diet is used - complete protein (2-3 days) with dairy-vegetarian (cottage cheese, fruits, rice, compotes).

In case of pigmented cirrhosis (hemochromatosis), the diet is poor in iron - no meat, egg yolk, offal, leafy greens, plums, apples).


Selection of food products

1. Milk and milk products

Allowed: fresh milk, preferably reduced-fat or skim cows, fresh soured yogurt, garlic-free tarator, soups made with fresh milk, fruit milks, unaged unsalted cottage cheese, fresh curd cheese, cheese made from skim milk.

Restricted: desalted cow's cheese, low-salt cheese, fresh cheese, low-fat cream.

Prohibited: smoked and processed cheeses, high-fat cream.


2. Meat and meat products

Allowed: lean, free from membranes, cartilage and tendon meat - veal, tender beef, lean lamb, tame rabbit, , after preliminary removal of extractive substances by cooking (boiled, grilled, grilled), poultry - chickens, lean young hens and roosters, turkey, broiler, lean meat soups with vegetables.

Restricted: lean pork, beef liver - best boiled, fillet boiled in water to desalt, dietary sausages.

Prohibited: fatty ham and bacon, fatty meats - pork, lamb, mutton, old and aged meats, animal entrails, pig ears and feet, shank, jellied dishes, canned meats and sausages, meat and liver pâtés, smoked breasts, strong meat sauces , fried and breaded meats, liver, fatty birds - geese, ducks, game - snipe, quail, partridge, pheasant, boar, wild boar, wild rabbit, deer.


3. Fish and fish products

Allowed: lean river fish - barbel, flounder, white fish, trout, pike, carp, etc., boiled or grilled or in the form of dishes, minced fish meat (steamed meatballs, soufflés, etc.)

Restricted: Lean sea fish - mullet, crucian carp, turbot, hake, hake, saffron, boiled or baked.

Prohibited: fatty sea and river fish - bonito, tuna, saffron, soles, catfish, fat carp, eel, lin, canned fish, caviar, non-fish ocean and sea products - squid, clams, oysters, crabs, lobsters, octopus, fish pâtés and fish snacks, fish stock and fish sauces.


4. Eggs and egg products

Allowed: fresh chicken eggs, egg white in the form of omelets, toppings, mousses, protein cream caramel, up to 1⁄4 yolk in meals (2-3 eggs per week ) .   

Prohibited: egg yolk, powdered eggs, duck and goose eggs, mayonnaise, hard-boiled and baked eggs.


5. Fats

Allowed: vegetable salad oils - olive, sunflower, sesame, corn, peanut, etc., fresh cow's oil up to 15-30 g per day.

Prohibited: lard, beef and sheep tallow, duck and goose fat, chicken and turkey fat, ghee, butter, margarine, bacon.


6. Vegetables and canned vegetables

Allowed: raw or cooked carrots, zucchini, cauliflower, beets, potatoes, peppers, collard greens, tomatoes, peas ( in puree form ) , green beans, okra, cucumbers, frozen vegetables, soups made from vegetables, vegetable broths with cheese and pasta, cold tomato soup, salads - raw, cooked.  

Limited: boiled cabbage, white cabbage, radishes, shelled lentils.

Prohibited: spinach, sorrel, eggplants, mushrooms, onions, garlic, pickles, sauerkraut, ripe beans, peas, chickpeas, fried potatoes (chips).


7. Fruit and fruit preserves

Allowed: lemons, oranges, grapefruits, bananas, pineapples, strawberries (garden and forest - have a hepatoprotective effect), cherries, sour cherries, apricots, peaches, melons, watermelons, pears, apples, quinces, pumpkin, grapes, rose hips, sterilized compotes, fruit purees, nectars, natural fruit juices, frozen fruit, fruit salads.

Restricted: currants, raspberries, blackberries, blueberries, dried apricots, raisins, chestnuts.

Prohibited: unripe and sour fruits, prunes, figs, dates, peanuts, walnuts, hazelnuts, almonds.


8. Bread and bakery products

Allowed: white bread (hard and toasted bread is best), breads made with soda, diet bread with cottage cheese, various types of buns, crackers, pretzels, rice flour, rice grains, pasta without eggs, noodles, starch and prepared from milk and fruit creams and sours, ordinary biscuits, oatmeal, porridge with semolina.

Restricted: biscuits made with cow or vegetable oil - "Tea", "Cat's tongue", biscuits, muffins with marmalade, kosunakni muffins, kozunak, pasta products prepared with eggs, homemade noodles.

Prohibited: type of whole grain bread, rye-wheat bread, soft bread, kachamak, fried snacks - doughnuts, soft cakes, pies, pies, burets, tutmanits, biscuits made of puff pastry, boiled and baked corn, popcorn.


9. Sugar, sugar and confectionery products

Allowed: pure bee honey, industrial sugar - cane and beet, glucose - liquid and crystalline, fructose, lactose, sweets made with quality fruit, jams, marmalades, syrups, Turkish delight, candies, fruit desserts with little fat, dietary semolina halva, egg whites, fruit creams, pickles, fruit jellies, egg white caramel, dairy desserts with semolina and rice.

Limited: apple strudel, halva with sesame or sunflower tahini.

Prohibited: butter and syrupy cakes, butter cakes, pastes, salted ice creams, butter cakes, cocoa creams, butter and egg creams, ice cream, chocolate, chocolate products and candies.


10. Drinks

Allowed: lime blossom tea, chamomile tea, mint tea, decoction of rose hips, St. John's wort, parsley, natural and sterilized fruit juices, slightly mineralized mineral waters, anise decoction.

Limited: sweet bosa.

Prohibited: carbonated mineral waters, soda, soft drinks, wine, sour beer, beer.


11. Condiments

Allowed: parsley, dill, celery leaves, devesil, lemon juice, jodgen, vanilla.

Restricted: sweet paprika, tomato paste.

Prohibited: garlic, hot red pepper, hot peppers and chives, spicy and hot sauces, vinegar, mustard, black pepper, allspice, bay leaf, cinnamon, cloves, nutmeg.

Table salt is slightly limited or completely prohibited in ascites!


Food should be taken evenly every 3-4 hours, in small amounts, so that it can be digested and absorbed fully. Eating should be done slowly, in a calm environment, paying enough attention to it. It is necessary to chew the food slowly and well and to salivate enough. Chewing the food is also important in connection with the better breaking down of the protein-containing food products, which leads to a more complete breakdown of these proteins into amino acids needed for restoration of liver structures.

Prevention and lifestyle

A sparing mode of life is particularly important. Sometimes it lasts the whole life of the sick. This mode of life must be characterized by great rigor, moderation and even pedantry, preventing any abuse of food, medicine and all excesses and excessive activity, in order to create conditions for the restoration of liver functions. In this regard, several groups of measures are required. The first group includes strengthening the nervous system and the physical health of the patients. The following recommendations can be given here:

1. Properly organized regime of work and rest;

2. Employment of light work, without particularly heavy tasks, without troubles and tension. Calming the home and work environment;

3. Frequent switching from one activity to another, which allows the nervous system to periodically rest;

4. Moderate physical work, regular morning gymnastics, water procedures;

5. Active struggle with constipation, as it usually complicates chronic hepatitis and deepens the course of liver cirrhosis;

6. Take care of daily rest and sufficient sleep (7-9 hours per day) with an additional break of 1-2 hours after lunch.

The second group of measures includes those that have a curative nature. Patients need systematic resort and balneotherapy in mid-mountain resorts with well-arranged dietary nutrition (Hisarya, Gorna Banya, Merichleri, etc.). In addition, the favorable impact must be taken into account of slightly mineralized alkaline waters for the improvement of bile formation and bile secretion, which stimulates the regeneration of liver cells.

From a prophylactic point of view, the most important thing is to protect against all bacterial, viral and parasitic infections. Every infection affects the liver. It is very important to actively fight against alcoholism and smoking.

Principles of diet therapy in cholelithiasis (PREMIUM)


The diet is like in chronic liver diseases.

Suitable foods: foods that support the macromolecular complex in the bile and prevent the disruption of the colloid-osmotic balance of the bile solution. Such foods are cottage cheese, low-fat milk, lean meats, mineral water, vitamin C, carotenes, all vegetables and fruits (apples, pears, quinces, carrots, beets, etc.). They support bile kinetics and have a hypocholesterolemic effect. Vegetable fats also have a cholecystokinetic effect.

Contraindicated foods: egg yolk, offal, brain, animal fats and fatty meats, bacon, caviar, mayonnaise, cheeses, beans (phytosterols), blue tomatoes, cabbage, spinach, fried foods.

The ratio of vegetable fats to animal fats is 3:1.

The food is moderately warmed - cold foods provoke biliary colic.

In non-calculous cholecystitis:

- atonic conditions and bile stasis - hyperlipidic diet with vegetable and animal fats (cow butter and olive oil, egg yolk, turnip juice), because of their choleretic action, fiber (vegetables and fruits).

-hypertensive cholecystitis- without irritating and cellulose foods.



Eating small portions of food is recommended. In total, 5-6 meals are needed during the day at strictly defined times. Thus, a constant and efficient outflow of bile to the duodenum is maintained - an important condition for avoiding bile stasis. Food should be chewed well, as this reflexively aids bile secretion. Patients should not be distracted during meals. The food should be tasty enough and give pleasure, it should be taken in a calm and cozy environment. This tones up the psyche of the patient and contributes to the harmonious and rhythmic action of the various departments of the body

the digestive system, including the gallbladder and bile ducts.


Prevention and lifestyle

Strict lifestyle. All abuses, including nutritional ones, must be strictly avoided. First of all, patients must regulate their movement regime well. The lack of movement leads to bile stasis, which facilitates the occurrence and development of gallstone disease. Outings among nature. Heavy physical work is prohibited, as well as avoiding lifting and carrying heavy objects. Many of the patients have obesity of II, III and IV    Any infection can become the cause of the invasion of pathogenic microorganisms in the gallbladder and bile ducts, the occurrence of inflammatory processes in the biliary system and the complication of gallstone disease. Stubborn fight against constipation! Regular emptying of the intestines is a condition for excreting significant amounts of cholesterin through the feces. It is recommended to rest in mid-mountain resorts and less often at the sea - mainly in spring and autumn, when it is not hot.


Dietary nutrition in pancreatic diseases (PREMIUM)

Diet therapy for acute and chronic diseases of the pancreas is of crucial importance in the complex treatment. The pancreas plays a major role in the processes of digestion. In one day, this large gland secretes 2 to 4 liters of digestive juice, contains bicarbonates, proteolytic (trypsin), amylolytic (diastase) and lipolytic (lipase) enzymes. The secretory activity of the pancreas is very large. Several times a day (every 2-3 hours) the pancreas synthesizes and emits enzymes.


Dietary requirements

The pancreas is very sensitive to the proteins in the food. The lack of these basic nutrients and especially essential amino acids quickly affects both the synthesis of structural proteins in the pancreatocytes and the normal formation of enzyme proteins. On the other hand, proteins stimulate the formation of the trypsin inhibitor , which prevents the autolysis of glandular cells. With this diet, we have a significant reduction in fat. This is aimed at maximally sparing the pancreatic gland, for whose secretory function fat is a specific irritant. The digestion of the other main food ingredients - proteins and carbohydrates - is the result of a complex effect of salivary enzymes (amylase ), gastric juice (pepsin), intestinal juice (disaccharidases and dipeptidases), etc., while fat digestion is highly dependent on pancreatic lipase. This determines the role and place of the pancreas in the breakdown and resorption of fats, but on the other hand it determines the requirement for the type and quantity of fats in case of disease of this important organ.

In case of chronic pancreatic insufficiency, the digestion and resorption of fats, as well as vitamins A, D, E, K, first suffers, steatorrhea develops. The pancreas has great compensatory capabilities, and in order for steatorrhea to occur, there must be severe damage with destruction of the secretory system. parenchyma 80-90% and a decrease in lipase activity by more than 90% of the norm.

Carbohydrates are the main source of energy in pancreatic diseases, but certain restrictions are imposed. Simple sugars are avoided - candy, sweets, jam, industrial sugar, etc. The menu includes mainly polysaccharides. It is important that the diet does not chemically irritate and damage the gland. Without fried foods, preserves, delicacies, sausages and all other food products containing extractive substances, spices, preservatives.

The food should be rich in vitamins - both water- and fat-soluble: B-group, C, D, E, K. The food should have a high mineral content - both macro- and micro-elements - Ca, K, Mg, Fe, Cu . NaCl is limiting.    

The diet for pancreatic diseases is poor in fat, poor in simple carbohydrates, in ballast substances, in some minerals, and rich in proteins, i.e. imbalanced, and this affects pancreatic function. Increased protein intake stimulates the secretion of proteolytic enzymes, which can deepen the damage to pancreatic structures. Reduced fat consumption causes a decrease in lipolytic enzymes (lipase). A deficiency of fat-soluble vitamins and PNMK-linoleic acid is possible and linolenic acid with a lipotropic effect. Fasting for 3 days (maximum 5 days) is mandatory. During longer fasting, an intrasecretory mechanism (gastrin-secretin-pancreocimin) is activated, as a result of which the secretion of trypsonogen increases sharply at the expense of its own body proteins.


Dietary requirements in acute pancreatitis (PREMIUM)

1. Hunger for 1-3 days.

2. In more severe cases, liquid intake is excluded.

3. In milder cases, give small amounts of alkaline water, rosehip decoction - slightly sweetened (0.5-1 l). The alkaline reaction suppresses the production of secretin (a powerful stimulator of fat secretion).

4. For parenteral nutrition - glucose solution, levulose, alvezin, aminofundin, electrolytes, vitamins, etc. (equivalent to 40 g of protein).

5. Nutrition - for 3-5 days with:

- alkaline waters and rosehip decoction;

- slimy soups of rice, oatmeal, semolina, linseed;

- porridges with skimmed milk and cottage cheese, applesauce, slightly sweetened pickles, cereal porridges, etc.

- creams without eggs, breadcrumbs;

- by the 8th day - pre-rubbed chicken, beef and fish;

- by day 10, the fats are vegetable and no more than 5 grams per portion;

- sugar 5 g per portion;

- salt-highly reduced.

Excluded: meat and fish broths, raw fruits and vegetables, fiber, brown bread, sweets, alcohol.


Dietary requirements in chronic pancreatitis (PREMIUM)

Fats - low, mainly vegetable or synthetic medium-chain fatty acids (portagen), for which pancreatic lipase is not necessary. With the inclusion of portagen in the diet, digestion and absorption in the intestines are sharply improved, steatorrhea is reduced, defecation is regulated, and body mass increases.

Proteins - animal proteins predominate (optimal amount).

Carbohydrates - a moderate amount of polysaccharides (rice, white bread, starch, purees, compotes, raw ripe sweet fruits, etc.).

Vitamins and minerals - high content.

Selection of food products

1. Milk and milk products

Allowed: low-fat and skimmed fresh cow's milk, fresh cow's milk only as an addition to meals and desserts, fresh fermented yogurt, milk sauces, creams made with milk, dietary cottage cheese.

Limited: well-cured brine cheese, fresh sweet or slightly sour cream with 12% fat content, dietary cheeses, fresh "Vitosha" cheese made from cow's milk.

Prohibited: full-fat fresh milk (sheep, buffalo), full-fat cream, smoked and processed cheeses.


2. Meat and meat products

Allowed: lean young meat - veal, tender beef, tame rabbit (without shells, cartilage and tendons) - steamed or roasted, poultry, lean turkey, etc. - roasted, cooked with vegetables and rice, with milk sauce, porridge of flour with a little fresh cow's butter.

Restricted: lean ham, fillet, dietary sausages, lean pork - grilled, boiled.

Prohibited: fatty and old meats, fatty birds - geese, ducks, animal entrails, shank, pig feet, ears and heads, jellied meats, canned meat of any kind, sausages.


3. Fish and fish products

Allowed: lean fresh river fish - barbel, bream, bream, trout, redfin, lean carp - steamed, boiled, in the form of minced meat for meatballs.

Limited: lean sea and ocean fish - cod, hake, turbot, hake, saffron, mullet - mostly cooked.

Prohibited: fatty sea and river fish - autumn mackerel, bonito, tuna, flounder, catfish, moray eel, fat carp, fish paste, canned fish, marinated fish, salted fish - anchovy, sprat, herring, bonito, mackerel, etc. , smoked fish, caviar, non-fish sea and ocean products - clams, oysters, shrimps, crabs, squid.


4. Eggs and egg products

Allowed: egg whites, egg white mousses, snowballs, egg white omelets.

Prohibited: egg yolk, mayonnaise, powdered eggs, fried eggs, goose and duck eggs.


5. Fats

Allowed: none

Restricted: refined and unrefined vegetable oils - sunflower, olive, corn, sesame (in salads and vegetable dishes), fresh cow's butter - in dishes, without frying, by placing at the end of cooking.

Prohibited: beef and sheep tallow, goose and goose fat, animal and vegetable margarines, lard, bacon, fish and chicken fat.


6. Vegetables and canned vegetables

Allowed: salads from young lettuces, cucumbers, carrots, boiled red beets, roasted peppers - without fat or with a little olive oil, zucchini, cauliflower, potatoes - cooked or stewed with a little oil, green beans (without beans), green peas in the form of pureed soups and purées, sterilized canned vegetables, frozen vegetables.

Prohibited: nettles, spinach, horseradish, loboda, sorrel, eggplants, olives, cabbage, turnips, radishes, green onions, leeks, celery, legumes - ripe beans, soybeans, chickpeas, peas, etc., mushrooms, vegetable juices, pickles, pickled salads, vegetable salads prepared with vinegar and spicy spices.


7. Fruit and fruit preserves

Allowed: peeled fruits, well-ripened fruits - apples, peaches, strawberries, cherries, water pears, watermelons, melons, oranges, tangerines, pineapple, bananas, sterilized compotes without much sugar, frozen fruits, fruit purees, freshly prepared diluted fruit juices, unsweetened nectars.

Restricted: raspberries, blackberries, blueberries, blackcurrants, bilberries, dried apples and pears,

Prohibited: dried fruits - dates, figs, prunes, dried apricots, raisins, etc., hazelnuts, almonds, walnuts, peanuts, pumpkin and sunflower seeds, poppy seeds, sesame, poorly ripe sour fruits, lemons, grapefruits, cherries, apricots .


8. Bread and bakery products. Cereals.

Allowed: white bread, "Dobrudja" bread - stale or lightly toasted, white bread rolls, crackers, plain biscuits, pasta, rice in the form of pilaf or with vegetables, with meat, rice grains in the form of porridge, rice flour, starch, pickles, oatmeal, semolina, oven-baked cottage cheese pies, muffins, pretzels, white bread with soda.

Restricted: wheat mucilage, ashure, kosunak and kosunakny kiflis.

Prohibited: type of whole grain bread, rye bread, rye-wheat bread rolls, biscuits prepared with butter, margarine and with a lot of vegetable fat, pies, pies and burettes, tutmanik, milinka, fried snacks - soft, pies, donuts, salted, saltines , biscuits with cinnamon and coffee, buns, corn-boiled or roasted, popcorn.


9. Sugar, sugar and confectionery products

Allowed: artificial sweeteners-saccharin, xylitol, sorbitol, dulcine, cyclamates.

Restricted: pure bee honey (up to 50 g per day), industrial sugar, marmalades, sweets, jams, Turkish delight, sweets prepared with little fat, egg whites, crème caramel with egg whites, eclairs.

Prohibited: chocolate, chocolate products and candies, fried sweets, highly syrupy sweets, desserts made from puff pastry, cakes, pastes made with a lot of fat, butter and chocolate creams, halva, ice cream, etc.


10. Drinks

Allowed: linden tea, mint tea, chamomile tea, rosehip decoction, slightly mineralized alkaline mineral waters from Hisarya, Gorna Banya.

Restricted: diluted vegetable juices, sweet boise, coffee substitutes - Inca, rye, chickpeas.

Prohibited: carbonated mineral waters, soft drinks, strong tea, strong coffee, nescafe, cocoa, alcoholic drinks, very cold and iced drinks.


11. Condiments

Allowed: parsley, dill, chives, savory, vanilla.

Restricted: sweet paprika, tomato juice, diluted lemon juice.

Prohibited: black pepper, allspice, bay leaf, nutmeg, cinnamon, cloves, tomato paste, horseradish, mustard, salsas, spicy and hot sauces, hot peppers and chives, hot red pepper, vinegar, garlic.

Table salt is given in moderate quantities (5-7 g per day) or is limited.


Prevention and lifestyle

Preventive measures concern food hygiene, the fight against alcoholism and smoking, and in the timely treatment of diseases of the digestive system. Nutritional hygiene consists mainly of regular meals with small portions of food, at regular and small intervals of time, and in limiting coarse and fatty food, especially during the warm seasons. All patients with acute pancreatitis should be diagnosed and actively monitored. These patients should also be put on a strict diet.

The treatment of peptic ulcer disease, chronic hyperacid gastritis, enteritis, as well as chronic hepatitis and liver cirrhosis plays a significant role in preventive measures to prevent the development of chronic pancreatitis.

Lifestyle recommendations:

1. A well-programmed, modest, simple and natural way of life.

2. Avoiding feasts, overeating, indulgence and overeating.

3. Fighting hypodynamia - moderate tourism, outdoor walks, excursions, etc.

4. Spa treatment in mid-mountain resorts, also in well-organized balneotherapy centers with well-organized dietary nutrition (Hisarya, Gorna Banya, etc.). Sea resorts should be avoided, as well as active exposure to the sun, since sunburn worsens the course of the disease process.

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