Liver Disease

Hepatitis is one of the most common liver diseases, affecting the active tissue of the liver. Acute hepatitis is infectious, and chronic can occur as a result of acute hepatitis, in some chemical intoxications, chronic infections, alcoholism. Chronic ones can be cured or develop into cirrhosis of the liver, in which liver cells are replaced with connective tissue. Hepatic failure may occur as a result of hepatitis and cirrhosis .

In acute hepatitis, diet 5a is recommended, which protects the digestive organs and provides maximum rest to the liver. A complete protein and carbohydrate diet limits fat to 70-75 g. In conditions such as food aversion, nausea, vomiting, bloating, constipation, diarrhea, etc., the amount of fat is reduced to 50 g and is completely excluded when established. intolerance to vegetable oils. The diet is enriched with products and sources of complete proteins and lipotropic substances, primarily dairy (cheese), a number of vitamins (vegetables, fruits, berries and their juices). The amount of easily digestible carbohydrates should not exceed physiological norms. Elevated sugar can impair the excretory function of the liver. You should take 2-2.5 liters of fluid and frequent meals in small portions. The foods are mainly cooked or in the form of puree, porridge. In case of severe acute hepatitis, unloading days are recommended: fruit, dairy or combined. If there are no complications, diet 5a is followed for 3-6 weeks. Further, the regimen continues with diet 5 for a period of 6-12 months.

In case of chronic hepatitis, diet 5 is prescribed . If the disease proceeds normally, without complications and without affecting the other digestive organs, diet 15 is possible, but a strict diet should be followed, do not overeat, exclude from the menu fatty meats, smoked foods, spices, appetizers, usually puff pastry, essential oils of vegetables. Alcohol is absolutely forbidden.

In active chronic hepatitis, if not exacerbated - diet 5, and if exacerbated - 5a. In severe stagnation of bile, sugar is limited and more vegetables, fruits, berries, juices, vegetable oils are added.

In cirrhosis of the liver, if the patient's condition is satisfactory, diet 5 is appropriate, and № 5a is recommended in dyspeptic conditions. In case of diarrhea with signs of impaired fat metabolism, the amount of fat in the diet is limited to 50-60 grams, whole milk and products that have a laxative effect are excluded. In case of edema, diets 5 or 5a are prescribed, depending on the patient's condition, but the meals are prepared without salt; the amount of free fluids is reduced and foods rich in potassium are included. Targeted prescribing of a salt-free diet №7 for a period of 5 to 10 days. With impaired protein metabolism, with the accumulation of nitrogen waste, the amount of animal protein in the diet is limited, and easily digestible carbohydrates increase. In the absence of appetite, an individual diet is prescribed, in which fresh vegetables, fruits, berries, their juices, sour milk products, a little spice, light and lean meat and fish soups predominate. Treatment with diuretics and corticosteroids requires a change in diet.

In severe liver failure due to acute hepatitis or cirrhosis, the amount of protein in the diet is limited to 30-40 grams (animal protein at the expense of dairy and yogurt products; and fat to 20-30 grams with a carbohydrate content of 200-300 grams.

Diet 5a

Diet 5 a is intended for use in acute hepatitis, cholecystitis, exacerbation of chronic hepatitis, gallstone disease, cirrhosis of the liver and other diseases that are in accordance with the diet.

The purpose of this diet is to spare the affected organs as much as possible and to provide complete nutrition in the conditions of pronounced disorders of the liver and bile ducts in connection with inflammatory and degenerative-dystrophic processes in the liver cells and bile organs; normalizes the work of the liver and excretory organs, also helps the organs that are most often involved in the pathological process (stomach, duodenum, pancreas, intestines).

Physiologically, the diet is complete, with reduced fat and salt, with chemical and mechanical irritants to the mucosa and the receptor system of the gastrointestinal tract; with the exception of products and dishes that enhance the processes of putrefaction and fermentation in the intestine; also stimulants for bile secretion, gastric secretion, pancreas, liver irritants (extracts, organic acids, products rich in essential oils, cholesterol, purines, baked goods containing products whose fats are not completely broken down. All dishes are cooked or steamed.Some baked foods without a hard crust are allowed.

Dishes are usually served in the form of puree - soups are mashed or vegetables are chopped very finely, and cereals are well cooked.

Food is taken 5-6 times a day in small portions.

Chemical composition: proteins - 80 g (60% animals), fats - 70-75 g (20-25% vegetable), carbohydrates - 350 g (80-90 g sugar), salt - 8 g, free liquid - 2- 2.5 liters. Caloric content - 2400 kcal.

1. Bread and bakery products:

• suitable: wheat bread made from first-class flour, dried or not fresh;
• unsuitable: fresh and rye breads, butter and puff pastry.

2. Soups:

• suitable: vegetarian with mashed vegetables, cream soups, purees, milk soups with water content; soups of well-cooked cereals, finely grated potatoes, carrots, pumpkin, seasoned with butter, cream, baked flour are allowed;
• not recommended: meat, fish and mushroom broths, and broths from legumes.

3. Meat and poultry:

• suitable: tender and lean meats - beef, rabbit, chicken, turkey; the tendons are separated from their flesh, and the skin from the chicken; boiled meatballs (souffle, meatballs, puree, etc.) are allowed;
• not recommended: fatty meats, duck, goose; fried, stewed and perishable meat products; liver, kidneys, brain, sausages, canned food, smoked meats.

4. Fish:

• allowed: only lean species, boiled or steamed fish;
• forbidden: fatty, salty, stewed fish, canned food, caviar.

5. Dairy products:

• suitable: milk (for colitis - only in food), sour milk products, non-sour fresh semi-skimmed or skimmed cottage cheese and products thereof (souffle, puddings, etc.), grated or steamed;
• unsuitable: cream, sour cream; full-fat and acidic cottage cheese, salty and spicy cheese.

6. Eggs:

• suitable: baked omelets (protein only); in the dishes is allowed only half or a maximum of 1 egg yolk per day;
• unsuitable: other dishes from and with eggs.

7. Cereals:

• allowed: porridge of milk, water and: semolina, rice, buckwheat puree, oatmeal, rice flour and buckwheat flour; semolina or rice souffle, cooked pasta (noodles, etc.);
• not allowed: legumes, millet, crumbly porridge.

8. Vegetables:

• allowed: potatoes, carrots, beets, cauliflower - grated or boiled (puree, souffle, etc.); zucchini and squash are boiled in pieces;
• not allowed: mushrooms, legumes, salted, pickled, pickled vegetables, cabbage, turnips, radishes, sorrel, garlic, onions.

9. Appetizers:

• are prohibited.

10. Fruits, desserts and pastries:

• allowed: ripe, soft and sweet fruits and berries - raw and grated; the fruits can be used boiled or baked; pickles, jellies, mousses; grated dried fruits, lactic acid, honey, sugar, jams, jellies, kisses;
• not allowed: sour and cellulose-rich fruits, chocolate, ice cream, creams.

11. Sauces and condiments:

• allowed: broth of fruits, vegetables and cereals; milk broth with sour cream; the flour should not be baked;
• not allowed: spices.

12. Drinks:

• tea with lemon, milk, light coffee with milk, sweet fruit juices (including forest), rosehip decoction;
• not allowed: cocoa, black coffee, cold and carbonated drinks.

13. Fats:

• allowed: oil, but in limited quantities (pure oil - 20-30 grams per day); if you do not have any intolerance, you can use fresh refined vegetable oils in the dishes;
• no other fats are allowed.

• First breakfast: steamed cottage cheese souffle, boiled rice puree with milk, tea;
• Breakfast: baked apple with sugar;
• Lunch: barley vegetarian soup in the form of puree, steamed meatballs with carrot puree, sour;
• Afternoon snack: rosehip decoction;
• Dinner: steamed fish meatballs with mashed potatoes, semolina pudding with sweet sauce, tea;
• Before bed / night: kefir (lactic acid product).