Therapeutic Diet № 4B - In Acute And Chronic Intestinal Diseases

Therapeutic diet № 4B is prescribed for acute intestinal diseases in the recovery period as a transition to a balanced diet. Also in chronic intestinal diseases during recovery amid exacerbation of the problem, as well as in the absence of exacerbation, but in the presence of affected other digestive organs.

Purpose of the diet

To provide complete nutrition in case of insufficient intestinal function, contributes to the recovery of the latter, as well as other organs of the digestive system.

Common feature

Physiologically complete diet with a small increase in protein and moderate restriction of salt, mechanical and chemical irritants of the intestine. Excludes products and dishes that increase putrefaction and fermentation, as well as those that dramatically enhance the secretory and motor functions, gastric secretion, pancreas, bile.

The food is not ground when served, steamed, boiled in water or baked. The temperature of the dishes is normal.

Chemical composition and calorific value:

• carbohydrates - 340-420 grams;
• protein - 100 - 120 grams (60% animal);
• fat - 100 grams (15 - 20% vegetable);
• calories - 2900 - 3000 kcal;
• sodium chloride - 10 grams;
• free liquid - 1.5 liters.

Diet

Feeding should be 5 times a day.

Recommended and prohibited foods and beverages

Soups - prepared from lean meat and fish broths, vegetable decoction with meatballs, various cereals (except millet), noodles, noodles, potatoes, finely chopped carrots, cauliflower, zucchini; if tolerated, white cabbage, beets, green peas can be used.

Highly concentrated and fatty broths, as well as milk, mushroom and bean soups, are prohibited.

Bread and pasta - unleavened or lightly dried bread made of high quality flour, snacks of non-fat and puff pastry (not to be hot), pies and pies with meat, apples, jam, cottage cheese.

Rye and fresh bread, puff pastry and butter dough are prohibited.

Meat and poultry - lean beef, veal, chicken, rabbit, turkey. Remove tendons, fat, skin and fascia. The meat should be cooked in pieces or finely chopped, boiled or steamed. Eat boiled tongue as well.

Do not eat sausages, smoked foods, canned food and fatty meats.

Fish - lean species, cut into pieces or finely chopped. Baking and frying are limited, not breaded.

Do not eat fatty fish, also salted, smoked and canned.

Dairy products - fresh milk added to the main dishes under tolerance, various yogurt drinks, fresh natural cottage cheese in the form of purees, baked or boiled puddings. Different types of cream as an addition to dishes, soft cheeses.

Excludes spicy and salty cheeses, dairy products with high acidity.

Eggs - 1 - 2 a day, soft-boiled, as steamed omelets or in dishes.

Fried and hard-boiled eggs should not be eaten.

Cereals - various porridges of them (without millet and barley). Prepare with water and 1/3 fresh milk. Puddings - baked or steamed, steamed rice balls, pilaf with fruit, cooked noodles, finely chopped pasta.

Legumes are excluded.

Vegetables - potatoes, carrots, cauliflower, pumpkin, zucchini cooked or steamed, crushed, in the form of puree or casserole; if tolerable - white cabbage, beets, green peas (all cooked). Carrot and beet souffle with cottage cheese, lettuce with cream, ripe tomatoes - raw and not more than 100 grams.

Turnips, radishes, onions, garlic, cucumbers, sorrel, spinach, mushrooms are prohibited.

Appetizers - salad of cooked vegetables with cooked meat or fish, jelly fish, boiled tongue, soft cheeses, lean ham.

Spicy and greasy appetizers, smoked products and canned food are prohibited.

Fruits, sweets and confectionery - sweet ripe fruits can be eaten, but their quantity is limited to 100 - 150 grams; apples and pears, oranges, tangerines, watermelon, strawberries, raspberries, grapes without skin are allowed if tolerated. Also baked and raw grated apples. Sour, mousses, jellies, compotes, oshav, jam, jams, kisses, and in case of tolerance and honey instead of sugar.

Do not take apricots, plums, figs, berries with a rough shell, chocolate, ice cream, cakes.

Sauces and spices - sauces based on meat broths and vegetable decoctions, bechamel, fruit sauces and rarely cream. Of the spices can be used vanilla, cinnamon, bay leaf, dill, parsley.

Spicy and greasy sauces, mustard, horseradish and black pepper are prohibited.

Drinks - tea, coffee, cocoa with and without milk, rosehip decoction and wheat bran, fruit and tomato juices diluted with water.

Do not drink grape, plum and apricot juices.

Fats - butter up to 10-15 grams per serving on a slice of bread or as a supplement to meals, if tolerated by refined vegetable fats, such are allowed up to 5 milliliters in the dishes.

All other fats are prohibited.

Sample menu

• First breakfast: soft-boiled eggs, oatmeal made with milk, tea.
• Breakfast: fresh apples.
• Lunch: meat broth soup, pilaf with boiled meat, sour.
• Afternoon snack: rosehip decoction.
• Dinner: boiled fish, mashed potatoes, baked cottage cheese pudding, tea.
• Before bedtime: milk drink.