Removal of the gallbladder (cholecystectomy) is performed for a number of reasons, but the most common cause is the presence of stones in the gallbladder. After surgery, the problem is resolved: there is no gallbladder and no stones in it, however, such patients have to follow a diet for the rest of their lives.
Basic dietary rules after cholecystectomy
Objectives of clinical nutrition after gallbladder removal:
- creating maximum chemical savings for the liver;
- improving bile secretion;
- ensuring normal functioning of the liver, bile ducts, and entire gastrointestinal tract.
According to a decree of the Ministry of Health, the diet after cholecystectomy in health care facilities complies with the main version of the standard diet (ATD). The diet after gallbladder removal is classified as Treatment Table 5.
Notwithstanding the restrictions in Treatment Table 5, the diet should be physiologically balanced, i. e. , contain the required amount of vitamins and minerals.
Daily nutrient content:
- proteins - 85-90 g, of which 45-50 g of animal protein;
- fats - 70-80 g, of which not more than 25-30% vegetable fat;
- carbohydrates - 300-330 g, and simple sugars - up to 30-40 g.
The daily caloric content of the treatment table after gallbladder removal is 2170-2400 kilocalories.
Principles of nutrition
- diet. The meal should be fragmented: no more than 4-6 times a day in small portions. Although there is no gallbladder, the bile ducts remain, so they must be emptied in time so that the bile does not stagnate in them. In addition, small amounts of food do not burden the liver and other digestive organs, which helps prevent inflammation. Concomitant eating is especially important: so the work of the liver and bile ducts is normalized. Small portions of food prevent the development of obesity, which is very important.
- food processing. Meals can be steamed, baked or cooked. Microwave baking should be avoided, multicookers and double boilers are not prohibited. Occasionally steaming food is allowed. In the first 45 days after surgery, the products are crushed and rubbed during cutting. This type of culinary processing ensures maximum mechanical sparing of the liver and stomach and has a beneficial effect on the entire digestive system.
- food temperature. Meals are only served hot (15-60 degrees Celsius). Foods that are too hot and cold cause bile duct cramps, irritate the stomach and duodenum.
- salt and liquid. The use of sodium chloride meets the physiological norm (8-10 grams per day). They exclude salty foods that irritate the gastrointestinal tract and cause fluid stagnation and thus bile in the body. Consume no more than 2 liters of fluid per day. It is recommended to drink 1 glass of alkaline mineral water without gas 30 minutes before eating, which stimulates the outflow of bile.
- alcohol. Alcohol consumption should be stopped (with rare exceptions). Ethyl alcohol causes smooth muscle cramps and increases bile duct tone. In addition, in the absence of the gallbladder, the liver alone breaks down alcohol, increasing its load. Systematic use of alcoholic beverages is dangerous not only for the recurrence of previous problems with the gallbladder, but also for the development of cirrhosis of the liver.
- we eat deliciously. All meals should be nicely arranged: at a table covered with a tablecloth, with flowers, in a relaxed atmosphere. You should eat slowly, chewing each piece carefully. This allows you to receive fairly moderate doses, which will have a beneficial effect on weight and minimal strain on the gastrointestinal tract.
Prohibited products
First, foods high in cholesterol should be excluded from the diet after gallbladder removal. It causes the bile to thicken and stagnate and promotes stone formation.
Second, since most fat-degrading enzymes are absent from bile after bladder removal, the consumption of animal (refractory) fats should be restricted.
Products that increase bile production and the excretion of gastric and duodenal juices (extracts, spices, marinades, etc. ) should also be avoided. It is contraindicated to eat foods that remain in the intestines for a long time, cause rot and fermentation, stimulate gas formation.
Consumption of simple carbohydrates should also be limited: they are easily broken down, increasing the level of "bad" cholesterol, and deposited in the form of fat layers.
The list of prohibited products includes:
- bread made from premium flour, all pastries and baked goods (pancakes, crepes, pies and pastries);
- cooking oil, margarine, lard of any kind:
- rich broths and soups made from them (meat, fish, poultry);
- fatty meats and poultry (geese, ducks, pork, lamb), tendrils;
- fatty fish (mackerel, sturgeon, catfish, burbot, salmon);
- canned meat and fish;
- all sausages;
- liver (kidney, liver, brain);
- fish caviar;
- sour and bitter vegetables (radish, radish, green onion, spinach, sorrel, daikon);
- fried eggs, egg yolk;
- pickles and pickles;
- smoked meats;
- spices: pepper, mustard, horseradish, vinegar, coriander and others;
- sour berries and fruits;
- ice cream, chocolate, cream products;
- strong tea, coffee, cocoa, sweet carbonated beverages, mineral carbonated waters;
- legumes;
- food from public grocery stores (pizzas, burgers).
Approved products
Foods that are recommended for a person undergoing gallbladder removal should not be irritating and may unnecessarily stimulate the gastrointestinal tract.
It should be used when cooking foods rich in pectin and lipotropics. Lipotropic substances break down cholesterol, preventing it from depositing on the walls of blood vessels (atherosclerosis) and accumulating in the bile, causing it to thicken. Pectins gently cover the mucous membranes of the digestive system, prevent the absorption of harmful substances, stimulate intestinal motility and have a healing effect.
In addition, after removal of the gallbladder, the patient should have a high amount of plant fiber in their clinical diet. It not only contains vitamins but also stimulates bowel movement, preventing bloating, constipation and food retention.
Fermented dairy products should not be forgotten either, as they are valuable sources of animal protein and calcium, containing live bacteria that have a beneficial effect on the gut microflora.
The list of approved products includes:
- yesterday's or dried bread, biscuits, biscuits, biscuits;
- soups in secondary broth, soups in vegetable soup;
- lean meats and poultry (turkey, chicken, veal, rabbit, beef);
- unsalted and low-fat ham;
- crumbly and semi-viscous cereals (buckwheat, oatmeal);
- all seafood as a source of iodine that neutralizes cholesterol;
- lean fish (pike, trout, salmon) as a source of polyunsaturated fatty acids;
- steam protein omelette;
- vegetable oils, butter in containers;
- cottage cheese, kefir, skimmed milk, "live" yoghurt, unsalted and low-fat cheeses;
- fruits and berries (in very sweet and sour processed form: jelly, mousses, jellies, compotes);
- jam, marmalade, chalk;
- fresh greens, tomatoes, cucumbers, sweet peppers, pumpkins, beets, zucchini, potatoes, carrots;
- tea with milk or lemon, weak coffee, alkaline mineral waters, fruit juices and fruit drinks;
- salted salmon, jelly fish, vinaigrette, soaked herring, fresh vegetable salads.
The need for diet
A diet after cholecystectomy allows the liver to maintain its optimal condition and bile secretion, normalizes the functioning of the entire digestive system, and prevents the occurrence of unpleasant moments that often occur after the gallbladder is removed, such as bloating, constipation, and bitterness in the mouth.
In addition, therapeutic nutrition after gallbladder removal prevents the development of atherosclerosis, improves patient appearance, and stabilizes weight.
Consequences of not following a diet
If the diet is not followed after removal of the gallbladder, postcholecystectomy syndrome does not last long, which is a collective term and includes the exacerbation of previous gastrointestinal diseases and the appearance of new ones.
In addition, those who neglect diet after surgery risk not only their appearance (obesity, hypovitaminosis) but also the health of other body systems.