The content of the article
- Причины и виды воспаления печени 1 Causes and types of liver inflammation
- Диета при гепатите A… 2 Diet for hepatitis A ...
- … гепатите B 3 ... hepatitis B
- … и гепатите C 4 ... and hepatitis C
- Как питаться во время болезни 5 How to eat during illness
- Проблема защелачивающей методики 6 Problem of alkalizing procedure
- Как кормить заболевшего ребенка 7 How to feed a sick child
- Список продуктов 8 Products List
- Ежедневное меню 9 Daily menu
The assimilated fats come back to the liver. Traveling with blood in a free form, the products of fat splitting can not, because they do not dissolve in water. And the liver gives them "packaging" in the form of containers of protein, forming lipoproteins.
But the main "responsibilities" of the liver concern the filtration of blood from the excessively obsolete or simply extraneous components existing there that it splits, turning them into something more suitable for digestion or excretion.
Causes and types of liver inflammation
Hepatitis is called inflammation of the liver tissue, and the inflammation of its ducts is cholangitis. Widely known and cholecystitis is an inflammation of the gallbladder. Due to the outflow of bile from the hepatic ducts into the gallbladder, and not vice versa, the cholecystitis can exist independently - not to affect the liver. But her diseases, especially those accompanied by the formation of stones, soon provoke and cholecystitis as a complication.
Hepatitis causes a variety of reasons.
- Specific viruses. Now the pathogens of not only A, B and C-varieties of hepatitis are known, but also D, G TT SEN. Some of them were discovered less than ten years ago and are in the active learning stage. To say something definite about their properties or treatment of the viral hepatitis caused by them is still difficult.
- Some medicines. Usually with a toxic effect on the liver (all means of atherosclerosis, part - from diabetes mellitus). Sometimes hepatitis provokes a long reception of several different drugs, when their excess is created. Most often, the drug hepatitis passes after the withdrawal of the funds that caused it, but this is not always the case. Particular danger in this regard is statins (means for atherosclerosis). They provoke not only hepatitis, but also liver cancer.
- Alcohol of different strength. With prolonged abuse of alcoholic beverages. Fortress consumed alcohol on the speed of development of the disease does not affect - only the scale and duration of "libations". Alcoholic hepatitis is also reversible, but the dependence that causes it is treatable worse.
- Poisons and toxins. Related to drug and alcohol is toxic hepatitis, since it occurs when ingested hepatotropic poisons (substances with specific toxicity to the liver). Such properties are possessed by antibiotics (especially sulfonamides like "Biseptol"), as well as phosphorus, arsenic, hydrocarbons (components of exhaust gases), phenols (the basis of many means for disinfection), pesticides. Single ingestion of a large dose of hepatotropic poisons into the body provokes acute toxic hepatitis, and repeated administration of their small doses is chronic. In both cases, with the cessation of the action of the poison (if only a single dose does not lead to organ failure), the inflammation of the liver fades and the functions are restored. Diet in toxic hepatitis is not as important as the rapid removal of toxin from the body. But during the acute period it should be strict - completely eliminate fat, fried and spicy food, be based on cooking, stewing and chopping cooked dishes. Patients with toxic hepatitis show a protein diet with a sufficient carbohydrate content. You need small portions and often six or more times a day. Simultaneous damage to the liver and kidneys is a contraindication to a pure protein diet. In this case, it is better to use them, generously "diluting" with carbohydrates and fiber.
- Pathologies of other organs. Most often, too, digestive or excretory. Also, reactive hepatitis can develop as a result of gastritis, duodenal ulcers, chronic pancreatitis or even intestinal infection with worms. It is eliminated by the discovery and treatment of its true cause, but until it is found it differs by a persistent, recurrent course.
- Autoimmune mechanisms. Autoimmune hepatitis is one of the rare and extremely dangerous scenarios of hepatitis due to its unpredictability and incurability. The effectiveness of immunosuppressors in it, unlike other autoimmune diseases, is reduced, the process of liver destruction with the help of the whole set of therapeutic measures can only be controlled partially.
- Bacteria and protozoa. For example, when infected with pale treponema (syphilis) or leptospirosis. The defeat of the liver with bacterial hepatitis is always secondary and develops slowly (bile is one of the least favorable media for the reproduction of bacteria). But it's harder to treat him later. Often, the focus remains in the liver, even after the successful treatment of the underlying infection.
Diet for hepatitis A ...
You can get infected with hepatitis A through dirty products and water, but there is a vaccine from it. Almost 99% of patients transfer this hepatitis in a mild form and recover with the formation of lifelong immunity. The remaining 1% are those who have had severe hepatitis A or died as a result of his fulminant development.
Diet in acute hepatitis A should be observed no more than two weeks, with light flow, minimal restrictions are required on the number of any fats in food. Heavy form requires the use of simple, low-fat, boiled or steam dishes, preferably in a crushed form.
... hepatitis B
Features of the virus B are as follows.
- Transmission path. The virus is transmitted from the patient to the healthy only with close personal contact, through the blood that has got on the damaged skin, as well as with saliva and sperm. Well adapted to survival in the environment, the hepatitis B virus retains infectiousness on blood-stained patient blades, needles of syringes, tips of scissors and other piercing-cutting "utensils" for a week. It is transmitted to the child from the mother during childbirth, but not during pregnancy.
- The influence of age. The younger the hepatitis B infected, the higher the risk of the disease transition into the latent chronic stage. And vice versa, the older it is, the higher the chances that after acute jaundice, hepatitis B spontaneously cures.
The diet for hepatitis B, which occurs with jaundice, requires strict restriction of foods containing any fats, sharp, fried, pickled dishes. There is a need in small portions, five to seven times a day, chopping food before consumption and avoiding "dry-fat".
... and hepatitis C
Hepatitis C is very similar to hepatitis B:
- а также со слюной и другими биологическими жидкостями больного; also transmitted with blood - as well as with saliva and other biological fluids of the patient;
- может колебаться от двух месяцев до полугода. has a long incubation period - can range from two months to six months.
But he is more likely than others to leak chronically and secretively, disguising himself for other pathologies of the liver. Because of the high capacity of the virus to "mimicry", patients may not suspect of infection by them for years and, therefore, do not worry about what can be eaten with hepatitis C, and what can not. Hepatitis C is carcinogenic, but it becomes really dangerous in combination with other liver diseases, including superinfection with closely related strains (B or D).
The meaning of the diet for chronic hepatitis C differs little from nutrition with other hepatitis: increased protein and fiber content and a restriction on fats of all kinds, spicy and fried.
How to eat during illness
Diet with hepatitis is designed to spare the liver as much as possible. It is based on three prohibitions.
- . On fats . All species, including plant, as for their cleavage, too, need bile. Animal fats should be restricted more strictly (from them cholesterol is allocated, "packing" which takes away from the liver an additional resource). Especially it concerns refractory fats: beef, sheep. But you can not completely abolish fats, because with a deficiency of cholesterol in food, the liver doubles its own production. Mixed and modified fats (margarine, spread) require complete elimination. They are characterized by poor digestibility and carcinogenicity even with a healthy liver.
- . On the sharp . Here we mean not only black pepper, but also vinegar. Stimulants of appetite like spices and marinades are also good cholagogues. With stones or obstruction of the ducts, their reception may end with colic. Uncontrolled and accelerated outflow of bile causes the liver to synthesize a new bile faster, which the liver is often unable to do because of hepatitis and the degenerative processes provoked by it.
- . At the fried . This prohibition was created at a time when it was implied that frying any dishes is possible only on fats. But in the last few years, aerogrilles, non-stick pans and other kitchen appliances have been on sale to reduce / eliminate the addition of oils. And now it is already allowed to lightly fry some products with their help.
Given the prevalence of chronic course, nutrition with hepatitis C can be special only if the disease worsens, and follow its rules throughout life is not necessary. As a basis for the drafting of an exemplary menu, the diet No. 5 for Pevzner is usually taken. However, it was compiled at the beginning of the 20th century, when much less was known about viral hepatitis and its varieties than now (the same C-strain of the virus was isolated only in the 1980s).
The problem of alkalizing technique
The alkalizing diet for hepatitis C and liver cirrhosis is often recommended, but not by doctors, but by "folk healers". Its essence consists in drawing up a menu of products rich in products, creating an alkaline environment in the intestine instead of acidic, because "cancer cells do not survive" in it, "rotting processes do not occur" and "no slag is formed".
However, the authors of this diet forget to clarify (or do not know) that the secretion to the duodenum is strongly alkaline, and does not need "help" in the form of dishes creating the same medium. This alkali with digestive enzymes dissolved in it synthesizes the pancreas, and it is called pancreatic juice. Pancreatic juice neutralizes hydrochloric acid, which falls along with the food mass from the stomach into the intestine. And the appearance of its deficiency (the real "oxidation" of the intestinal environment, since alkalis ceases to suffice to neutralize gastric acid) threatens him not just with "slag", but with inflammation and erosions of his walls.
In this case, there are degenerative processes in the pancreas, and the use of alkaline products from them will not help. It is necessary to first cure chronic pancreatitis and make sure that the patient does not have pancreatic cancer, as it is characterized by rapid progress and poor prognosis. And measures like taking baking soda give a palliative effect and mask the true extent of the disease. They also have nothing to do with the work of the liver and hepatitis.
How to feed a sick child
Planning a diet for children older than three years with hepatitis does not differ from its formulation for adults. The complexity is only of the infant age, since the mother's milk is rich in fat, and it contains cholesterol, which is critical for the growth and development of the baby.
The solution may consist in replacing breast milk with an artificial mixture with cholesterol and a reduced content of unsplit fat. But the doctors' comments on the results of such a transfer are usually not the best (the course of hepatitis is relieved slightly, but the risk of developmental lag and digestive disorders for the whole life is growing). In the case of infants, pediatricians consider it more appropriate to designate hepatoprotectors and immunomodulators without weaning.
The table (diet) No. 5 according to Pevzner is calculated on the pathology of the liver in their normal course (beyond exacerbations). The menu can include:
- any stale bread;
- low-fat dairy products;
- protein of any eggs;
- all cereals;
- boiled sausages without fat;
- Soups and borscht on low-fat broth and without the addition of oils;
- low-fat meat (chicken, turkey, rabbit);
- pasta without butter (can be on milk);
- vegetables and fruits, except pickled and sour from nature.
In addition, the following are allowed:
- – мед, сахар-песок, мармелад, желе, варенье, джем и пастила; from sweets - honey, sugar, marmalade, jelly, jam, jam and pastille;
- – укроп, петрушка, корица и ваниль; from spices - dill, parsley, cinnamon and vanilla;
- – кофе (только некрепкий и с молоком), чай, травяные отвары и настои, кисель, фруктовые и овощные соки и фреши. from drinks - coffee (only not strong and with milk), tea, herbal infusions and infusions, jelly, fruit and vegetable juices and fresh.
From diet number 5 are excluded:
- sweet pastries, chocolate and fat-based creams;
- pork, duck and all by-products;
- meat and canned fish;
- Smoked meat and sausages with added fat;
- egg yolks;
- fish roe (any);
- pickled vegetables;
- dressings from vinegar and sour sauces;
- milk and sour cream with high fat content;
- cream, including vegetable;
- legumes, including peas;
- ketchup and mayonnaise;
- radish, radish, horseradish, mustard, garlic;
- any vegetables with a sharp, burning taste;
- spinach, sorrel and other sour vegetables / herbs;
- pure coffee, cocoa, ice cream, cold dishes and drinks.
The diet menu for hepatitis C for each day should be counted on five or more receptions, in small portions (not more than 300 g total weight in each), in a warm form. Recipes are better to choose simple - no more than three components, since complex in composition dishes and are digested with great difficulty. A sample table of foods and meals for each day of the diet can look like this.
Table - Sample diet menu for hepatitis C for a week
|Days||First breakfast||Lunch||Dinner||Afternoon snack||First Supper||Second Supper|
|1|| - Chicken steamed steak; |
- pyshenka on low-fat broth, without oil;
- cottage cheese casserole with raisins
|Rice pudding with carrots and sour cream|| - Borsch without bacon and beans, with meat; |
- cabbage rolls with meat and rice
| - Boiled turkey sausage from turkey; |
- potatoes in uniform without oil
| - Cabbage stew with meat; |
- vegetable salad
|Casserole casserole with powdered sugar|
|2|| - Salad from any fresh vegetables; |
- braised rabbit with sour cream sauce
| - Milk-rice soup; |
- chicken rolls;
- pasta on broth, without oil
| - Buckwheat; |
- grilled chicken breast
|Protein Omelette with boiled pork loin sausage|| - Crab salad; |
- curd pasta with raisins
| - Fruit salad; |
- yesterday's white bread with jam
|3|| - Potato casserole with chicken; |
- Vegetable smoothies without oil
| - Grilled cod fillets; |
- vegetable stew
| - Ear with the addition of vegetables and greens; |
- chilled meat from poultry, without horseradish;
- mashed potatoes
|Domestic dumplings with poultry and smttana|| - Vermicelli with milk; |
- curd pasta with raisins
| - Rice pudding; |
- fruit jelly
|4|| - Macaroni in the Navy; |
- a fresh vegetable salad;
| - Cauliflower in batter; |
chopped chicken fillet
| - Oatmeal soup with low-fat cheese; |
- fillet of pollock, hake or pike perch, baked with vegetables;
- Apples baked with sugar
|Omelet from proteins with crab sticks and squid|| - Vegetable stew; |
- chopped chicken cutlet
| - Vegetable cabbage rolls; |
- fresh fruits
|5|| - Boiled fish with greens; |
- mashed potatoes with sour cream
| - Oatmeal on milk; |
- Vareniki with fruit filling
| - Vegetable soup with rice; |
- chicken, baked with vegetables and cheese;
- carrot and apple cutlets
| - Beet salad with prunes, without garlic, with sour cream; |
- stale bread with jam or jam
| - A sandwich with loin sausage from a bird; |
- fruit smoothies
|6th|| - Zucchini stuffed with vegetables, under a cheese coat; |
- curd and fruit mousse
| - Pike fillet with potatoes; |
- compote or kissel
| - Buckwheat soup with chicken and low-fat sour cream; |
- vegetable stew;
- poultry meatballs
| - Salad from red cabbage; |
- grilled chicken breast
| - Seafood salad; |
- vegetable stew
| - Milk porridge on milk with strawberry jam; |
- milkshake without ice cream and cream, with fruit
|7th|| - Sandwich with low-fat hard cheese and loin sausage from poultry meat; |
- cottage cheese casserole with raisins
| - Meatloaf with dried apricots or prunes and nuts; |
- rice porrige
| - Rice soup with chicken meatballs; |
- Vareniki with potatoes
| - Stewed cabbage with chicken; |
- albumen omelette with crab sticks, shrimps and cheese
| - Fish meatballs for a couple; |
- a fresh vegetable salad
| - Pike perch with sour cream sauce; |
- sweet pumpkin porridge
There are white / black / bran yesterday's bread you can eat with any of these dishes or individually in quantities up to 100 grams per day. The total amount of consumed fats should not exceed 80 g (with exacerbation - 50 g) per day. Nutrition for hepatitis C allows for more frequent preparation of mixed salads (vegetables plus animal products, as in Greek salad). But they still should not be filled with mayonnaise and vinegar, add fat, use marinated "inclusions", cheese, meat and high-fat fish.