Diet in diseases of the pancreas and gallbladder

Gallbladder diet
The diet in gallbladder diseases is very similar to the diet in pancreatic and hepatic diseases. It is typical for this group of diseases that dietary treatment has played a crucial role in the past. Today, on the it is typical that dietary treatment has some significance in prevention and only limited symptomatic significance - in relief from pain. Diets have lost their significance in treatment

Bile is stored and thickened in the gallbladder. The main function of bile is fat emulsification, which allows the action of digestive enzymes. Bile also has an excretory function (it eliminates harmful substances from the body). Many substances pass through the so-called enterohepatic circulation, meaning the substamces return to the body after reabsorption from the intestine.

Gallstones (cholelithiasis) is a very common disease. It occurs both in relative malnutrition in developing countries (up to 70%) and in developed countries with excessive food intake (30-60% of adults in Europe). It is more common in women, probably due to estrogen. Other risk factors include obesity, long-term parenteral nutrition and constipation. That is probably due to the effect of deoxycholate produced by intestinal bacteria. Influence of the BMI and waist circumference is more visible at a younger age. The protective effect of vegetables and fiber has only been demonstrated in some studies. Alcohol consumptipm probably slightly protects against gallstones (cholelithiasis) and higher cholesterol intake does not have a significant impact on the development of cholelithiasis in humans. Intake of sugar, starch and potatoes probably increses the risk of developimg cholelithiasis. In diagnosed cholelithiasis, a diet with general fat restriction is appropriate. A sufficient amount of quality fat-free protein and relatively more carbohydrates should be taken before surgery. More or less, there is no evidence that a fat-restricted diet plays a role in already existing cholelithiasis. Rather, gradual mild weight reduction and a healthy, babalanced diet, without any deficiency diseases preoperatively are appropriate. Children with gallstones have small fat and protein reserves and tend to have malnutrition.

The daily bile production is about 1000 ml and the gallbladder contains about 70 ml of bile concentrated 10-20 times. Normally, bile is excreted within 5-20 minutes after a meal. In the prevention of gallstones, the regularity of intake(eg 5 times a day) and the restriction of food before bed to 2-3 hours are stated. It is advisable to bite well and eat well and without stress.

A special diet is recommended for bile ducts, which accompanies the movement of the stone through the bile ducts. Acute colic requires plenty of fluids. Suitable is tea, biscuits, cooked fruit, the next days rice, pasta, carbohydrate (sugar) diet. We serve protein first in bread, potatoes and plant foods, and later in skimmed milk, yoghurts, cottage cheese, lean meat. We eliminate long-term fats, such as butter. We don't even serve cheese at first. Cereals and flour products are the main components of the diet. We excrete spices, as do eggs. We recommend cooked and stewed meat, rice mash, water-diluted milk, fat-free mashed potatoes, leafy vegetables or carrots.

Prof. The peacock in the 1980s showed that a diet with a predominant dose of gallbladder-type carbohydrates did not require a reduction or increase in insulin dose in diabetics. Reducing insulin dose in the belief that carbohydrate intake is more complex and dietary volume smaller is the most common mistake in clinical practice. Insulin doses may sometimes need to be increased slightly for inflammation.

A more varied diet is possible with chronic gallbladder disease. This diet is very individual and depends on the tolerance of specific meals in a particular individual. Most patients do not eat fatty meats, fatty spreads, creams and mayonnaise salads. Bound fat in dough is more suitable, butter or vegetable fat can be carefully added up to 30 g / day. Sour dairy products are better tolerated, as are sweet foods, cottage cheese and non-aromatic cheeses up to 30% fat. Fats only fresh, not burnt, from eggs only protein, veal, fish and lean beef. Pork and tendons and intestines are unsuitable. Pastries rather older, unleavened. The greatest variability is in the tolerance of vegetables. Carrots, cauliflower, asparagus, spinach are usually well tolerated, especially apples, apricots, peaches and tangerines, while garlic and onions are not well tolerated. In the acute stages of gallbladder inflammation ( cholecystitis ), we serve a tea diet, or tea and a biscuit, and we can switch to a gallbladder No. 4 diet for 2–3 days, resp. strictly saving with the exclusion of free fat.