Therapeutic nutrition for functional disorders of the stomach

Functional disorders of the stomach are manifested by a violation of its individual functions, a change in the position and tone of the stomach. The causes of the disorder of certain functions of the stomach may be nutritional, nervous or humoral factors.
A violation of the secretory function of the stomach can not always be regarded as a disease. This function, like other functions of the stomach, is subject to known fluctuations depending on the state of the neuro-glandular apparatus of the stomach and regulatory mechanisms. Violations of the secretory function of the stomach include hypersecretion and hyposocretion . In clinical practice, the principle of differentiation of the secretory function of the glandular apparatus of the stomach according to the level of free hydrochloric acid has been established.
The principles of constructing dietary treatment for patients suffering from hypersecretion and increased acidity of gastric juice are based on creating rest for an “irritated stomach” by maximizing mechanical, chemical and thermal sparing of its mucous membrane. Showing foods and dishes related to weak pathogens of secretion and quickly leaving the stomach, depending on the consistency of the poor. Liquid and mushy beggars evacuate from the stomach faster than solid.
Spicy snacks, fried foods, extractive substances, meat, fish, vegetables, mushrooms, spices, savory snacks, canned food, coffee, alcohol, spices, marinades, carbonated drinks, and ice cream are prohibited.

General characteristics of the diet

The diet is mixed, physiologically complete, with a normal content of proteins, fats and carbohydrates. Food is given in liquid and mushy form with the restriction of dishes containing many cell walls.
Culinary processing. All dishes are cooked boiled or steamed, mashed. The chemical composition and calorie content. Proteins 100-110 g (at least 60% of animal origin), fats 100 g (of which 1/3 are vegetable), carbohydrates 400-450 g. Calories 3000-3200 kcal. The amount of free fluid is 1.5 liters. Salt – 12 g. The mass of the daily diet is about 3 kg. Fractional diet (5-6 times a day). A list of recommended foods and dishes. Bread and bakery products. Yesterday’s or dried wheat bread, as well as crackers. Soups Cereals, dairy, mashed. Meat and fish dishes. Meat of low-fat varieties (beef, veal, chicken) in boiled or steam form, mashed (cutlets, dumplings, meatballs, soufflé, roll, etc.). Non-rigid and lean meat is allowed in a boiled form with a piece. Low-fat (mainly river) fish, boiled or steam in pureed form and a piece. Dishes and side dishes from vegetables. Potatoes, carrots and beets boiled in water, in mashed form. Dishes and side dishes from cereals and pasta. Porridges and puddings semolina, rice, buckwheat and oatmeal crouy , boiled vermicelli, melkonarublennye pasta. Dishes from eggs. Soft-boiled eggs, steam omelet. Fruits, berries, sweet foods and sweets. Sweet varieties of berries and fruits, sugar, honey. Stewed fruit compotes, baked apples, jelly, mousse, jelly. Milk, dairy products. Whole , condensed milk , cream, fresh non-sour cream, fresh low-fat cottage cheese. Snacks Uncooked cheese. Beverages. Tea is weak with milk. Fruit and berry juices (from sweet varieties of fruits and berries), diluted with water, weak. Fats. Unsalted butter, olive, sunflower, well refined. A sample menu is given in table. The technique of dietary therapy. In addition to the quantitative composition of the diet, it is important to follow a diet. Food should be not only frequent, but also fractional, regular. Eating small amounts of food improves digestion and absorption. Patients with functional disorders of the stomach, as a rule, are treated on an outpatient basis. Follow a diet and diet should be a long time and only 2-3 months after the disappearance of all functional disorders of the stomach, you can gradually switch to diet No. 15. At first, the patient refuses mashed food, receives boiled meat with a piece, cereal is friable, vegetables are not mashed . Then 1 time per week include a weak meat or fish broth on the menu. Diet should be observed all life. Achilia functional is caused not by organic damage to the parietal cells producing hydrochloric acid, but by their deep inhibition, which is often based on nervous disorders. Among the causes of the development of functional achilia, there may be eating disorders, mainly unbalanced nutrition, for example, when consuming excess amounts of carbohydrates or fats and insufficient protein content; in case of non-compliance with the diet, violation of its rhythm, overeating, frequent use of alcoholic beverages. Dietary treatment for functional achilia is aimed at activating the secretory function of the stomach. Prescribe mechanical sparing diets containing stronger secretion pathogens. The diet is physiologically complete, with the exception of spicy dishes, smoked meats, fat mutton, pork, duck, goose, marinade, pastry, canned snacks, raw vegetables and fruits, legumes, brown bread, carbonated drinks, milk in kind when intolerant.

Violation of the motor function of the stomach. Functional hypotension of the stomach is one of the options for impaired motor function of the stomach. A typical symptom of decreased stomach tone is a constant splashing in the epigastric region during palpation. Before eating, patients feel good, after eating, they feel pressure, bursting and heaviness in the epigastric region and fast satiety. Diet therapy provides a high-calorie, nutritious, high-protein, vitamin-rich diet. Food should not contain large amounts of slag and water. It is recommended to eat food in small portions, immediately eat no more than two dishes and do not take solid and liquid foods at the same time.

General characteristics of the diet 15

A physiologically complete diet, with a high protein content and slightly higher than the physiological norm of fats and carbohydrates.
The chemical composition and calorie content. Protein 100 g (including animals 70 g), fat 100 (including vegetable 1/3), carbohydrates 500 g. Caloric value 3300 kcal. Salt -15 g. Culinary processing – the usual rational about the preservation of vitamins. Fractional diet (5-6 times a day). The temperature of a beggar is ordinary. A list of recommended foods and dishes. Bread and bakery products. White and rye bread , nechee , biscuit. Soups Different. Meat and fish dishes. Different in any cooking. Fatty varieties of pork, lamb, beef, geese, ducks are excluded. Dishes and side dishes from vegetables and mushrooms. Varied. Dishes from eggs. In any culinary processing. Fruits, berries, sweet foods and sweets. Various. Milk, dairy products and dishes from them. All kinds of. Spices. Pepper, mustard are allowed in moderation. Snacks Varied. Snack canned foods – in moderation. Beverages. Tea, coffee, cocoa, fruit and berry juices. Fats. Butter, ghee, olive, sunflower. A sample menu is given in table. Food is recommended to be taken in small portions, 5-6 times a day. Of great importance is the normalization of working conditions, adequate rest during the day, and sleep for at least 8 hours a day. Hydro-procedures (showers, rubbing with water at room temperature) have a tonic effect . Treatment at balneological resorts is contraindicated, taking a large amount of mineral water is impractical. Functional hypotension of the stomach is treated more often on an outpatient basis. Treatment should be lengthy until all clinical manifestations of the disease disappear , after 2-3 months the diet can be gradually expanded. The hypertonic state of the stomach is characterized by increased motor activity of the stomach, an increase in its tone, and convulsive contraction. Hypertension of the stomach can occur as an independent disease, often as a result of strong nervous overstrain. Secondary functional hypertension of the stomach develops in the initial stages of B1-vitamin deficiency, with some intoxications (zinc, lead), with gastritis, peptic ulcer of the stomach and duodenum, etc.

Movement of the stomach also includes spasm of the stomach, which is observed mainly in young people. The reason for almost all functional motor diseases of the stomach are stress reactions, strong nervous overstrain.
The treatment of patients with functional motor disorders is mainly dietary combined with drug therapy. The principles of constructing dietary treatment, recommended foods and dishes coincide with those for functional diseases of the secretory apparatus of the stomach. The diet is mechanically, chemically and thermally sparing prescribed until complete recovery, after 2-3 months the diet can be expanded. Dietary fractional (5-6 times a day), in small portions. Vitamin therapy is mandatory, especially B vitamins. Sometimes tranquilizers, antispasmodics, physiotherapy exercises, and hydrotherapy are prescribed .
Habitual vomiting develops as a result of a violation of the motor function of the stomach, increased peristalsis and its antiperistalsis. Not always familiar vomiting occurs due to organic lesions of the stomach. The causes of its appearance may be increased excitability of the vomiting center, mental stress, hysterical state, reflex effect on the stomach of nearby organs, etc. Vomiting may become habitual as a result of functional motor disorders of the stomach. The cause that initially caused vomiting may already work, but the established connection between eating and the act of vomiting often remains and becomes fixed. In diseases accompanied by vomiting, it begins a few hours after eating, at the height of pain; vomiting is preceded by nausea; Vomit contains a large amount of acidic liquid and food. Familiar vomiting associated with functional motor disorders of the stomach occurs immediately after or with food. Vomiting is easy. If s is the treatment, the patients lose weight, develop symptoms of vitamin deficiency, disorders of water-salt metabolism. In cases where the cause of habitual vomiting is an organic disease, treatment should begin with the underlying disease. If habitual vomiting is associated only with a violation of the motor function of the stomach, it is necessary to take into account the state of its secretory function. The principles of dietary treatment are aimed at relieving the symptoms of an “irritated stomach”. A diet is prescribed mechanically, chemically and thermally sparing, used for functional disorders of the secretory apparatus of the stomach. If habitual vomiting occurs in individuals with functional achilia, clinical nutrition should be mechanically sparing, but chemically irritating. In some cases, it is advisable to take solid and liquid foods separately. Vitamin therapy and measures aimed at normalizing water-salt metabolism are indicated. Dietary fractional (5-6 times a day), in small portions. It is recommended to expand the diet 2-3 months after clinical recovery. One of the frequent functional disorders of the stomach is aerophagia, i.e., ingestion of a large amount of air and associated belching. Aerophagy is often a symptom of organic damage to the stomach and is observed in chronic gastritis, gastric ulcer and duodenal ulcer. Dietary treatment is aimed at reducing the sensations of heaviness and raspirapiya associated with eating. Exclude nutrients that are long in the stomach (rich in connective tissue, fat), containing carbon dioxide. Clinical nutrition is similar to diet therapy prescribed for functional disorders of the secretory apparatus of the stomach. Dietary fractional (6 times a day), in small portions. In severe cases of aerophagy, a separate intake of solid and liquid food is prescribed. Vitamins are shown in large quantities, especially ascorbic acid and B vitamins. Psychotherapy is essential. Timely and adequate treatment of functional diseases of the stomach leads to a complete recovery and prevents the development of organic lesions of it.

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