Therapeutic nutrition for acute gastritis should include in the first hours and days of the disease the most complete mechanical, chemical and thermal sparing of the gastric mucosa. Careful monitoring of the water-electrolyte balance is required. On the 1st day of the disease, it is necessary to refrain from eating, drinking up to 2 liters per day is allowed (broth of wild rose, sweet tea with lemon). On the 2nd day, liquid beggar is prescribed : slimy sun , kissel, jelly, meat soufflé. On the 3rd day, white crackers, steam cutlets, meatballs, dumplings, low-fat broth, potato or carrot puree, mashed compote are allowed. From the 4th-5th day – milk soups, boiled chicken without skin, porridge and shore in a thicker form, fruit juices. When the process attenuates, gradually (after 1-2 weeks ) the patient is transferred to diet No. 15.
If acute gastritis has developed due to any infectious disease, a nutritious diet rich in protein containing all the necessary amino acids in optimal proportions (meat, fish, cottage cheese) is prescribed , eggs). Diet mechanically and chemically sparing, not irritating to the stomach. In the presence of diarrhea, milk is excluded from the diet. The diet contains a sufficient amount of fats, carbohydrates, mineral salts and vitamins.
Therapeutic nutrition for chronic gastritis with secretory insufficiency
Diet therapy is leading in the comprehensive treatment of chronic gastritis. It is built depending on the stage of the disease. The most strict diet is prescribed during the period of exacerbation. As the patient’s well-being improves, the diet gradually expands, and during the period of clinical and endoscopic remission, the food is held as healthy with the exception of indigestible (smoked meats, fatty meats and fish) and irritating the gastric mucosa (spicy, salty, seasoned dishes) types of food.
When building a diet, the state of the secretory, acid and enzyme-forming functions of the stomach should be taken into account .
With all forms of chronic gastritis, nutrition should ensure the intake of a sufficient amount of protein, fat and vitamins. In the period of exacerbation of the disease, it is advisable to take food at least 4-5 times a day.
Therapeutic nutrition for chronic gastritis with preserved and increased secretion
Diet therapy is built on the same principles as for gastric ulcer and duodenal ulcer (diet No. 1).
Chronic gastritis with secretory insufficiency. The main requirements for therapeutic nutrition for gastritis with secretory insufficiency:
full- day nutrition, which contributes to the development of compensatory-adaptive reactions of the digestive system and slows down the rate of progression of chronic gastritis;
fractional diet, in which the processes of digestion and absorption of food substances improve . Diet therapy for patients with chronic gastritis with secretory insufficiency (diet No. 2) is based on mechanical sparing of the gastric mucosa and chemical stimulation of its glandular apparatus with food irritants. This diet is most justified in cases where there is an inflammatory process in the mucous membrane of the stomach, leading to inhibition of secretion.
Particular attention is paid to vitamin therapy (nicotinic, ascorbic acid, vitamins B6 and B12). Niacin and pyridoxine increase the acidity of gastric juice.
General characteristic of diet No. 2
The diet is physiologically full-chain , rich in extractive substances. It has a stimulating effect on the secretory apparatus of the stomach, promotes compensatory and adaptive reactions of the body, and prevents the development of the disease.
Culinary processing. Allowed dishes with varying degrees of grinding and a variety of heat treatment (boiling, baking, frying without breading). The chemical composition and calorie content. Proteins 90-100 g, fats 90-100 g, carbohydrates 400-450 g. Calories 3000-3200 kcal. Free liquid 1.5 l, table salt up to 15 g. The total weight of the daily diet is 3 kg. Fractional diet (4-5 times a day). Food temperature: hot dishes from 57 to 62 ° C, cold – not lower than 15 ° C. The diet can be prescribed for a long time both in the hospital and on an outpatient basis. List of recommended products and dishes Bread and bakery products. Wheat bread white and gray yesterday’s baking, unprofitable varieties of bakery products and cookies. Soups On fat-free meat and fish broth, on vegetable broths with mashed vegetables and cereals. Meat and fish dishes. Cutlets of low-fat beef, veal, poultry, chopped fish products (before frying, do not roll in breadcrumbs so that a rough crust does not form). Partial fish, chicken – in boiled form. Dishes and side dishes from vegetables . Mashed potatoes from various vegetables, puddings, vegetable patties, baked and fried so that a crust forms (not seasoned in flour or breadcrumbs), boiled cauliflower with butter, zucchini and stewed pumpkin, tomato salad. The finely chopped early greens can be added to various dishes. Dishes and side dishes from cereals and pasta. Baked cereals, puddings, cereals cutlets, fried so that a rough crust does not form; finely chopped pasta, boiled vermicelli. Fruits, berries, sweet dishes. Mashed compotes, mashed potatoes, jelly, jelly, mousses from sweet varieties of fruits and berries. Sugar, honey. Milk and dairy products. Milk with tea and other drinks and as part of various dishes, cottage cheese, yogurt, kefir, acidophilus milk. Dishes from eggs. Soft-boiled eggs, scrambled eggs. Nanitki . Tea with milk, cocoa and coffee on the water and with milk. A broth of wild rose and wheat bran, fruit and berry juices (diluted). Snacks Uncooked cheese (grated), soaked herring, doctor’s sausage, low-fat ham. Fats. Butter, sunflower, olive. Sauces: meat, fish, sour cream. Forbidden: pastry, fried meat and fish, boneless in breadcrumbs; canned meat, mushrooms and other snack foods; raw vegetables and fruits; legumes, in-kind milk, brown bread, carbonated drinks, lard, goose, duck, pickles, smoked products, marinades, very hot and cold dishes. A sample menu for patients with chronic gastritis with secretory insufficiency is given in table. Chronic atrophic gastritis develops gradually and is not diagnosed for a long time due to the compensatory activity of the pancreas and intestines. If chronic atrophic gastritis is asymptomatic, it is necessary to stimulate the compensatory capabilities of the digestive tract to prevent the pathological process in other digestive organs and to ensure the physiological nutritional needs of the body. Physiologically complete diet No. 15 meets these requirements without mechanical and chemical dandruff . The content of proteins, fats, carbohydrates and calories correspond to the diet of a healthy person who is not engaged in physical labor, and vitamins are prescribed in an increased amount. Exclude fatty meat, beef, lamb and lard, pastry; spices – in moderation. Culinary processing is conventional rational with the preservation of vitamins. Eating 4-5 times per depot . Treatment of both acute and chronic gastritis of various etiologies should be comprehensive, individualized. In the complex treatment of chronic gastritis, spa treatment is widely used (Essentuki, Pyatigorsk, Zheleznovodsk), local gastrointestinal sanatoriums with salt-alkaline sources. Acceptance of alkaline and salt-alkaline mineral waters 15-20 minutes before a meal stimulates gastric secretion, intake of the same waters 1.5-2 hours before a meal has an inhibitory effect on gastric secretion. Under the influence of mineral waters acting on the interoreceptors of the stomach, evacuation and motor function of the stomach improves.