Patients operated on for gastric cancer should be prescribed a complete diet to limit the amount of simple carbohydrates, foods containing animal fat, cholesterol, and with an increase in vegetable oil, buckwheat, sago.
Observations of recent years have shown that in patients operated Io gastric cancer, quite often there are complications from other digestive organs (pancreatitis, cholecystitis, enteritis, colitis). It is known that in patients with organic lesions of the stomach by the time of surgery there are significant violations of the functional state of the digestive system and metabolic processes. Therefore, after surgery, as a rule, complications arise from a number of digestive organs. This fact sets before gastroenterologists the task of compiling a diet for patients who underwent surgery for gastric cancer, taking into account the existing complications.
Patients after gastrectomy who have complications from a number of digestive organs can be recommended the same diet options as for patients who underwent partial resection of the stomach, only slightly reduced calorie content and limited animal fat.
The general principles of nutrition of patients after total resection of the stomach are:
Balanced therapeutic nutrition with sufficient protein content.
Consideration of the nature of osloashei arising after the operation.
Limitation of easily digestible carbohydrates (sugar, honey, steam) and animal fats.
After a gastrectomy in the first 1-2 months , a wiped version of the diet is recommended. Then you can switch to the non – rubbed version. In the long term after surgery, patients after total removal of the stomach, having concomitant pancreatitis, it is better to identify the wiped version of the diet. Often in patients after gastrectomy , various types of intestinal dyskinesia occur. With a tendency to diarrhea, apples are given in a baked form or raw without a peel, exclude milk, sugar. With constipation, vegetable juices, prune broth, cream in tea, vegetable oil in cereals, vegetables, soups can be added to the non-mashed version of the diet; boiled beets. In the absence of complications from the digestive system, a peppermint diet with the usual culinary treatment is prescribed .
Patients operated on for gastric cancer are advised to limit the amount of fat and, if possible, include low-fat products (low-fat cottage cheese, milk, etc.).
Diet option for patients after total removal of the stomach with the presence of complications from the digestive system 1.5-3 months after surgery
General characteristics of the diet
The diet is physiologically complete, with a high protein content, fat content at the lower normal range , with a restriction of complex carbohydrates to the lower pore border and a sharp restriction of easily digestible carbohydrates, with a moderate restriction of chemical irritants of the gastrointestinal tract. Exclude stimulants of bile secretion and pancreatic secretion. Gynoatria diet .
Culinary processing. All dishes are cooked boiled or on the bun, roasting is not allowed. The food is given unprotected . Dishes can be baked with preliminary boiling or stewed with the removal of the first portion of the juice released during braising. The chemical composition and calorie content of the diet. Proteins 120-130 g, fats 80-90 g, carbohydrates 330 g. Calories 2700-2800 kcal. Salt of 8-10 Directed power their fractional (5-6 times a day). The set of products and dishes in this diet is not significantly different from that in the diet for patients with severe dumping syndrome. This diet includes low-fat protein foods – meat, fish, cottage cheese. Oil is introduced into dishes; they don’t give it to the table. An approximate one-day menu of this diet is given in table. The same foods are prohibited as in the diet for patients after partial resection of the stomach.
Historical data
The study of acute intestinal infections has a long history, but it has become especially intense at the end of the last century and in the last decades of the 20th century. The concept of dysentery is very ancient, before it included a variety of intestinal disorders ( dys – disorder, enteros – gut). At the end of the last century, dysentery was isolated from the group of intestinal disorders as an independent infectious disease with a specific pathogen. Other diseases were determined by clinical syndromes: dyspepsia, enteritis, colitis, gastroenteritis, enterocolitis, gastroenterocolitis . In the course of the study, in parallel with the successes of microbiology, virology, immunology, their etilogy also revealed a predominantly infectious factor.
Acute gastrointestinal infections in children have been studied by many domestic scientists (M. G. Danilevich, A. I. Dobrokhotova , V. D. Zinerling . M. A. Skvortsov, M. N. Sukhareva. E. M. Novgorodskaya. M. Berman. N.I. Nisevich , G.A. Timofeeva and many others).
To date, it has been established that the vast majority of acute intestinal diseases has an infectious origin. They can occur as a result of nutritional disorders, but such cases are rare and violations are short-lived. With severe manifestations and severe forms, the infectious nature is detected almost always, with the exception of rare cases of poisoning. ” Syndrome | L > 1e” diagnoses are becoming increasingly rare.
The group of acute gastrointestinal infections in children includes dysentery, salmonellosis, coli infection, staphylococcal infection. They can justifiably be classified as “childhood” infections in connection with the predominant distribution in the pathology of children. For practical measures to combat intestinal infections in children, diarrhea with viral infections is usually included in this group. Typhoid fever is not included in this group, as it has a distinct distinct morphological, pathogenetic, clinical characteristic. Typhoid fever is described in a separate chapter.
Dysentery was identified as an independent nosological unit at the end of the last century, after the discovery of dysentery bacillus. The role of salmonella in the etiology of diseases in humans was clarified at about the same time as dysentery, but in those years only the occurrence of foodborne toxicoinfections was associated with salmonella , subsequently toxicoinfections and toxico-septic conditions in newborns. Salmonellosis received a more complete clinical characterization only in the 50-60s of our century.
The situation was similar with a group of staphylococcal diarrhea. Since the end of the last century, a form in the form of foodborne toxicoinfection has been known . The remaining forms began to be intensively studied in the 50s and even 60s of the present century in parallel with the opportunity to differentiate individual strains of staphylococcus and use immunological methods that confirm the etiological role of staphylococci.
Intestinal coli infection was isolated into an independent nosological form mainly in the 50s in connection with the refinement of the antigenic structure of Escherichia coli; among them, a group of enteropathogenic Escherichia coli (EPA) of various serological types causing intestinal diseases was found.
Finally, intestinal infections caused by viruses were also detected relatively recently – mainly in the 60s, in parallel with the introduction of virological and serovirusological methods of examination.
In recent years, observations have been accumulated suggesting that intestinal diseases can also be caused by Pseudomonas aeruginosa, Proteus, and other microorganisms, but the frequency of these diseases is small, and the clinic has not yet been adequately studied. In addition, intestinal diseases caused by Klebsiella and Yersinia are possible .
Acute intestinal infections are often of mixed etiology (mainly in younger children and in severe forms of the disease). The following concomitant infections are most common: with staphylococcus, with coli infections, with dysentery; dysentery and salmonellosis. Mixed infections can be of a viral and microbial nature, of a mixed viral nature.
Dysentery, salmonellosis, and coli infection are justifiably referred to as intestinal infections. These are intestinal infections, in which intestinal changes are the main essence of the disease, and staphylococcal, viral diarrhea is just one form of staph infection or viral diseases. An intestinal lesion caused by staphylococcus can be an independent, isolated disease, and can also be combined with other localizations of the pathological staphylococcal process.
Acute intestinal infections of various etiologies have
much in common in epidemiological patterns. A number of common features in pathogenesis and morphological changes, some common features in clinical manifestations are noted, therefore, similar, sometimes completely identical, hygienic and therapeutic measures are used. Along with the similarity, each etiological form has its own specific features, which necessitate various preventive measures. Therefore, an accurate clarification of the etiology of each individual case is necessary. Nizho given the epidemiology of acute intestinal infections with the indication of the identities of specific etiologic forms. Separately described pathogenesis, pathological anatomy and clinical characteristics, and differential diagnosis, treatment and prevention in view of the identity of the main provisions are presented in general chapters. An independent chapter is devoted to typhoid fever.