Digestion after surgery on the digestive tract is greatly weakened. Recovery of a patient after surgery requires extreme caution, especially in nutrition. During the rehabilitation period, the patient should receive enough nutrients and vitamins, but not harm the weakened stomach and intestines with heavy food. To solve these problems, a surgical diet is prescribed, which is called table No. 0.
The therapeutic diet is designed to quickly restore the normal functioning of internal organs and the general well-being of the patient. In addition to patients with gastroenterological diseases, this nutrition system is used to rehabilitate patients in a clinically serious condition.
Scope of the diet
Table number 0 is used in clinics during the recovery period of a patient after operations or brain injuries. Special sparing nutrition is required for patients with impaired cerebral circulation and after traumatic brain injuries.
Infectious diseases that are accompanied by indigestion and fever are treated with this diet and medications. The 0 table is used even for patients in a fainting state caused by serious illnesses.
General characteristics of clinical nutrition
The treatment table No. 0 was compiled by Manuel Pevzner, a scientist, professor of gastroenterology and dietetic nutrition. This diet is designed to restore the patient’s vitality, replenish nutrient reserves and increase the body’s resistance to pathogens.
The diet is very strict, the speed of restoration of health will depend on the exact observance of all the rules. Since such a nutrition system is designed for a weakened body, it implies a decrease in the load on the internal organs, primarily the gastrointestinal tract. To unload the gastrointestinal tract, Pevzner identified three types of sparing that dictate the quality of food for the patient. Food sparing in thermal, mechanical and chemical terms.
Thermal sparing means that food and drinks should be warm. It is forbidden to be very cold and very hot, since such types of food put an additional burden on the stomach and intestines. In the case of impaired brain activity, hot and cold are dangerous, as it excites the central nervous system.
Chemical – means the composition of food and drinks. Until the patient is completely restored, synthetic additives are completely prohibited, salt and sugar are limited. All food must be natural and of high quality. Spices and sauces, sour and salty foods, coffee and strong tea are prohibited. After gastrointestinal surgery, the goal of therapeutic nutrition is to prevent the formation of gases. For this reason, legumes, cabbage, whole milk are prohibited.
Mechanical sparing is a very important point in the diet. It implies the look and texture of food. Indigestible food, coarse fiber is prohibited. Solid food can be allowed by the attending doctor, in other cases, the food should be liquid, in the form of sticky cereals, liquid mashed potatoes. All components must be grinded or passed through a meat grinder several times.
The Pevzner 0 diet number is assigned in three stages. As the patient recovers, more and more permitted products are added to the menu. Each stage lasts from two to four days and has its own name. So, in the first days after complications or surgical interventions, the 0 diet is applied – it is the most strict and limited. After it, the diet expands – this is the 0b diet, the closing phase is called 0v and is designed to prepare the patient for the usual diet.
First stage: 0a table
The initial phase of the diet is intended for patients in a very serious condition: critically elevated temperature, the first days after operations on the digestive system, impaired blood circulation of the brain.
In such situations, the patient may be almost unconscious. At the same time, he needs to replenish the supply of nutrients so that the body is able to rehabilitate.
The 0a diet completely eliminates:
- solid food;
- hot and cold;
- legumes, mushrooms, cabbage;
- spicy, sour, salty.
The patient’s diet at the beginning of treatment will be similar to baby food both in composition and texture. All dishes should be crushed as much as possible, frayed, cooled to normal temperature. Food and drink should be approximately 400-450. It is allowed to introduce into the diet:
- Light meat broth. The meat for him must be selected lean, without skin. It is better to cook the broth on a secondary broth (do not use the first), salt is not allowed. You can add carrots in large pieces during cooking, and get it before eating.
- Not sweet jelly. They need to be prepared only from fresh ingredients, you can use berries or fruits, adding sugar is not recommended.
- Rice jelly. For him, you need to boil one part of the cereal in four parts of water, strain everything. You can add a little cream with low fat content.
- Homemade jelly. You can use non-acidic fruits and berries, you can eat only frozen syrup, whole fruits and pieces are not allowed.
- Natural fresh. Only fruit and berry options are allowed, vegetables are prohibited even in the form of juice. For cooking, you can use non-sour varieties of berries and fruits. An accurate list of permitted items can only be given by the attending doctor, based on the overall picture of the disease.
This will look like table # 0a in the first recovery period. Everything that is not included in the list is prohibited, food and drinks are not seasoned with salt and spices. The entire daily diet should be divided into 7-8 meals, but in small portions. The volume of one medical meal should not exceed 300 g.
In addition to nutrition, the patient needs to ensure an optimal drinking regimen. A day relies from 1500 to 2200 ml of liquid, you need to drink purified warm water. Forbidden sweet water, soda, coffee, strong tea. With the permission of the doctor, a decoction of rose hips or other medicinal drinks are administered.
The caloric content of such nutrition will be no more than 1200 kcal, which will cover energy costs for the vital functions of the body. During the diet, the patient must observe bed rest. After the deadline set by the doctor, the next stage of the diet begins, table number 0а is replaced by 0b.
Second stage: table 0b
The next step is to increase the rate of nutrients and increase calories. Per day, the patient is shown to consume up to 1700 kcal. The diet expands due to mashed and boiled dishes, soups with cereals, various soufflés.
To the above list of permitted ingredients you need to add:
- Buckwheat, Herculean, rice porridge. To prepare, use the proportion of 1: 3, grits well boiled in clean water, then rubbed through a fine sieve several times. Before serving, the dish should cool to the optimum temperature.
- Fish and meat puree. For them, you need to use only lean species. Bones, fat and skin are removed. Mashed potatoes should be minced several times, you can use a blender.
- Chicken eggs. Of these, it is allowed to cook omelet for a couple of proteins. Soft-boiled eggs must be knead well with a fork.
- Mousses. They can be made from non-acidic berries, meat or fish. You need to cook them for a couple.
- Vegetable soups. They are allowed to add cereals, but well boiled.
Food is still not salted, cooked sparingly: steamed or boiled. Of drinks, the same soda, coffee, milk and dairy products are prohibited. It is important, with a minimum set of products, to diversify the patient’s diet as much as possible to make up for the missing macro- and microelements, vitamins.
Preparation of medicinal dishes will take time, but the diet will not last long, and its beneficial effect will significantly speed up rehabilitation. As a rule, table number 0b is appointed for one to two weeks, the exact duration of such nutrition is established by the attending physician. Often this stage of recovery takes place at home, in which case it is better to stock up on useful recipes and make a menu a week in advance. Consider a few of these recipes that will help diversify the diet.
Meat Mousse Recipe:
- lean meat – 100 g;
- one chicken egg;
- 50 ml of milk.
Boil the meat fillet, cool it two times, pass through a meat grinder, you can chop it with a blender to a puree state. Divide the egg into yolk and protein, mix the yolk with meat paste, and beat the protein until a dense foam. Carefully combine the protein mass with the meat mass. Steam the mousse in a greased form.
Recipe for rice soup:
- 200 ml of milk;
- a tablespoon of rice;
Rinse rice cereal until clean water, send it to boil until cooked. Strain the broth and put it on the fire again. Separately, heat the milk and pour a raw egg into it, mix quickly to make flakes. Pour the milk mixture into the rice broth, mix and bring to a boil again. You can put a piece of butter in the soup before serving, unless prohibited by the doctor.
Diet jelly recipe:
- 100 g berries (currants, cranberries, blueberries);
- 400 ml of water;
- potato starch.
Well-washed berries need to be crushed through a sieve, put the glass juice aside, and put the remaining mass from the berries to cook. Strain the finished broth and return to the stove. In cold berry juice, dilute potato starch and pour it into a boiling broth, boil for another minute and leave to cool. With the permission of the doctor, you can add a little sugar or a substitute.
The power mode for the 0b table varies slightly from the previous one. The number of meals is slightly reduced, and the portions are increasing. Per day, the patient can be eaten 5 times, allowed to 400 g of food at one time. The amount of fluid can be increased to 2000 ml.
After the digestion and well-being of the patient improve significantly, it is transferred to the next stage of dietary nutrition.
Stage Three: 0c Table
The final phase of treatment will be the 0c diet. In chemical composition and calorie content, it is close to good nutrition, but it preserves the principles of sparing. It is prescribed only after all the functions of the internal organs are restored.
Dairy and sour-milk products are added to the list of allowed dishes for 0a and 0b tables. Of these, it is allowed to eat low-fat cottage cheese, add sour cream to dishes, you can dilute tea with low-fat milk, cook porridge with milk.
For the first dishes, you can use cereals and vegetables, preferably cream soups. The second allowed boiled and steamed dishes of fish, lean meat, mashed vegetables. From berries and fruits you can still cook jelly, mousse, mashed potatoes, freshly squeezed juices, baked apples of non-acidic varieties are allowed.
Additionally introduced crackers of white bread, preferably homemade. No more than 100 g of dry bread is allowed per day, it can be eaten separately with juice or weak tea, or added to the first dishes.
Option № 1
Breakfast: pureed oatmeal porridge with milk, weak black tea.
Snack: pear juice jelly, steamed protein omelette.
Lunch: mashed soup with rice and potatoes, mashed buckwheat porridge.
Snack: currant jelly, fresh cottage cheese.
Dinner: mashed boiled rabbit, apple compote.
Option № 2
Breakfast: milk tea, tea.
Snack: non-acidic baked apple, decoction of bran.
Lunch: soup on porridge, meat mousse, compote.
Snack: broth hips, carrot jelly.
Dinner: steamed zrazas of lean meat, mashed potatoes with butter.
Option № 3
Breakfast: boiled chicken eggs, dried fruit jelly.
Snack: cottage cheese with sour cream, lime tea.
Lunch: vegetable puree soup, steam hake souffle.
Snack: wheat crackers and pear compote.
Dinner: steamed beef cutlets, mashed oatmeal on the water.
In the process of cooking, the ingredients are still well crushed. Cottage cheese and eggs before meals, too, need to grind to a state of homogeneous mass. Of the heat treatment allowed only boiling in water or milk, steam cooking, with the permission of the doctor enter the baked dishes without a hard crust.
Depending on the condition of the patient and the regression of the disease, the 0 table diet can be expanded with additional ingredients. It is strictly forbidden to introduce prohibited foods into the diet on your own. Ingredients with dubious quality and synthetic additives remain banned until complete recovery. Throughout the entire treatment course, alcohol is contraindicated for the patient, even in small quantities.
Power mode should be fractional, and the portions need to be formed within 350-400 gr. The permissible amount of salt is set by the doctor. If there are no complications, the 0 table allows up to 7 of sodium chloride per day. It is recommended not to salt food during cooking, but to give salt to the patient in his hands for use during meals.
The drinking regimen remains within the physiological need. From drinks decoctions and weak teas, home-made compotes, fresh juices are allowed. Sour-milk drinks can be introduced into the diet after doctor’s approval.
Until the completion of the treatment program, the food should be warm while maintaining chemical and mechanical cleansing.
Results of the therapeutic diet
During the first days of the diet – the 0a table – the patient gradually restores the work of internal organs, primarily the gastrointestinal tract. During this time, the load on all systems of the human body is reduced, which gives him the opportunity to independently fight the disease.
The bulk of nutrients and vitamins comes in at the second stage – the 0b table. During the time set by the doctor, the unloading of internal organs continues, the body accumulates energy and stores it. At this stage, the patient is noticeably recovering, showing a desire to eat.
The 0c table prepares the body’s internal systems to return to their normal way of life and normal diet. The duration of this stage depends on the severity of the disease and its regression. During this period, the patient may look like a completely healthy person, increased appetite and activity, there is a desire to move more.
In some cases, after the 0c table, the patient is prescribed another therapeutic diet according to Pevzner: No. 1, No. 15 and others. This may be necessary if the body still requires sparing, and the disease has not receded.
In addition to its direct purpose – the restoration of affected organs and their functions – the diet provides general health improvement of the body. Natural and easily digestible food will free from the accumulation of toxins, heavy metals, hazardous compounds. Such a nutrition system will reduce the side effects of drug therapy and will allow you to quickly return to an active lifestyle. The main thing is to strictly observe the rules of the diet and the recommendations of the doctor.