Treatment of gastrointestinal diseases combines drug therapy and diet. The main part of special dietary diets was compiled in the twentieth century by Professor Manuel Pevzner. Each of his 15 diets has been used successfully to rehabilitate normal digestion. Such diets are called “tables” and have their own serial numbers.
In acute bowel diseases and digestive disorders, a fourth diet is prescribed. This food system is divided into several options, each of which corresponds to a specific condition of the patient. Let us consider each item in more detail: how to properly observe them, what can be eaten, and what is tasty to cook if you can only kissel.
Treatment table №4
Diet No. 4 is prescribed for bowel diseases, accompanied by frequent and loose stools, acute pain and flatulence. In addition, it is used for colitis and exacerbations of chronic diseases of the gastrointestinal tract (ulcer, gastritis, dysphagia). Similar complications are accompanied by upset stools, abdominal pain, nausea, cramping.
The diet is aimed at restoring microflora, relaxing muscles, improving intestinal motility, reducing and completely eliminating inflammatory processes. The purpose of the diet is to provide the easiest nutrition for the patient, to restore the normal functioning of the digestive tract. To achieve this, M. Pevzner compiled a list of necessary measures and products to maintain the digestive system. This is sparing, control of consumed products, compliance with a certain menu.
Mechanical The system provides for maximum chopping. In order to restore the tissues of the tract and accelerate recovery, it is necessary to abandon large-sized foods. The food should be porridge, liquid, mucous. In order not to irritate the walls of the organs and the lining of the tract, the ingredients are ground, knead, and passed through a meat grinder. In other words, the food should look like baby food.
Chemical. It means eating food that does not increase secretion, does not cause rotting or fermentation in the intestines. To better understand the chemical composition, below we consider in detail the list of products. The 4 table is considered inferior, as the amount of carbohydrates and fats must be reduced. The basis of the diet should be proteins. The amount of salt and sugar should be minimal.
Thermal Shaving. It means maintaining a certain temperature of the served dish. Too cold or very hot food (and drink) irritates the mucous membrane. Patients who follow the 4 table are shown exceptionally warm drinks and dishes. The optimum temperature is from 150 to 650. Everything that is consumed by the patient should not irritate the oral cavity. The food should be pleasant, soft and swallow freely. The same rule applies to the composition of food: if it irritates the mucous membrane (spicy, sour, very salty), you can’t eat it.
The basic rules of the diet: you need to eat in small portions and often, on 4-6 once a day, it is strictly forbidden to starve and overeat. From the heat treatment is completely excluded fried and baked with a crust. Food can be cooked, steamed, baked in foil, stewed. These rules apply to all variants of the diet: №4, 4a, 4b, 4v.
In the preparation of the therapeutic menu exclude:
- rich broths, first courses with pasta and whole grain cereals;
- flour products (it is possible only crackers from white bread);
- fatty meat, fish;
- eggs in any form;
- all legumes;
- vegetables (only for decoctions);
- fresh and dried berries and fruits (the use of a small amount of such products in jelly is allowed);
- sparkling water, coffee, strong tea;
- sauces and spices, pickles and canned food.
You can make the menu:
- soups from lean fish, meat and vegetables;
- wheat crackers (100-200 g per day);
- steam and baked rabbit meat, chicken, turkey, low-fat veal and beef;
- semolina, oatmeal, rice and buckwheat (speech about mashed cereals);
- cocoa without milk, decoctions of herbs;
- butter (5 g per meal).
For a visual example, consider an exemplary menu and diet recipes. The menu for the week can be independently composed by choosing from the lists provided.
Menu for table №4
Menu for table №4
|Food intake||List of dishes|
|For breakfast||Liquid semolina, mashed oatmeal, fat-free cottage cheese, grated apples, cocoa, baked pears or apples, green tea|
|For lunch||Broth with semolina, mushroom broth and mashed buckwheat, rice soup with meatballs, weak fish broth with herbs and rice, wheat crackers|
|For dinner||Pureed cereals from permitted cereals, steam cutlets, stewed fish and meatballs, semolina souffle, meat puddings, baked fish (without skin)|
|For snacking||Homemade jelly, jelly, rosehip decoctions, wheat crackers, berry and fruit decoctions (sugar free), cocoa on water, baked pears and apples|
It is quite difficult to follow such a strict diet. The duration of the treatment course is set by the doctor. As a rule, this is a short-term diet, so you have to endure a little. After feeling better, the doctor prescribes a different diet. Consider some recipes that will help diversify the daily menu.
Rice Cocoa Recipe
For cooking you will need:
- 100 g of rice;
- 1,5 L of water;
- 50 Cocoa;
- a little sugar.
Washed rice should be fully cooked over low heat. Strain the resulting mass through cheesecloth. Cocoa grind with sugar until smooth. In a decoction of rice pour cocoa and strain everything again. Serve the resulting drink warm. The recipe is suitable for all variants of the diet and table №10.
Meat dumplings recipe
For cooking you will need:
- Xnumx curd;
- 200 of beef (fillets without tendons and fascias);
- 1 egg;
- 10 g of butter.
Beef must be cut and minced twice. Cottage cheese carefully rubbed through cheesecloth. Mix the minced meat and cottage cheese, salt a little, beat the egg, then add soft butter. Mix everything well and form dumplings. Cook 20 for a couple of minutes. The recipe is suitable for tables: 4, 4a, 4b, 4c.
Medical table 4a
The 4 diet is prescribed for any disorders of the intestines that are caused or accompanied by fermentation, as well as for chronic colitis. To restore the digestive process, products that cause oxidation are completely excluded from the treatment menu. This is the entire list of dishes and ingredients for the 4 table. You should also limit the amount of chicken, fresh dairy products, completely exclude raw vegetables and fruits, coffee, any sweets, carbonated drinks.
The diet consists mainly of protein foods. Fats and carbohydrates are greatly reduced. As a rule, such a diet is prescribed for the first time of treatment, then the patient is transferred to another diet according to Pevzner. Also, all three types of sparing should be strictly observed. The rules for dieting are the same as in No. 4.
You can eat mashed, soft food in a warm form. Of flour products, vermicelli and white crackers are allowed. From dairy products, you can eat fresh and calcined cottage cheese, yogurt and kefir for the night. Cereals are completely excluded, from which only mucous decoctions can be made. Soups can be prepared on secondary fish and meat broths. A complete list of products for colitis should be compiled with a gastroenterologist based on the patient’s condition.
For breakfast: calcined cottage cheese, soft-boiled egg, tea.
At lunch: meat cream soup, chopped vermicelli.
Safe, baked ripe apples.
For dinner: steamed meatballs from lean fish (hake, zander, cod).
A couple of hours before bedtime: 250 ml of yogurt.
Calcined Cottage Cheese Recipe
For the preparation of dietary curd, you need calcium chloride or calcium lactic acid powder. On a liter of milk 0,5 you need one and a half tablespoons of solution or 3 g of powder. Milk should be heated at a low heat to about 400, without removing from the heat add powder or solution. As the curd appears, it must be placed on a cheesecloth to stack.
It is better to choose home-made milk, as it may not be possible at all, or it will turn out from store curds, but too little. This cottage cheese is suitable for all four diet options.
Medical table 4b
If diseases of the intestine are accompanied by disorders in the pancreas, liver, stomach, a therapeutic diet 4b is prescribed. It is used during exacerbations with moderate inflammation. Compared to previous options, this diet is more balanced.
The list of banned products remains almost the same, but less severe. Allowed bread of the first and highest grade, soups with well-cooked cereals (except for millet, barley and pearl barley), boiled cereals, mild cheese, boiled sausage. You can add a little sour cream, cream and milk to the dishes. Butter should be no more than 10 g per day. Natural desserts are allowed: meringues, jellies, marmalade, marshmallows. Some vegetables are also allowed: potatoes, cauliflower, carrots. The rest of the patient will have to adhere to the same framework as in the 4 diet. You need to eat fractionally, the food should be warm and soft.
The menu for the week can be made from a sample list.
- 2 steam omelette with greens, fruit jelly;
- semolina with sweet jam;
- sandwich from dried bread and grated cheese, baked apple;
- oatmeal on the water, grated apple.
- fish broth with potatoes and boiled rice;
- weak beef soup with greens and sour cream, mashed potatoes, steam cutlets;
- soup with barley and grated carrots, buckwheat porridge and meatballs;
- vegetable broth with bread crumbs and sour cream, boiled veal.
- apple jelly, tea;
- dogwood or currant jelly;
- cocoa on water with breadcrumbs or dry biscuits (100 g);
- baked pears, homemade compote;
- calcined cottage cheese.
- pike perch in foil, steam cauliflower;
- boiled beef puree, dried bread, compote;
- boiled tongue, mashed grated boiled carrots;
- fish meatballs in sour cream, boiled rice;
- buckwheat soft porridge, steam rabbit cutlets.
On the day, you should try to consume at least 2500 kcal, nutrition should be balanced and full. That is, you need to eat enough, do not starve, in the diet should be present and cereals, and soups, and meat, and boiled grated vegetables. Adhere to such a power supply system 2-4 week, then prescribe 4v or another diet. The above recipes for rice cocoa and meat dumplings are suitable for this table.
Medical table 4c
The 4 diet is prescribed during the period of remission of diseases of the digestive tract. It is prescribed during the recovery of the patient. The purpose of this diet is to gradually return the patient to normal nutrition. This is a physiologically complete diet. Mechanical sparing is not so strict – it is not necessary to grind food strongly. The meat, vegetables and fruits are finely chopped, cereals are well cooked. Thermal sparing remains the same: dishes and drinks should be warm. Chemical sparing is significantly reduced.
It is forbidden, until the patient is completely restored, to eat: fried, too sour, very salty, fatty, pickled, smoked and canned. Raw raw vegetables, fruits, and berries are also limited (up to 200 g per day). Legumes are not allowed. Coffee, soda and alcohol are also prohibited.
You can enter more dairy products (if tolerated) and fruit juices diluted with water. The weekly menu for the 4b table is also suitable for this diet, but the diet can be further diluted. You can add milk to cereals, some fresh sweet fruits to oatmeal and semolina. It is allowed to add more finely chopped vegetables to soups. Meat and fish are allowed to eat not chopped. For snacks, you can make sandwiches with dried bread, pate, cheese and sausage. From berries and fruits make mashed potatoes, compotes, puddings, jellies. Recipes will be more varied, and cooking them is easier.
The diet is maintained until the patient’s health is restored. Such a diet is periodically recommended for healthy people to prevent gastrointestinal diseases, the main thing is to be sure that there are no problems with the gastrointestinal tract.
The entire cycle of the fourth Pevzner diets is aimed at restoring a complex process of digestion. Strict adherence to the rules will be the key to a speedy recovery and return to the usual menu. To avoid problems with digestion in the future, the basic rules of the diet should become a way of life. Fractional nutrition, healthy and high-quality food, a minimum of fried and fatty, soups for lunch. Minimum requirements for the prevention of complex and extremely unpleasant diseases.