Диета при воспалении поджелудочной железы | Меню и рецепты диеты при воспалении поджелудочной железы

Какая диета при воспалении поджелудочной железы?

При лечении воспаления поджелудочной железы диетой можно не просто прибегнуть к общим рекомендациям по составу пищи, возможности или невозможности есть те или иные продукты, а использовать уже существующие разработанные врачами схемы диет.

Читайте также: Диета при панкреатите

Самым распространённым подходом является использование вариантов диет (так называемых диетических столов), которые разработаны профессором М. И. Певзнером.

Каждый из этих столов рассчитан на использование при конкретном ряде заболеваний. При чём весь рацион подобран таким образом, чтобы блюда и продукты, которые включены в него не вызвали ухудшения состояния больного даже при тяжёлом его состоянии.

В частности, для лечения диетой при воспалениях поджелудочной железы рекомендован стол №5п. Данный стол рассчитан на торможение внешней секреции поджелудочной железы, щадящий режим для желудочно-кишечного тракта с точки зрения, как химических раздражителей, так и механических, предупреждение дистрофии самой поджелудочной железы, также учитывается и влияние на печень и жёлчный пузырь.

Предлагается пяти или шести разовое питание. Порции еды небольшие. В основном в рацион входит варёная или приготовленная на пару еда относительно жидкой консистенции.

Данная диета низкоэнергетична (1500-1700 ккал), снижено содержание жиров и углеводов, исключены продукты, которые стимулируют секрецию кишечника и желёз, а также грубая клетчатка.

Меню диеты при воспалении поджелудочной железы

Диета для лечения воспаления поджелудочной железы по своему химическому составу должна содержать около 80 г белков, 40 – 60 г жиров, 200 г углеводов. Рекомендовано употреблять в сутки около 1,5 литров жидкости. Соль – не более 8 – 10 г.

В меню включены сухари из пшеничного хлеба, нежная говядина, курица, кролик или индейка, нежирная рыба в виде суфле или кнелей, омлет из белков на пару (можно употреблять не более половины желтка в день в различных блюдах). Молоко можно использовать в приготовлении блюд (но не в сыром виде), а также свежий пастообразный творог, паровые молочные пудинги. Можно в готовых блюдах использовать сливочное и рафинированное растительное масло. Каши должны быть протёртыми, в виде суфле или пудингов. Овощи, такие как картофель, морковь, цветная капуста, кабачки, также могут быть приготовлены на пару, в виде пудингов. Супы также должны быть вязкими – крем-супы из мяса, слизистые супы с добавлением перловки, манки, овсянки, риса. Рекомендованы протёртые компоты, кисели, муссы, а также отвар шиповника или некрепкий чай.

В любом случае тактика лечения диетой при воспалении поджелудочной железы выбирается врачом, потому какие-либо изменения в рационе или меню должны согласовываться с ним и даже могут быть внесены изначально по решению лечащего врача.

Рецепты диеты при воспалении поджелудочной железы

Существует много классических рецептов приготовления продуктов, которые приведены в меню. Но при лечении диетой воспаления поджелудочной железы необходимо их модифицировать так, чтобы не нанести вред здоровью. Приведём несколько примеров рецептов блюд, которые будут не только полезными, но и вкусными при использовании диеты для лечения воспаления поджелудочной железы.

Крем-суп из мяса

Состав:

• Говядина нежирная – 100 г.
• Чечевица – 200 г.
• Укроп (зелень) – 50 г.
• Соль и в очень ограниченных количествах.

Чечевицу предварительно замочить на 20 минут, после чего отварить в 1 литре воды. Мясо нарезать небольшими ломтиками и положить к чечевице, когда та будет готова (через 2 часа приблизительно). Когда мясо будет готово, всё содержимое кастрюли измельчить в блендере или протереть через мелкое сито. Приправить полученный крем солью, украсить мелко нарубленной зеленью. Также можно положить в крем-суп сухарики из пшеничного хлеба.

Чайно – молочный пудинг

Состав:

• Яйцо 1 шт (1 белок и ½ желтка).
• Сахар 1 ст. л.
• Молоко 1 стакан
• Чайные листья 3 чайных ложки.

В молоко добавить чайные листья, довести до кипения и охладить. Яйцо взбить с сахаром и добавить в молоко. Затем разлить по формам и поставить в духовку для запекания на полчаса. Блюдо подают холодным.

Овощи на пару

Состав:

• Кабачок 1 шт.
• Морковь 2 шт.
• Картофель 2 шт.
• Вода 1 стакан.
• Масло оливковое 2 чайных ложки.

Картофель и морковь очистить от кожуры, кабачок освободить от кожуры и косточек. Все овощи порезать мелкими ломтиками. Затем для приготовления на пару можно использовать пароварку, либо разместить овощи в сите над паровой баней. После того, как они будут готовы (минут через 20 – 30) нужно добавить к ним воду (желательно предварительно подогреть до тёплого состояния) и оливковое масло, затем измельчить в блендере. Если нет возможности использовать блендер, то овощи протирают через сито с добавлением воды, а только потом добавляют масло. Соль можно добавить в небольшом количестве.

Читайте также: Рецепты диеты при панкреатите

Важно помнить, что диета при воспалении поджелудочной железы подразумевает тёплую температуру блюд, их нежную консистенцию, а также неразадражающий вкус, потому следует использовать соль и другие специи и приправы как можно осторожнее.

90000 Inflamed Colon: Causes, Symptoms, and Treatment 90001 90002 Colitis is a general term for the inflammation of the inner lining of the colon, which is your large intestine. There are different types of colitis categorized by cause. Infections, poor blood supply, and parasites can all cause an inflamed colon. 90003 90002 If you have an inflamed colon, you’ll likely have abdominal pain, cramping, and diarrhea. 90003 90002 There are a few different types of colitis and other conditions that can cause colon inflammation.90003 90008 Infection 90009 90002 Infectious colitis can be caused by viruses, bacteria, and parasites. A person who has infectious colitis will have diarrhea and fever, and a stool sample that tests positive for enteropathogens such as: 90003 90002 Depending on the cause of the infection, infectious colitis may be contracted from contaminated water, foodborne illnesses, or poor hygiene. 90003 90002 Pseudomembranous colitis is another type of infectious colitis. It’s also referred to as antibiotic-associated colitis or 90015 C.diff 90016 colitis because it results from an overgrowth of the bacteria 90015 Clostridium difficile 90016. It’s most often caused by antibiotic use that interferes with the balance of healthy bacteria in the colon. 90003 90008 Inflammatory bowel disease (IBD) 90009 90002 According to the Centers for Disease Control and Prevention, approximately 3 million U.S. adults had IBD as of 2015. IBD is a group of chronic diseases that cause inflammation in the digestive tract. There are many conditions that fall under the IBD umbrella, but the two main types are: 90003 90024 90025 90026 Crohn’s disease.90027 This condition causes inflammation of the lining of the digestive tract. Any part of the digestive tract can be affected, but it most often develops in the ileum, which is the last part of the small intestine. 90028 90025 90026 Ulcerative colitis. 90027 This causes chronic inflammation and ulcers in the innermost lining of the colon and rectum. People with ulcerative colitis have an increased risk for colon cancer. 90028 90033 90008 Ischemic colitis 90009 90002 Ischemic colitis occurs when there’s reduced blood flow to a portion of the colon.This stops the cells in your digestive system from getting the oxygen they need. 90003 90002 It’s usually caused by narrowed or blocked arteries. People who are age 60 or older, have high cholesterol, or a clotting disorder have an increased risk for ischemic colitis. 90003 90002 Ischemic colitis can affect any part of your colon but you usually feel pain on the left side of the abdomen. It can occur gradually or suddenly. 90003 90002 [INSERT BLOCK QUOTE: If you feel severe pain on the right side of your abdomen, get emergency medical care.] 90003 90002 Symptoms on your right side may indicate blocked arteries to your small intestine that can quickly cause necrosis of intestinal tissue. This is life-threatening and requires urgent surgery to clear the blockage and remove the damaged portion. 90003 90008 Allergic reactions 90009 90002 Allergic colitis is more common in babies than adults, affecting between 2 and 3 percent of infants. The inflammation is an allergic reaction to the proteins found in cow’s milk. A baby with an inflamed colon may be irritable, gassy, ​​and have blood or mucus in their stools.Anemia and malnutrition are also possible. 90003 90002 Eosinophilic colitis is similar to allergic colitis. When it occurs in an infant, it usually resolves by early childhood. In adolescents and adults, the condition is often chronic. The exact cause of eosinophilic colitis is not always known, though proteins in cow’s milk often makes symptoms worse. People with a personal or family history of allergies and asthma appear to have a higher risk. 90003 90008 Microscopic colitis 90009 90002 Microscopic colitis can only be seen through a microscope.It’s characterized by an increase in lymphocytes, which are a type of white blood cell, in the lining of the colon. 90003 90002 There are two types of microscopic colitis and though both show an increase in lymphocytes, each type affects the tissue of your colon in a different way. 90003 90024 90025 Lymphocytic colitis has a higher number of lymphocytes, and the tissues and lining of the colon are of normal thickness. 90028 90025 In collagenous colitis, the layer of collagen under the lining of the colon is thicker than normal.90028 90033 90002 The cause of microscopic colitis is not known, but researchers believe it may be linked to: 90003 90024 90025 autoimmune diseases 90028 90025 certain medications 90028 90025 infections 90028 90025 genetics 90028 90033 90002 The symptoms of this type of colitis often come and go , sometimes disappearing without treatment. 90003 90008 Drug-induced colitis 90009 90002 Certain medications, mainly nonsteroidal anti-inflammatory drugs (NSAIDs) have been linked to inflamed colon in some people.Elderly people and people with a history of long-term use of NSAIDs appear to be at highest risk for developing this type of colitis. 90003 90002 Even though there are different types of colitis with different causes, most of the symptoms are the same: 90003 90024 90025 diarrhea with or without blood 90028 90025 abdominal pain and cramping 90028 90025 fever 90028 90025 urgency to have a bowel movement 90028 90025 nausea 90028 90025 bloating 90028 90025 weight loss 90028 90025 fatigue 90028 90033 90002 Treatment for colitis may vary depending on the cause.If it’s caused by an allergy to a certain food or side effect from a drug, your doctor will recommend removing the food from your diet or changing medication. 90003 90002 Most types of colitis are treated using medication and changes to your diet. The goal of treatment for colon inflammation is to reduce the inflammation causing your symptoms. 90003 90002 Medications used to treat colitis may include: 90003 90002 The following lifestyle changes may help relieve your symptoms: 90003 90024 90025 keep track of and avoid foods that trigger or worsen your symptoms 90028 90025 eat smaller, more frequent meals throughout the day 90028 90025 avoid foods that increase stool output, such as caffeine and raw fruits and vegetables 90028 90025 limit alcohol consumption 90028 90025 stop smoking; this can be difficult, but a doctor can help you create a plan that’s right for you 90028 90033 90002 Surgery may be recommended if other treatments are not able to relieve your symptoms or if you have severe damage to your colon.90003 90002 Chronic diarrhea, severe abdominal pain, or blood in your stool should be evaluated by a doctor. Severe abdominal pain that comes on suddenly and makes it difficult for you to get comfortable may be a sign of a serious condition that requires emergency medical treatment. 90003 90002 The symptoms of an inflamed colon, known as colitis, can cause discomfort that impacts your quality of life. There are treatment options that can help. Speak to a doctor to find out the best way to treat your symptoms.90003.90000 6 Foods That Cause Inflammation 90001 90002 Inflammation can be good or bad depending on the situation. 90003 90002 On one hand, it’s your body’s natural way of protecting itself when you’re injured or sick. 90003 90002 It can help your body defend itself from illness and stimulate healing. 90003 90002 On the other hand, chronic, sustained inflammation is linked to an increased risk of diseases like diabetes, heart disease, and obesity (1, 2, 3). 90003 90002 Interestingly, the foods you eat can significantly affect inflammation in your body.90003 90002 Here are 6 foods that can cause inflammation. 90003 90014 1. Sugar and high-fructose corn syrup 90015 90002 Table sugar (sucrose) and high fructose corn syrup (HFCS) are the two main types of added sugar in the Western diet. 90003 90002 Sugar is 50% glucose and 50% fructose, while high fructose corn syrup is about 45% glucose and 55% fructose. 90003 90002 One of the reasons that added sugars are harmful is that they can increase inflammation, which can lead to disease (4, 5, 6, 7, 8).90003 90002 In one study, mice fed high sucrose diets developed breast cancer that spread to their lungs, partly due to the inflammatory response to sugar (6). 90003 90002 In another study, the anti-inflammatory effects of omega-3 fatty acids were impaired in mice fed a high sugar diet (7). 90003 90002 What’s more, in a randomized clinical trial in which people drank regular soda, diet soda, milk, or water, only those in the regular soda group had increased levels of uric acid, which drives inflammation and insulin resistance (8).90003 90002 Sugar can also be harmful because it supplies excess amounts of fructose. 90003 90002 While the small amounts of fructose in fruits and vegetables are fine, consuming large amounts from added sugars is a bad idea. 90003 90002 Eating a lot of fructose has been linked to obesity, insulin resistance, diabetes, fatty liver disease, cancer, and chronic kidney disease (9, 10, 11, 12, 13, 14, 15). 90003 90002 Also, researchers have noted that fructose causes inflammation within the endothelial cells that line your blood vessels, which is a risk factor for heart disease (16).90003 90002 High fructose intake has likewise been shown to increase several inflammatory markers in mice and humans (10, 17, 18, 13, 19, 20). 90003 90002 Foods high in added sugar include candy, chocolate, soft drinks, cakes, cookies, doughnuts, sweet pastries, and certain cereals. 90003 90040 90041 SUMMARY 90042 Consuming a diet high in sugar and high fructose corn syrup drives inflammation that can lead to disease. It may also counteract the anti-inflammatory effects of omega-3 fatty acids.90043 90014 2. Artificial trans fats 90015 90002 Artificial trans fats are likely the unhealthiest fats you can eat. 90003 90002 They’re created by adding hydrogen to unsaturated fats, which are liquid, to give them the stability of a more solid fat. 90003 90002 On ingredient labels, trans fats are often listed as partially hydrogenated oils. 90003 90002 Most margarines contain trans fats, and they are often added to processed foods to extend shelf life. 90003 90002 Unlike the naturally occurring trans fats found in dairy and meat, artificial trans fats have been shown to cause inflammation and increase disease risk (21, 22, 23, 24, 25, 26, 27, 28, 29).90003 90002 In addition to lowering HDL (good) cholesterol, trans fats may impair the function of the endothelial cells lining your arteries, which is a risk factor for heart disease (26). 90003 90002 Consuming artificial trans fats is linked to high levels of inflammatory markers, such as C-reactive protein (CRP). 90003 90002 In fact, in one study, CRP levels were 78% higher among women who reported the highest trans fat intake (26). 90003 90002 In a randomized controlled trial including older women with excess weight, hydrogenated soybean oil increased inflammation significantly more than palm and sunflower oils (27).90003 90002 Studies in healthy men and men with elevated cholesterol levels have revealed similar increases in inflammatory markers in response to trans fats (28, 29). 90003 90002 Foods high in trans fats include French fries and other fried fast food, some varieties of microwave popcorn, certain margarines and vegetable shortenings, packaged cakes and cookies, some pastries, and all processed foods that list partially hydrogenated vegetable oil on the label. 90003 90040 90041 SUMMARY 90042 Consuming artificial trans fats may increase inflammation and your risk of several diseases, including heart disease.90043 90014 3. Vegetable and seed oils 90015 90002 During the 20th century, the consumption of vegetable oils increased by 130% in the United States. 90003 90002 Some scientists believe that certain vegetable oils, such as soybean oil, promote inflammation due to their very high omega-6 fatty acid content (30). 90003 90002 Although some dietary omega-6 fats are necessary, the typical Western diet provides far more than people need. 90003 90002 In fact, health professionals recommend eating more omega-3-rich foods, such as fatty fish, to improve your omega-6 to omega-3 ratio and reap the anti-inflammatory benefits of omega-3s.90003 90002 In one study, rats fed a diet with an omega-6 to omega-3 ratio of 20: 1 had much higher levels of inflammatory markers than those fed diets with ratios of 1: 1 or 5: 1 (31). 90003 90002 However, evidence that a high intake of omega-6 fatty acids increases inflammation in humans is currently limited. 90003 90002 Controlled studies show that linoleic acid, the most common dietary omega-6 acid, does not affect inflammatory markers (32, 33). 90003 90002 More research is needed before any conclusions can be made.90003 90002 Vegetable and seed oils are used as cooking oils and are a major ingredient in many processed foods. 90003 90040 90041 SUMMARY 90042 Some studies suggest that vegetable oil’s high omega-6 fatty acid content may promote inflammation when consumed in high amounts. However, the evidence is inconsistent, and more research is needed. 90043 90014 4. Refined carbohydrates 90015 90002 Carbohydrates have gotten a bad rap. 90003 90002 However, the truth is that not all carbs are problematic.90003 90002 Ancient humans consumed high fiber, unprocessed carbs for millennia in the form of grasses, roots, and fruits (34). 90003 90002 However, eating refined carbs may drive inflammation (34, 35, 36, 37, 38). 90003 90002 Refined carbs have had most of their fiber removed. Fiber promotes fullness, improves blood sugar control, and feeds the beneficial bacteria in your gut. 90003 90002 Researchers suggest that the refined carbs in the modern diet may encourage the growth of inflammatory gut bacteria that can increase your risk of obesity and inflammatory bowel disease (34, 36).90003 90002 Refined carbs have a higher glycemic index (GI) than unprocessed ones. High GI foods raise blood sugar more rapidly than low GI foods. 90003 90002 In one study, older adults who reported the highest intake of high GI foods were 2.9 times more likely to die of an inflammatory disease like chronic obstructive pulmonary disease (COPD) (37). 90003 90002 In a controlled study, young, healthy men who ate 50 grams of refined carbs in the form of white bread experienced higher blood sugar levels and increases in levels of a particular inflammatory marker (38).90003 90002 Refined carbohydrates are found in candy, bread, pasta, pastries, some cereals, cookies, cakes, sugary soft drinks, and all processed foods that contain added sugar or flour. 90003 90040 90041 SUMMARY 90042 High fiber, unprocessed carbs are healthy, but refined carbs raise blood sugar levels and promote inflammation that may lead to disease. 90043 90014 5. Excessive alcohol 90015 90002 Moderate alcohol consumption has been shown to provide some health benefits. 90003 90002 However, higher amounts can lead to severe problems.90003 90002 In one study, levels of the inflammatory marker CRP increased in people who consumed alcohol. The more alcohol they consumed, the more their CRP levels increased (39). 90003 90002 People who drink heavily may develop problems with bacterial toxins moving out of the colon and into the body. This condition – often called “leaky gut” – can drive widespread inflammation that leads to organ damage (40, 41). 90003 90002 To avoid alcohol-related health problems, intake should be limited to two standard drinks per day for men and one for women.90003 90040 90041 SUMMARY 90042 Heavy alcohol consumption may increase inflammation and lead to a “leaky gut” that drives inflammation throughout your body. 90043 90014 6. Processed meat 90015 90002 Consuming processed meat is associated with an increased risk of heart disease, diabetes, and stomach and colon cancer (42, 43, 44). 90003 90002 Common types of processed meat include sausage, bacon, ham, smoked meat, and beef jerky. 90003 90002 Processed meat contains more advanced glycation end products (AGEs) than most other meats.90003 90002 AGEs are formed by cooking meats and some other foods at high temperatures. They are known to cause inflammation (45, 46). 90003 90002 Of all the diseases linked to processed meat consumption, its association with colon cancer is the strongest. 90003 90002 Although many factors contribute to colon cancer, one mechanism is believed to be colon cells ‘inflammatory response to processed meat (47). 90003 90040 90041 SUMMARY 90042 Processed meat is high in inflammatory compounds like AGEs, and its strong association with colon cancer may partly be due to an inflammatory response.90043 90014 The bottom line 90015 90002 Inflammation can occur in response to many triggers, some of which are hard to prevent, including pollution, injury, or sickness. 90003 90002 However, you have much more control over factors like your diet. 90003 90002 To stay as healthy as possible, keep inflammation down by minimizing your consumption of foods that trigger it and eating anti-inflammatory foods. 90003.90000 ME AND MY OPERATION: The gentle way to tackle an inflamed pancreas 90001 90002 Every year more than 60,000 Britons develop pancreatitis, an inflamed pancreas. Heike Goedelt- Russell, 50, an NHS manager, was one of the first to have a less-invasive procedure. 90003 90002 THE PATIENT 90003 90002 My pancreas problems came out of the blue. One evening last September, I was suddenly overwhelmed by nausea just as my husband Mark asked me what I wanted for dinner. 90003 90002 I rushed to the toilet, where I was sick and also had diarrhoea.Afterwards, I felt a stabbing pain in my upper abdomen just underneath my breasts. The pain got progressively worse and by 11pm, I could not bear it any more and told Mark to call an ambulance. 90003 90010 90010 90002 Every year more than 60,000 Britons develop pancreatitis, an inflamed pancreas. Heike Goedelt- Russell, 50, an NHS manager, was one of the first to have a less-invasive procedure to gradually remove the pancreas 90003 90002 The paramedics advised me to see my GP the next morning, but I persuaded them to get me to hospital.90003 90002 There, scans ruled out gallstones, which can cause similar symptoms, but showed that my pancreas was inflamed. 90003 90002 The pancreas makes digestive juices containing enzymes. These are meant to be activated in the digestive tract, but in pancreatitis, they start working inside the pancreas, attacking it, causing swelling and acute pain. I do not know why this happened – apparently, alcohol is a major cause, but I do not drink much at all. 90003 90002 Parts of my pancreas were so damaged that the tissue had died and the inflammation had caused the blood vessels supplying it to shrink.The doctors said I was seriously ill. I was admitted to a ward. 90003 90002 They put me on a drip, with anti-nausea medication and morphine. The hope was my symptoms would improve in a few days – this happens in most cases of acute pancreatitis – but the pain continued. 90003 90002 I was discharged after two weeks, still on morphine. After five days at home I could not eat or drink without vomiting. So I went back to the hospital, where they found fluid was leaking from the inflamed tissue and that I had an infection.90003 90026 90026 90002 Heike was suddenly overwhelmed by nausea, sickness, diarrhoea and a stabbing pain 90003 90002 I was immediately referred to a specialist hospital – too ill to really know what was happening. Friends who visited later told me they thought I was not going to live. A few days later I underwent surgery. 90003 90002 But instead of removing the pancreas with open surgery, which has a risk of bleeding and means longer recovery times, the dead tissue was removed gradually in keyhole procedures, leaving a tiny bit of pancreas behind.90003 90002 The first step involved having a tube inserted, under local anaesthetic, under my left breast, to create a tunnel into my pancreas. 90003 90002 The next day, they gave me a general anaesthetic to remove the tissue, repeating this three more times in two weeks under sedation. All this time I was on painkillers and had problems drinking and eating because I felt so sick. 90003 90002 I was discharged in early December. At first, I was so weak I could hardly climb the stairs. Now I can walk for ten minutes before getting tired.I have discomfort after meals, but the nausea and pain has gone. 90003 90002 Before every meal, I take digestive enzymes – I’ll need these all my life as I have only about 5 per cent of my pancreas left; it’s effectively dead. 90003 90002 I’ll develop diabetes at some stage as what’s left of my pancreas will eventually not produce enough insulin. But I’m still healing – and lucky to have survived. My aim is to return to work and I’m looking forward just to feeling normal. 90003 90002 THE SURGEON 90003 90002 Dhanny Gomez is a hepato-pancreato-biliary surgeon at Nottingham University Hospitals NHS Trust.90003 90002 Pancreatitis, inflammation of the pancreas, can come on quickly, when it is described as ‘acute’, with symptoms ranging from mild to severe, or it can be a long-standing problem, when it’s known as ‘chronic’, where the pancreas slowly becomes more damaged over time. 90003 90002 The most common symptom for both is pain in the abdomen that radiates to the back, along with nausea and vomiting. 90003 90002 Gallstones are to blame for more than a third of cases – they can block the pancreatic duct, the opening of the pancreas.Alcohol is also a major trigger. 90003 90002 The theory is alcohol can cause the pancreatic duct to spasm, blocking the release of digestive juices. That inflames the pancreatic tissue. Other less common factors are faulty genes and viral infections such as measles or mumps. 90003 90002 However, in 15 to 20 per cent of cases, we never find the cause. 90003 90002 Before every meal, I take digestive enzymes – I’ll need these all my life as I have only about 5 per cent of my pancreas left; it’s effectively dead 90003 90002 Around 25,000 cases of pancreatitis every year in Britain are acute.In 80 per cent of these, patients recover within a week. However, 5 per cent of patients will be extremely unwell, with serious and even fatal complications. 90003 90002 The dead tissue is vulnerable to infection and can lead to organ failure, so we need to remove it. 90003 90002 We can not do this immediately because the tissue is so inflamed that it touches everything around it. To remove the pancreas would damage the large intestine and blood vessels, and risk uncontrollable bleeding. 90003 90002 Instead, we wait several weeks for the inflammation to subside, treating the patient with anti-nausea medication, painkillers and fluid (via a drip).By around four weeks, the gland has shrivelled up so it’s easier to remove. 90003 90002 The traditional treatment for severe acute patients with an infection is open surgery, with an incision across the entire abdomen to access and remove the pancreas, which is behind the stomach. 90003 90002 However, this carries a serious risk of bleeding, and as the pancreas is already infected there is a high risk of the wound becoming infected and reopening. Surgery also means long recovery times. 90003 90002 But since January 2014 року, I’ve been using a new approach, which some other UK centres have adopted.We remove just the dead tissue through a keyhole process known as minimal access retroperitoneal pancreatic necrosectomy (MARPN). 90003 90002 We typically do this in three stages at seven to ten-day intervals – this is because the tissue becomes rigid over time and easier to pull out, which is important as there is little room to manoeuvre. Depending on the extent of the infected dead tissue, some patients need only two removal procedures, others may need seven. Heike needed four. 90003 90076 90076 90002 Dhanny Gomez is a surgeon at Nottingham University Hospitals NHS Trust explains the operation involves removing the organ piece by piece under general anaesthetic in a series of multiple operations 90003 90002 First, we make a 1.5cm incision under local anaesthetic in the left side inserting a plastic tube (around 5mm in diameter) into the pancreas. The tube is a guide, creating a passage allowing me access. 90003 90002 We attach a waste bag to the other end, to drain the fluid that’s leaked out from all the inflamed tissue. 90003 90002 On the next day, I perform the first of the dead tissue removals under general anaesthetic, accessing the pancreas using a dilator to enlarge the passage created by the drain, until it’s 15mm wide.90003 90002 Then I insert a nephroscope, a device with a camera on one end, to relay images of the pancreas to a screen. I then remove the dead tissue using tiny graspers inserted through the scope. 90003 90002 You can not remove all the dead tissue in one go – a lot will still be inflamed and stuck to surrounding tissue, but we flush with saline solution to make the pancreas soggy and easier to remove at the repeat procedure. It takes 90 minutes. 90003 90002 The patient can be sedated for the repeat tissue removal procedures, but not for the first, as it would be too painful for the dilator to be inserted this way.90003 90002 The drain tube stays in the patient after they leave hospital and they wear a bag. This is because we need to give the passage time to close properly – the tube is removed gradually 3cm at a time at each follow-up appointment. 90003 90002 Once we have taken out all the dead tissue (we can not take out live tissue because of the bleeding risk), most patients are left with a minute amount of pancreas, if any. 90003 90002 What’s left will continue to produce insulin, but it will not be enough to meet the patient’s demands once they have recovered and are active again, and all patients will develop diabetes.It can happen immediately or eight months later. They will need insulin for life. 90003 90002 It takes four to six months after surgery for patients to get back to normal, but with an open procedure, it takes a year or more. 90003 90002 The main risks are bleeding and damage to other organs, but these are lower than with open surgery. 90003 90002 A study published in 2010 showed there are fewer complications and deaths with this technique compared with open surgery – 19 per cent of patients died afterwards, compared with 38 per cent with conventional surgery.90003 90002 I perform 20 operations a year, but thousands more people nationwide could benefit if MARPN is more widely adopted. 90003 90002 ANY DRAWBACKS? 90003 90002 ‘The drawbacks relate to the need for repeated procedures, which lengthen hospital stays, and the financial expense,’ says Chris Halloran, a clinical senior lecturer and consultant pancreato-biliary surgeon at the Royal Liverpool University Hospital. 90003 90002 Research into new techniques and surgical instruments will improve patient outcomes.90003 90002 The procedure is available only on the NHS (the cost is approximately £ 30,000, including emergency care) .. 90003.90000 Diet, Symptoms, Causes and More 90001 90002 The pancreas is an organ in your body located behind your stomach and small intestine. One of its functions is to make enzymes that aid in the digestion of food in your intestines. These enzymes, in the form of a digestive juice, are released from the pancreas through the pancreatic duct into the top of the small intestine. 90003 90002 Pancreas divisum is the most common anomaly of the pancreas that is present from birth. Normally, all human embryos start life with the pancreas in two parts, each with its own duct – the ventral duct and the dorsal duct.During development, these two parts usually fuse, and the two ducts also fuse to make one duct. In pancreas divisum, the ducts have failed to fuse during development, leaving the pancreas with two separate ducts. 90003 90002 It is not known what causes the failure of pancreatic ducts to fuse in utero. What researchers do know is that it occurs in approximately 10 percent of embryos. 90003 90002 Most people who are born with pancreas divisum will never experience any symptoms. The condition is sometimes only found during autopsy.90003 90002 A very small group of people with the condition do develop symptoms, and these can include: 90003 90012 90013 nausea 90014 90013 vomiting 90014 90013 abdominal pain 90014 90013 sudden (acute) or long-term (chronic) pancreatitis, which is inflammation of the pancreas 90014 90021 90002 Most people with pancreas divisum have no symptoms, so no treatment is required. 90003 90002 For the people with this condition who do have symptoms, treatment options may be challenging. A surgeon may recommend a Puestow procedure or sphincterotomy.They can cut the minor papilla, an opening between the small intestine and one of the ducts, to enlarge the opening and allow digestive juices to flow more normally. During surgery, they may insert a stent into the duct to ensure that it does not close and cause a blockage. 90003 90002 As with any surgery, there are risks. You’ll want to discuss these with your doctor. 90003 90002 Some research has shown that surgical removal of the gallbladder may also help certain individuals with pancreas divisum.90003 90002 In cases where pancreas divisum leads to pancreatitis, there are several things you can change about your diet that may decrease the risk of flare-ups. 90003 90032 Reduce the amount of fat you consume 90033 90002 The total amount of fat that individuals require is dependent on their height and weight. But on average, it’s suggested that you limit total fat intake to no more than 30 percent of your total daily calories. An average person eating 2,000 calories a day should have no more than 65 grams of fat daily.It’s best to limit saturated fat to around 20 grams each day. 90003 90002 Lean proteins like boneless, skinless chicken breast, turkey, and fish are naturally low in saturated fat. So incorporating them into your diet is an easy way to reduce the fat content in your meals. However, certain individuals experience flare-ups with high-protein diets. Talk to your doctor about your protein intake before you add more to your diet. 90003 90002 Using a cooking spray instead of butter will also help to cut fat from your diet.90003 90032 Eliminate alcohol and always be well-hydrated 90033 90002 If you have any kind of pancreatic disease, you should never drink alcohol. Alcohol causes direct injury and inflammation to the pancreas. Dehydration can also cause a flare-up in the pancreas, so always make sure you’re well-hydrated. Carry water or some other nonalcoholic liquid with you all the time. Sports drinks are another good way to keep from becoming dehydrated. 90003 90032 Try temporary fasts 90033 90002 Sometimes it may necessary to give an inflamed pancreas a rest by limiting your food intake.If you are having a flare-up, your doctor may recommend that you stick to a clear liquid diet for a day or two. Foods you can have on this diet include: 90003 90012 90013 gelatin 90014 90013 chicken or beef broth 90014 90013 water 90014 90013 sports drinks 90014 90013 popsicles 90014 90013 apple and white grape juice 90014 90021 90002 This diet is not nutritionally complete, so you shouldn ‘t maintain it for long. You should begin to increase your food intake, with small portions, as soon as you feel you’re able to tolerate it.Talk to your doctor to develop the best diet plan for you. 90003 90002 The main risk that comes with pancreas divisum is that it may lead to pancreatitis. By making changes to your diet, you may be able to decrease the likelihood of pancreatitis developing. If pancreatitis does occur, the diet changes discussed previously may help to alleviate its symptoms. 90003 90002 In the majority of cases, pancreas divisum will have absolutely no effect on your life, and it’s probable that you may never even know you have it.90003 90002 If you do experience symptoms and are diagnosed with the condition, it’s important that you make changes to your diet, eliminate alcohol, and ensure that you’re well-hydrated at all times. If you follow these important steps, you may avoid the complication of pancreatitis. 90003 90002 If you’re symptoms are severe, you should talk to your doctor or a specialist about treatment options, as many treatments have their own risks. 90003.