Therapeutic Diet №0

The main problem after surgical interventions on the organs of the gastrointestinal tract is a violation of absorption and digestion. Therefore, the nutrition of the patient after surgery requires special attention and caution. During the rehabilitation period, the patient should receive enough nutrients and vitamins, but not damage the weakened stomach and intestines with heavy food. To solve these problems, a surgical diet is prescribed, which is called table number 0.

Such a therapeutic diet provides maximum sparing of the gastrointestinal tract and contributes to its rapid recovery. In addition to patients with gastroenterological diseases, this nutrition system is used for the rehabilitation of patients with other severe pathologies who are in the intensive care unit.

When is diet #0 used?

The scope of table No. 0 is quite extensive. In addition to patients after surgical interventions on the gastrointestinal tract, it is used in violation of cerebral circulation, after traumatic brain injury.

Also, the appointment of diet No. 0 is required for patients with infectious diseases who are in serious condition.

General characteristics of clinical nutrition

Treatment table No. 0 was compiled by Manuil Pevzner, a scientist, professor in the field of gastroenterology and dietary nutrition. As already mentioned, this diet is designed to restore the vitality of the patient, replenish nutrients and increase the overall resistance of the body.

The diet is very strict, the speed of health recovery will depend on the exact observance of all the rules. Since such a nutrition system is designed for a weakened body, it implies a reduction in the load on internal organs, primarily the gastrointestinal tract. First of all, it concerns the rules of cooking. To facilitate the work of the digestive tract, Pevzner has three types of sparing: thermal, mechanical and chemical.

Thermal sparing means that food and drinks must be warm. It is forbidden very cold and very hot, as these types of food additionally burden the intestines and stomach. In cases of brain damage, cold or hot food excites the central nervous system, which adversely affects the recovery of damaged nerve cells.

Chemical sparing provides for a certain composition of food and drinks. Until the patient is fully restored, synthetic additives are completely prohibited, salt and sugar are limited. All food should be natural and of high quality. Spices and sauces, sour and salty foods, coffee and strong tea are prohibited. After operations on the gastrointestinal tract, the task of therapeutic nutrition is to prevent the formation of gases. For this reason, legumes, cabbage, whole milk are prohibited.

Mechanical sparing is another very important diet. All food consumed should be well boiled or steamed, indigestible foods that contain a lot of coarse fibers are prohibited. Solid food can be allowed by the attending doctor, in other cases the food should be liquid, in the form of boiled cereals, liquid purees. All components must be ground 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: 0 table

The introductory phase of the diet is intended for patients in a very serious condition: a critically elevated temperature, the first days after operations on the digestive system, in violation of cerebral circulation.

In such situations, the patient may be in a state of disturbed consciousness. At the same time, he needs to replenish the supply of nutrients so that the body is able to rehabilitate itself.

The 0 diet completely eliminates:

• solid food;
• hot and cold;
• fatty;
• roast;
• legumes, mushrooms, cabbage;
• spicy, sour, salty.

The patient’s diet at the beginning of treatment will be similar to baby food in both composition and texture. All dishes should be crushed as much as possible, ground, cooled to normal temperature. Food and drinks should be around 40-45 degrees. It is allowed to enter into the diet:

1. Light meat broth. You should choose dietary varieties of meat and poultry: veal, skinless chicken breast, turkey or rabbit. It is better to cook the broth from a whole piece of meat on a secondary broth (do not use the first one), salt is not allowed. You can add large pieces of carrots during cooking, and take them out before eating.
2. Not sweet jelly. They need to be prepared only from fresh ingredients, you can use berries or fruits, adding sugar is not recommended.
3. 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.
4. Homemade jelly. You can use non-acidic fruits and berries, you can eat only frozen syrup, whole fruits and pieces are not allowed.
5. 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 is what table #0a will look like in the first recovery period. Everything that is not included in the considered list is prohibited, food and drinks are not seasoned with salt, sugar 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 0б.

Second stage: table 0б

The next stage is that the diet of patients is expanding and the daily calorie content is growing. The patient is shown to consume up to 1700 kcal per day. The diet is mainly represented by boiled soups and cereals, a variety of soufflés.

To the above list of permitted ingredients you need to add:

1. 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.
2. 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.
3. 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.
4. Mousses and soufflés. Mousses can be made from non-acid fruits and berries. Meat or fish soufflés are prepared in a water bath.
5. Vegetable soups. They are allowed to add cereals, but well boiled.

Food is still boiled or steamed with a minimum of salt added. From drinks, carbonated drinks, coffee, milk and sour-milk products are prohibited. It is important, with a minimum set of products, to diversify the patient’s diet as much as possible to replenish 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 soufflé recipe:

• lean meat – 100 g;
• one chicken egg;
• 50 ml of milk.

Boil the meat fillet, cool it twice, pass it through a meat grinder, you can grind it with a blender to a puree state. Separate the egg into yolk and protein, mix the yolk with meat paste, and beat the protein until a dense foam. Gently combine the protein mass with the meat. Steam the soufflé in a greased dish.

Recipe for rice soup:

• 200 ml of milk;
• a tablespoon of rice;
• egg.

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 should be wiped through a sieve, the drained juice should be poured into a separate container, and the remaining mass from the berries should be boiled. Strain the finished broth and return to the stove. Dilute potato starch in cold berry juice and pour it into the boiling broth, boil for another minute and leave to cool. With the permission of the doctor, you can add a little sugar or a sweetener, stevia is best.

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: 0 Table

The final phase of diet therapy will be table 0v. In terms of chemical composition and calorie content, it is close to a full-fledged diet, but the principles of sparing are preserved. It is prescribed only after the functions of the gastrointestinal tract and other organs are close to full recovery.

Dairy and sour-milk products are added to the list of allowed dishes for tables 0a and 0b. Of these, it is allowed to eat low-fat cottage cheese up to 3,5% fat, add 10% fat sour cream to dishes, you can dilute tea with low-fat milk, cook porridge with milk.

For first courses, you can use cereals and vegetables, it is preferable to cook cream soups. Boiled and steam dishes from fish, lean meat, mashed vegetables are allowed for the second. It is still possible to make jelly, mousses, mashed potatoes, freshly squeezed juices, which are diluted with water 1: 2, from berries and fruits, and baked apples of non-acidic varieties are also allowed.

Additionally, crackers from white bread are introduced, preferably homemade. No more than 100 g of dry bread is allowed per day, it can be eaten separately with juice, lightly brewed tea, or added to first courses.

An example of such a menu

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 patient’s condition and the dynamics of the pathological process, the 0 table diet can be expanded with additional ingredients. It is categorically not recommended to introduce prohibited foods into the diet on your own. Foods of dubious quality and synthetic additives remain banned until full 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 framework of the physiological need. From drinks, decoctions and weak teas, home-made compotes, fresh juices diluted with water are allowed. Sour-milk drinks can be introduced into the diet after the approval of the doctor.

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 – table 0a – the patient gradually restores the work of internal organs, primarily the gastrointestinal tract. During this time, the body systems are given a “rest”, which allows it to independently fight the disease.

The main mass of nutrients and vitamins comes at the second stage – table 0b. During the time set by the doctor, the unloading of the gastrointestinal tract continues, but at the same time the body is replenished with energy. At this stage, the patient is noticeably on the mend, there is an appetite.

The 0 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 0 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 – is designed to improve the body as a whole. Natural and easily digestible food will free you from the accumulation of toxins, heavy metals, dangerous compounds. Such a nutrition system will reduce the side effects of drug therapy and allow you to return to an active lifestyle faster. The main thing is to strictly follow the rules of the diet and the recommendations of the doctor.