Therapeutic Diet №4

Treatment of diseases of the gastrointestinal tract should be comprehensive. In the first place in the treatment of these diseases comes a special dietary nutrition, which was developed by professor-gastroenterologist Manuil Pevzner in the 15th century. Each of his XNUMX diets has been successfully used so far and is designed to help patients recover faster from various pathologies. 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 number 4 is prescribed for intestinal 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). Under such conditions, the patient develops dyspepsia, which is characterized by stool disorder, abdominal pain, nausea, and spasms. Therefore, therapeutic nutrition should fully provide the patient during this period not only with nutrients, but also help reduce inflammatory reactions from the gastrointestinal mucosa.

Also, the diet is aimed at restoring microflora, relaxing muscles, improving intestinal motility. The purpose of the therapeutic diet is to provide maximum relief of the digestion process, and then the restoration of the gastrointestinal tract. To do this, Manuil Pevzner created a therapeutic diet, which includes special foods and dishes, as well as food processing methods (sparing). Table No. 4 provides for the observance of a special menu with strict control of food consumed. But, in the first place, in such a diet it is important to take into account the methods of sparing the mucous membrane of the gastrointestinal tract. We’ll talk about them below.

Mechanical – grinding the dish, food is consumed in a shabby, liquid form. This is necessary in order to restore the mucous membrane of the digestive system and speed up recovery. Eating food in pureed, mushy and liquid form does not irritate the walls of organs and the membrane of the tract. In other words, the food should be like baby food.

Chemical. This refers to the use of food that does not increase the secretion of gastric juice, bile and enzymes, does not cause putrefaction or fermentation in the intestines. To better understand the chemical composition, below we consider in detail the list of products. Table 4 is considered inferior, since 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 sparing – involves maintaining a certain temperature of the served dish. Too cold or very hot food (and drink) irritates the mucous membrane. Patients who observe table number 4 are shown exclusively warm drinks and dishes. The optimum temperature is from 15 degrees to 45. Everything that is consumed by the patient should not irritate the oral cavity. Food should be pleasant, soft and easy to swallow. The same rule applies to the composition of food: spicy, spicy, sour, salty and pickled are excluded from the diet.

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;
• dairy;
• eggs in any form (no more than one per day);
• 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

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, 4, 4, 4.

Medical table 4

Diet 4a is prescribed for any intestinal disorders that are caused by increased gas formation, 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 4th 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 present in the diet in minimal quantities. As a rule, such a diet is prescribed for the first time of treatment, then the patient is transferred to another Pevzner diet. You should also strictly observe all three types of sparing. The rules for the diet are the same as in #4.

You can eat mashed, soft food in the form of heat. From flour products, vermicelli from soft varieties and white crackers are allowed. From dairy products, you can eat low-fat and calcined cottage cheese, yogurt and kefir at night. Whole-grain cereals are completely excluded, only crushed ones are allowed, from which it is easy to prepare mucous decoctions. Soups can be cooked on the second fish and meat broths. A complete list of products for colitis is best compiled with a gastroenterologist, based on the patient’s condition.

Sample menu for the day for the table 4

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 4б

If intestinal diseases are accompanied by disorders in the work of the pancreas, liver, stomach, a therapeutic diet 4b is prescribed. It is mainly used for non-severe inflammatory phenomena on the part of the intestinal mucosa. Compared to the 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.

For breakfast:

• 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.

For lunch:

• 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.

Snacks:

• apple jelly, tea;
• dogwood or currant jelly;
• cocoa on water with breadcrumbs or dry biscuits (100 g);
• baked pears, homemade compote;
• calcined cottage cheese.

For dinner:

• 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 4v

Diet 4c is prescribed during the recovery period after past diseases of the gastrointestinal tract or after their exacerbation. 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. Meat, vegetables and fruits are finely chopped, cereals are well boiled. Thermal sparing remains the same: food and drinks should be warm. Chemical sparing is significantly reduced.

It is forbidden, until the patient is fully recovered, to eat: fried, too sour, highly salty, fatty, pickled, smoked and canned. Raw raw vegetables, fruits, berries are also limited (up to 200 g per day). Exclude legumes, white cabbage in any form. Coffee, carbonated and alcoholic drinks are also prohibited.

You can enter more dairy products (if tolerated) and fruit juices, diluted with water 1:1. The menu for the week for table 4b is also suitable for this diet, but the diet can be further diversified. Milk can be added to cereals, some fresh sweet fruits can be added 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. Puree, compotes, puddings, jelly are made from berries and fruits. Recipes will be more varied and easier to prepare.

The diet is followed until the patient’s health is restored. Such a diet is periodically recommended for healthy people to prevent gastrointestinal diseases.

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.