Therapeutic diet No. 4 for adults and children: food recipes

Part of the complex treatment of inflammatory diseases of the gastrointestinal tract is diet therapy, including specialized diet No. 4.

In domestic gastroenterology, diet No. 4 according to Pevzner has long been recognized as an effective method of correcting and optimizing the daily nutrition of patients, taking into account the impact of chemical, mechanical and thermal factors of food on the gastrointestinal tract.

Indications

The main indications for prescribing diet No. 4 include exacerbation of colitis (inflammation of the mucous membrane of the colon, cecum, transverse colon, sigmoid and rectum - in combination or with limited localization) and enterocolitis (inflammation of the small and large intestines), as well as simultaneous acute inflammation of the intestine and stomach (gastroenterocolitis) - with profuse diarrhea.

Diet No. 4 is also prescribed for intestinal diseases associated with infection, in particular, diet No. 4 should be followed for salmonellosis (intestinal damage by enterobacteria Salmonella) and dysentery (caused by Shigella bacteria or amoebas). In all the above cases, as well as for diarrhea of entero- and rotavirus etiology, diet No. 4 for children is necessary (with the same rules as for adults).

In addition, diet No. 4 will help to quickly bring the intestines back to normal for diarrhea associated with irritable bowel syndrome or dysbacteriosis.

Since this is a diet for acute conditions, there are no contraindications to its use.

It should be borne in mind that diet No. 4 is not intended for gastritis: diet No. 1 according to Pevzner is intended for the treatment of exacerbations of inflammation of the gastric mucosa, diet No. 2 is intended when the inflammatory process subsides, and after the patient’s condition has stabilized, they are transferred to the general diet (diet No. 15).

Diet No. 4 is not prescribed for constipation, since with intestinal constipation the food consumed should promote regular excretion of feces. This is facilitated by diet table No. 3 according to Pevzner.

Diet No. 4 is not prescribed after gallbladder removal: patients who have undergone such an operation are prescribed diet No. 5, that is, a diet after cholecystectomy, which must be followed for a sufficiently long time (unlike diet No. 4, which is prescribed for a maximum of a week).

In the same cases and for the same period, diet No. 4 for pregnant women can be prescribed.

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General information diet table 4

The essence of diet No. 4 is to create the most gentle mode of operation of the digestive system, which is achieved by including in the diet only those food products and prepared dishes, the digestion of which does not require the release of a large amount of gastric secretion and does not cause fermentation of undigested food by intestinal microflora and intestinal peristalsis. As a result, the chemical and mechanical impact on the gastrointestinal tract is reduced to a minimum. Therefore, the benefits of the diet for the above diseases are obvious.

Diet No. 4 for colitis involves eating small meals five times a day (the so-called fractional diet), as well as excluding certain foods and methods of cooking them (dishes should be steamed or boiled). It is essential to chop the ingredients with a blender or rub them: pureed food is digested faster and easier and does not irritate the inflamed intestinal walls. In addition, the food should not be cold (below +15°C) or too hot (above +50°C).

At the same time, diet No. 4 for diarrhea and colitis, although it provides no more than 1970-1980 kcal per day, is quite enough for those few days during which it should be followed - until the condition improves. The fat content is reduced to 70 g per day, carbohydrates - to 250 g, and proteins - to 100 g (60% of animal origin). The amount of salt (up to 10 g per day) and sugar (up to 35-40 g) is limited. But the daily volume of liquid consumed - in order to prevent dehydration due to diarrhea - should be increased to one and a half to two liters (drinking water should be at room temperature).

What can and what can not?

You can eat no more than two chicken eggs a day - soft-boiled or in the form of a steamed omelet; 150-200 g of low-fat cottage cheese (pre-strained), the same amount of strained sweet fruits or berries (steamed in water or steamed, in the form of jelly or mousse - without adding sugar), drink jelly from sweet berries (blueberries are especially useful), green and black tea, a decoction of rose hips and apple peel.

What can you eat?

The list of what you can eat during exacerbations of intestinal diseases with diarrhea (according to diet No. 4 according to Pevzner) includes:

• white (wheat) bread rusks – about 200 g per day;
• cereal soups of a thick consistency (based on broth from lean beef or chicken);
• liquid mashed porridges with water from crushed rice, oatmeal or buckwheat (with the addition of 5 g of butter per serving);
• lean meat and fish (in the form of steamed meatballs or soufflé).

What shouldn't you eat?

Diet No. 4 according to Pevzner prohibits the use of:

• any food prepared by frying or grilling;
• black and white bread, yeast baked goods and confectionery products, pasta;
• fatty meats, poultry and fish;
• sausages and smoked meats; salted and smoked fish;
• canned goods, pickles and marinades;
• mushrooms and legumes;
• whole milk and other dairy products (except low-fat cottage cheese and natural yogurt);
• fresh vegetables and fruits (including fruit juices);
• carbonated water, alcohol of any strength.

All seasonings and spices (garlic, onions, herbs), as well as sauces (mayonnaise, ketchup, etc.) are strictly prohibited.

An approximate menu for a week of diet No. 4 is described in the publication - Diet for intestinal infection

And recipes for dishes from diet No. 4 can be found in the articles:

• Diet for colitis
• Diet for enterocolitis
• Diet for diarrhea

Possible risks

Nutritionists believe that the risks associated with diet No. 4 are minimal or absent, since, as noted earlier, the reduction in caloric content (compared to the energy value of a normal diet at 2800 kcal) is 30%. And this should not affect the level of glucose in the blood and the energy supply of brain cells. In extreme cases, the body begins to use glycogen reserves in the liver.

However, if the caloric content decreases below 1920-1930 kcal, possible complications will manifest themselves as dizziness, convulsions and even loss of consciousness, which indicates a glucose deficiency and cerebral hypoxia.

In addition, eating pureed food for several days and the absence of fiber in the diet can reduce the activity of beneficial intestinal microbiota. Therefore, after diet No. 4, you should gradually return to a normal diet, allowing obligate intestinal microorganisms - lacto- and bifidobacteria and saprophytes - to help the gastrointestinal tract work again.

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Reviews

There is no need to quote the reviews of gastroenterologists: they have been prescribing therapeutic diet No. 4 for many decades, and no one doubts its effectiveness. And patients note positive changes in their condition - cessation of diarrhea and reduction of intestinal spasms - three to four days after starting to use this diet.