Therapeutic nutrition for children with gastric diseases

The high load on the gastric mucosa is compensated by the high regenerative activity of the tissue. In pathological conditions, the regenerative processes of the epithelial cover are decompensated, especially in the acute period of the disease, which substantiates one of the most important principles of therapeutic nutrition for children with gastric diseases - sparing the mucosa.

Mechanical sparing is achieved by selecting food products, limiting the volume of food consumed at one time. The following products should be limited or excluded from the diet:

• containing rough skin and cell membranes - vegetables (turnips, radishes, radishes, beans, peas), fruits and berries (gooseberries, currants, grapes, unripe fruits), whole grain bread, nuts;
• rich in plant fibers and cellulose - raw vegetables and fruits (white cabbage, plums, apricots, dried fruits);
• containing coarse connective tissue - cartilage, skin of birds and fish, sinewy meat.

Special culinary processing is used: rubbing, pureeing, boiling until soft.

The volume of food that causes overstretching affects the secretory and motor functions of the organ, which is why frequent meals in small portions are necessary. The time of retention of individual food products in the stomach should be taken into account:

• for 1-2 hours - 200 ml of water, tea, cocoa, broth, soft-boiled egg;
• for 2-3 hours - 200 ml of milk, hard-boiled eggs, scrambled eggs, stewed fish, jelly, compotes, dry biscuits, white bread;
• for 3-4 hours - boiled vegetables, boiled beef, chicken, veal, rye bread, apples;
• for 4-5 hours - fried meat or game, herring, bean puree.

For the purpose of chemical sparing in various diseases of the stomach, the diet should be built taking into account changes in the functional activity of the gastric glands. In children, first of all, there is a violation of the secretory and acid-forming functions, later, with the formation of atrophy of the main cells, enzyme formation disorders develop. Strong irritants of digestive secretion are excluded from the diet:

• products and dishes containing extractive substances (broths, sauces, fried dishes, mushrooms);
• foods and dishes containing essential oils (spices, smoked meats, coffee, cocoa, chocolate, turnips, radishes, garlic, onions, sorrel, horseradish, dill, parsley, bell peppers);
• black bread, soft pastries, nuts;
• concentrated vegetable infusions and juices, strong tea, carbonated drinks.

Weak stimulants of gastric secretion are considered to be:

• milk and dairy dishes (porridge, soups, jelly);
• soft-boiled eggs and omelette;
• well-cooked meat;
• boiled fish;
• white dried bread;
• weak tea;
• alkaline mineral waters without carbon dioxide.

Special culinary processing includes boiling, steaming, stewing, and blanching.

The temperature of the food consumed plays an important role in sparing the mucous membrane. Cold dishes inhibit acid- and enzyme-forming functions and slow down the regeneration of the epithelium. Too hot food is also unfavorable; the recommended temperature of food during an exacerbation is 30-40 °C, during a remission - 20-60 "C.

The number of gastric glands directly depends on the patient's body weight, as well as on the degree of atrophic processes caused by a decrease in regenerative capacity, in connection with which it is necessary to individualize the diet taking into account these parameters.

As recovery proceeds, along with a gentle diet, the so-called zigzag therapeutic nutrition of children with stomach diseases is used, which involves expanding the diet for short periods with a subsequent return to a gentle diet. Such a diet is considered training, promoting the revitalization of regenerative processes.

When compiling a menu for children with stomach diseases, it is necessary to take into account the age-related need for basic food ingredients and calories. The child must receive food that satisfies age-related physiological needs. Restriction of certain ingredients, deviation of their ratios or reduction of caloric content are possible only for a short period of time.