Therapeutic diet number 4 for adults and children: recipes for dishes

Part of the complex treatment of inflammatory diseases of the gastrointestinal tract is dietotherapy, including a specialized diet number 4.

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

Indications

The main indications for the appointment of diet number 4 include exacerbation of colitis (inflammation of the mucosa of the thick, blind, transverse colon, sigmoid and rectum - in combination or with limited localization) and enterocolitis (inflammation of the small and large intestine), as well as simultaneous acute inflammation of the intestine and stomach (gastroenterocolitis) - with profuse diarrhea.

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

In addition, faster to bring the intestines back to normal diet will help # 4 with diarrhea associated with irritable bowel syndrome or dysbiosis.

As this diet of acute conditions, there are no contraindications to its purpose.

It should be borne in mind that diet number 4 with gastritis is not provided: for treatment of exacerbations of gastric mucosa inflammation, diet No. 1 is prescribed for Pevzner, when inflammation stops, diet No. 2, and after stabilization of the condition, patients are transferred to a common table (diet No. 15) .

Diet No 4 is not prescribed after removal of the gallbladder: patients who underwent such surgery are prescribed diet number 5, that is, a  diet after cholecystectomy, which must be followed long enough (in contrast to diet No. 4, prescribed for a maximum of a week).

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General information of the dietary table №4

The essence of diet number 4 is to create the most gentle mode of digestive system, which is achieved by including in the diet only those foods and ready meals, the digestion of which does not require the allocation of a large amount of gastric secretion and does not cause fermentation of undigested food by intestinal microflora and intestinal motility. As a result, the chemical and mechanical effects on the gastrointestinal tract are reduced to a minimum. Therefore, the benefits of diet for these diseases is obvious.

Diet № 4 for colitis provides for five meals a small portion (the so-called fractional diet), as well as the exclusion of certain products and methods for their preparation (the dishes should be cooked for a couple or cooked). Be sure to grind the ingredients blender or grind: the food consistency of mashed potatoes is faster and easier to digest 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, the diet No.4 for diarrhea and colitis, although it provides no more than 1970-1980 kcal per day, but this 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 consumed liquid - to prevent dehydration due to diarrhea - should be increased to one and a half to two liters (water for drinking should be at room temperature).

What can and what can not?

In the day you can eat no more than two chicken eggs - soft-boiled or in the form of a steam omelet; 150-200 g skimmed cottage cheese (pre-wiped), the same number of wiped sweet fruits or berries (added in water or a couple, in the form of jelly or mousse - without added sugar), drink jelly from sweet berries (especially useful blueberries), green and black tea, a decoction of wild rose and apple peel.

What can you eat?

In the list of what can be eaten during exacerbations of bowel diseases with diarrhea (according to Pevzner's diet No. 4), the following appear:

• rusks from white (wheat) bread - about 200 g per day;
• cereal soups of a consonant consistency (on broth from lean beef or chicken);
• liquid mashed porridge on water from crushed rice, oat flakes or buckwheat (with the addition of 5 g butter in a bowl per serving);
• Low-fat meat and fish (in the form of steamed meatballs or soufflé).

What you can not eat?

When diet number 4 according to Pevzner is forbidden to use:

• Any dishes cooked by roasting or grilling;
• black and white bread, yeast pastries and confectionery products, pasta;
• fatty meat, poultry and fish;
• sausage and meat smoked products; salted and smoked fish;
• canned food, pickles and marinades;
• mushrooms and legumes;
• whole milk and other dairy products (except for low-fat cottage cheese and natural yogurt);
• Fresh vegetables and fruits (including fruit juices);
• carbonated water, alcohol of any strength.

Under strict prohibition, all seasonings and spices (garlic, onion, spicy greens), as well as sauces (mayonnaise, ketchup, etc.).

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

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

• Diet in colitis
• Diet with enterocolitis
• Diets with diarrhea

Possible risks

Nutritionists believe that the risks associated with diet number 4 are minimal or absent, because, as noted earlier, the reduction in caloric value (compared to the energy value of a normal diet at 2,800 kcal) is 30%. And this should not affect the level of glucose in the blood and energy supply to brain cells. In extreme cases, the body begins to use glycogen stores in the liver.

However, with a decrease in calorie content below 1920-1930 kcal, possible complications will be manifested by dizziness, convulsions and even loss of consciousness, which indicates a deficiency of glucose and cerebral hypoxia.

In addition, eating a mashed food for several days and lack of fiber in the diet can reduce the activity of a beneficial intestinal microbiota. Therefore, after diet number 4, go to normal diet should be gradual, allowing obligate intestinal microorganisms - lacto- and bifidobacteria and saprophytes - to again help the digestive tract.

[2], [3], [4]

Reviews

Reviews gastroenterologists should not lead: they prescribe a therapeutic diet number 4 for many decades, and its effectiveness, no one doubts. And patients note positive changes in their condition - stopping diarrhea and reducing intestinal spasms - three to four days after the beginning of the diet.