The most strict diet. Diet 0 according to Pevzner is prescribed after surgery on the digestive organs, including when the patient is unconscious.
The "Table 0" diet after the operation will provide the patient's body with the necessary amount of calories and nutrients, subject to contraindications to the intake of solid food. In addition, the treatment table number 0 according to Pevzner guarantees maximum unloading of the organs of the gastrointestinal tract and prevents the formation of gases in the intestines.
0 the food table consists of three stages, the purpose of which is to gradually transfer the patient to the usual menu.
- 0 "A"
- 0 "B"
- 0 "B"
Outcome
After surgery, the patient needs calories and nutrients more than ever. Table 0, as practice shows, not only provides the body with useful substances, but also helps to establish digestive processes, which speeds up rehabilitation.
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Diet number 0 according to Pevzner, most often referred to as surgical, since it is prescribed after surgical interventions on the organs of the gastrointestinal tract, is designed to provide the body of the patient, often unconscious and therefore deprived of the opportunity to take solid food, with the right amount of nutrients and calories.
Description
In addition, the zero table helps:
- unload the digestive organs as much as possible;
- prevent excessive formation of intestinal gases;
- replenish fluid reserves;
- restore the vital energy of the patient;
- activate the body's defenses.
Diet number 0 according to Pevzner has three modifications:
- No. 0a;
- No. 0b;
- No. 0v.
Assigned one after the other, they are characterized by a gradual expansion of the diet, designed to prepare the patient's intestines for a varied and nutritious diet. Each version of the zero treatment table, therefore, is a necessary step on the way from a completely empty intestine (which is exactly what it happens at the time of surgery) to physiological nutrition.
The appointment period for each modification of the zero table is approximately 72 hours, but if necessary, the doctor can extend it. After diet No. 0b, which completes the list, the patient is prescribed a treatment table corresponding to his underlying pathology. In the absence of contraindications, it is quite possible to transfer it to the general table.
Chemical daily composition
The chemical composition of the daily diet of a patient observing No. 0 (depending on the variant of the treatment table) should contain:
- squirrels- from 5 to 10 g;
- fats- from 15 to 20 g;
- carbohydrates from 150 to 200 g.
When is it appointed?
Being the most strict diet, number 0 is assigned to patients:
- who underwent a surgical operation on the organs of the digestive tract (, any departments,);
- suffering from infectious diseases accompanied by digestive disorders;
- who received a head injury;
- suffering from cerebrovascular accident.
Basic principles
Patients who are assigned No. 0, after undergoing surgery, most often remain in a semi-conscious or unconscious state and therefore cannot eat on their own. In addition, the motility of their digestive tract can be greatly weakened by the action of anesthesia.
The requirements for food for such patients are due to the above circumstances:
- Since nutrition is most often taken into the body of patients through a tube, the food should have a semi-liquid or liquid consistency. Croutons and cereals are introduced into their diet only during the late postoperative period.
- In order for the mucous membranes of the intestines and stomach not to suffer from hypothermia or, food and drinks served to patients should have a temperature of 20 to 40 degrees.
- Given the decrease in intestinal motility and the synthesis of digestive enzymes, due to the influence of the operation, it is necessary to feed the patient with food characterized by easy and complete digestion. On the one hand, it will not overload the intestines, and on the other hand, after its digestion, a small amount of stool remains, which facilitates the care of bedridden postoperative patients.
- From the diet of patients on diet No. 0, the following are excluded: sweets, carbonated drinks, spices and seasonings, any pastries.
- Tea and cereals, present in diets No. 0a and 0b, not only can, but should be sweet: thanks to them, the patient's body will receive much-needed glucose for it.
- The salt content in the diet is sharply limited: from 1 g per day in diet No. 0a to 5 g in diet No. 0b.
- The zero table - especially in modification 0a - goes well with intravenous nutrition, which can compensate for the deficiency of nutrients in the patient's diet by introducing solutions of albumin, glucose, etc.
- Since most of the products allowed to the patient are perishable, the way they are prepared and stored is of particular importance. Food for patients on diet number 0 is prepared in such quantity that it is enough for one or two meals. Surplus food prepared from products with a limited shelf life cannot be stored: they must be thrown away.
- Restriction of fluid intake applies only to table 0a. Patients on a diet 0b and 0c are allowed to drink in any amount.
- Treatment table number 0 prescribes frequent (from 7 to 8 times a day) meals, the temperature of which should not exceed 45 degrees. The amount of food consumed at one time should be from 200 to 300 g. A small amount of food contributes to its better digestion and complete assimilation.
What can and cannot be eaten?
Diet number 0a
Diet No. 0a, which is prescribed immediately after the surgical operation and is the most strict version of the zero table, is characterized by the lowest energy value, which ranges from 730 to 1200 kcal.
Considering the serious condition of the patients who have just been operated on, who are in a semi-conscious state, they, by introducing food into it, the texture and composition of which resemble baby food (that is, having a liquid or jelly-like consistency and not containing lumps and foreign inclusions), and the temperature does not exceed 45 degrees .
Nutrition with this dietary table option is fractional, providing for 7-8 meals, the maximum amount of which at one time should not exceed 300 g. Therefore, the maximum amount of food eaten by the patient during the day can be 2400 g.
Patients should not drink water during the early postoperative period. In case of strong thirst, they are only allowed to wet their lips. The salt content in food should not exceed 1 g per day.
The duration of adherence to the dietary table No. 0a is from 2 to 3 days, however, for patients in the intensive care unit, this period can be extended up to 7 days.
Table number 0b
The second stage in the restoration of normal bowel activity is dietary table No. 0b, prescribed immediately after diet No. 0a, characterized by a slight expansion of the diet and the presence of not so strict restrictions.
Thanks to the introduction of new products, the energy value of the diet increases to 1500-1700 kcal. The amount of food taken at one time can be increased to 400 g, and the number of feedings can be reduced to six times a day.
The leading method of heat treatment of products is steaming and boiling. Fluid intake at this stage corresponds to the daily rate required by a healthy person.
A patient on diet No. 0b is no longer fed through a probe, but from a spoon, but he is not yet able to chew solid food, so the food must have a consistency that allows it to be swallowed with ease without chewing.
The duration of adherence to the dietary table No. 0b - depending on the patient's condition - is from 7 to 14 days.
Table number 0v
The final stage, preceding the transfer of the patient to the treatment table, which involves the use of a wider range of permitted products, is diet number 0b. At this stage, foods that require chewing are introduced into the patient's diet, since he is already able to eat on his own.
The calorie content of this dietary table, corresponding to the lower limit of the daily calorie requirement, is 2000 kcal. According to the content of proteins, fats and carbohydrates, the diet meals are close to normal.
Since the appointment of diet No. 0c, cold and hot dishes appear in the diet of patients, and the temperature of cold dishes should not fall below 20 degrees, and hot ones should not exceed 50 degrees.
It is necessary to eat at least six times a day, the use of fluid is allowed in unlimited quantities. The salt content in meals is limited to five grams per day.
Despite the introduction of crackers, any types of pastries and bakery products in the patient's diet continue to be banned. The duration of this diet is 3-4 days.
Dish recipes
We offer recipes for healthy dishes that can be introduced into the diet of a patient following diet number 0.
Chicken egg white omelet
Ingredients:
- Whites of two eggs.
- Milk - 60 ml.
- Butter - 5 g.
- Salt.
Break the eggs, carefully separating the yolks from the whites. After adding a pinch of salt, beat the egg whites with a whisk. Without stopping beating, pour in the milk. The milk-egg mixture is poured into molds greased with butter and sprinkled with flour. Prepare an omelette in a water bath.
Kissel from blackcurrant berries
Ingredients:
- Blackcurrant - 1.5 tablespoons.
- Blackcurrant leaves - 2-3 pieces.
- Sugar - 1 tablespoon.
- Potato starch - 1 teaspoon.
- Water - 200 ml.
To prepare jelly, you can take only very juicy and ripe berries, peeled from the stalks and well washed with cold water. After squeezing the juice, pour it into an enamel saucepan and put it in a cold place.
The berry mass left after squeezing the juice is poured with boiling water and boiled over low heat for five minutes along with washed currant leaves. The finished broth is filtered using a sieve or gauze.
After pouring sugar, bring the syrup to a boil, be sure to remove the resulting foam with a slotted spoon, after which starch, previously diluted in a small amount of cold water, is poured into it. Stirring vigorously, bring the jelly to a boil and immediately add chilled berry juice to it.
The finished jelly is thoroughly mixed and poured into small glasses. To prevent the formation of a film, the surface of the drink is lightly sprinkled with sugar.
Soft-boiled egg
After washing the egg, put it in cold water, add a pinch of salt, bring to a boil and cook for three minutes. To remove the shell, the egg is cooled quickly in a bowl of cold water. When serving, you can add a small piece of butter to the table.
Rosehip decoction
Ingredients:
- Dried rose hips - 20 pieces.
- Water - 200 ml.
To prepare a decoction, rose hips are sorted, washed with cold water, and then lightly crushed with a kitchen hammer. The prepared raw materials are placed in a stainless steel saucepan, poured with hot water and, covered with a lid, boil for ten minutes. The finished broth is infused for a day (the minimum infusion time is 8 hours).
The quality of nutrition determines the level of health for any person. With the help of a properly selected diet, almost all physiological problems can be solved: lose or gain weight, normalize or reduce sugar levels. For simple tasks, there are a lot of simple diets, and in a more complex situation, medical techniques are used.
Modern dietology uses medical diets compiled in the middle of the last century. Despite the prescription of their formation, the principles of these diets have not been refuted by modern scientists and are still working effectively. The author of these techniques, Manuil Pevzner, devoted his life and all his scientific works to the creation of a cycle of therapeutic diets. Thanks to this, we still use them today in sanatoriums, hospitals, and at home.
The system consists of 16 diets, which are called treatment tables. Each such table is assigned a serial number from zero to 15: table No. 1, No. 2, No. 3, and so on. Some of these diets are divided into subspecies: No. 1a, No. 4c, No. 7g. All tables are made taking into account the physiological needs of the organism affected by a particular disease. Diets of therapeutic nutrition are prescribed for use depending on the severity and type of the disease:
- for patients in serious condition after brain injuries, operations on the gastrointestinal tract, viral diseases with fever.
- with gastritis with high acidity, after an exacerbation of peptic ulcer during the attenuation period:
- - exacerbation of gastritis and peptic ulcer;
- - in the first days after exacerbations of peptic ulcer and gastritis with high acidity.
- not exacerbated chronic colitis, low acidity of the stomach, gastritis with a lack of acidity, gastric achylia.
- in diseases of the digestive system with difficult defecation (constipation) or its absence.
- for the treatment of intestinal diseases accompanied by diarrhea; colitis with diarrhea; gastroenterocolitis:
- - exacerbation of colitis and enteritis with diarrhea;
- - attenuation of diseases accompanied by diarrhea;
- - in the period of compensation of chronic enteritis and colitis.
– during recovery and remission after hepatitis, cholecystitis, cholelithiasis:
- - exacerbation of hepatitis and liver disease;
- - pancreatitis without complications and exacerbation.
- with diathesis and gout.
- during the recovery period after nephritis, hypertension:
- - a severe form of acute nephritis.
- with excessive deposition of adipose tissue - obesity.
- mild to moderate diabetes mellitus.
- for the treatment of pathologies of the heart and blood vessels:
- - severe circulatory disorders;
- - after myocardial infarction;
