In the phase of a dying exacerbation of chronic pancreatitis, in order to achieve a stable remission, it is important to normalize and stimulate metabolic and reparative processes in the pancreas (RV) and other organs and systems of the body, to correct the excretory and endocrine function of the RV, to normalize the immune status..

To solve these problems, the patients are prescribed nutritional therapy corresponding to the diet option with an increased amount of protein (II extended version of the table 5p according to Pevzner - tab.. 28. 4).

This diet is balanced and complete in terms of basic nutrients, satisfies the needs of the patient's body in proteins, fats, carbohydrates, vitamins, minerals and energy.

Compared to the previous version of the diet, the diet is enriched with protein (110-120 g / day, 60% of animal origin), due to which it stimulates the synthesis of pancreatic enzymes and their inhibitors, which is extremely important, since as inflammation decreases, the damaged tissue of the pancreas.

The gradual loss of exocrine parenchyma leads to the formation of exocrine pancreatic insufficiency, which contributes to the disruption of the digestive process. A decrease in pancreatic tissue leads to a decrease in production and the secretion of pancreatic juice into the duodenum, containing digestive enzymes and bicarbonates.

It should be noted that pancreatic enzymes are essential for the hydrolysis of all types of nutrients. Proteolytic enzymes (trypsin, chymotrypsin, elastase, carboxypeptidase A and B, aminopeptidase) cleave internal and final bonds in proteins and peptides. Lipolytic enzymes (lipase, lecithinase) hydrolyze neutral fats to fatty acids and monoglycerides. Pancreatic a-amylase breaks down starch and glycogen.

Pancreatic juice bicarbonates neutralize gastric acid hydrochloric acid, creating a favorable alkaline environment for the action of pancreatic enzymes. Thus, with the loss of acinar cells of the pancreas, violations of protein, fat and carbohydrate metabolism occur..

In addition, the deficiency of pancreatic enzymes against the background of a decrease in the digestion of fats, proteins and polysaccharides contributes to the disruption of the processes of abdominal intestinal digestion and absorption with the subsequent development of intestinal dysbiosis. As a result, patients develop steatorrhea, weight loss, abdominal pain, signs of hypovitaminosis (especially a deficiency of fat-soluble vitamins).

In conditions of a lack of pancreatic enzymes, absorption processes move from the duodenum to the distal parts of the small intestine, which leads to disruption of the motor and secretory functions of the gastrointestinal tract and aggravates diarrhea.

Protein has an anti-inflammatory effect, promotes regenerative and reparative processes in the pancreas, enhances the body's defenses and replenishes protein deficiency.

The average protein content in the diet is 1.4-1.5 g / kg of normal body weight. With pronounced weight loss, the daily protein quota is increased to 130 g. Such patients are shown the inclusion in the diet of protein enpit, ovolact, isolated soy proteins, homogenized and puree canned food for baby and dietary food.

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