Tuberculosis is a predominantly chronic infection that most often affects the lungs.. Less common tuberculosis of the larynx, intestines, kidneys, bones and joints, skin.
In tuberculosis, the most serious problem is a complete, pathogenetically balanced diet, both in the process of treating the disease and at the stage of rehabilitation.. The disease has a chronic, relapsing course, so there is always a danger of resuming the activity of the process.
The nature of the diet therapy of patients with tuberculosis is determined primarily by the peculiarity of the course of the tuberculosis process, the stage of the disease and the general condition of the patient, as well as complications from other organs..
The main objectives of therapeutic nutrition for pulmonary tuberculosis are:.
Providing the body with good nutrition in the conditions of protein breakdown, catabolism of fats and carbohydrates, increased consumption of vitamins and minerals.
Increasing the body's resistance to infection and intoxication.
Normalization of metabolism.
Promoting the recovery of tissues affected by tuberculosis infection.
To accomplish these tasks, it is necessary to introduce an increased amount of protein with food (at least 120-140 g), the consumption of which is increased in patients with tuberculosis.. Recommend easily digestible protein foods (milk, fish, eggs, meat).
The amount of fat should be within the physiological norm (100-120 g). Fats should be given easily digestible, rich in vitamin A (butter, cream, sour cream), about a third - in the form of vegetable fat. The amount of carbohydrates is within the physiological norm (450-500 g).
In cases where there is a violation of carbohydrate metabolism in tuberculosis, allergization of the body (allergic diathesis, bronchial asthma, chronic eczema), overweight, patients need to limit carbohydrate intake to 300-400 g, mainly due to easily digestible (sugar, honey, jam)..
With an exacerbation of the tuberculosis process, there may be an increased release of mineral salts (calcium, potassium, phosphorus, sodium chloride), therefore, foods rich in them are introduced (milk, cheese, cottage cheese, eggs, figs, dried apricots, raisins, meat and fish products, nuts).
With exudative pleurisy, transudate, tuberculous meningitis, with an increase in secretions into the bronchi, kidney damage leading to edema, a hyposodium diet is prescribed, that is, food is prepared without adding salt.
This diet helps to increase diuresis, the resorption of fluid accumulated in the cavities, and the subsidence of the inflammatory process.. The liquid is injected in the amount of 900-1000 ml. With a large loss of blood, repeated vomiting, diarrhea, excessive sweating, the amount of sodium chloride is increased to 15 g / day.
The energy value of the diet depends on the characteristics of the course of the disease, body weight and concomitant diseases.. With exacerbation of tuberculosis and bed rest, 2500-2600 kcal / day is enough. With half-bed rest - 2700 kcal; when exacerbation subsides - 3000-3400 kcal.
In pulmonary tuberculosis with a chronic course, especially in young people, a high-calorie diet is recommended - 3600 kcal. A higher calorie diet is not healthy. Rapid and large weight gain may not improve, but worsen the patient's condition.
Diet therapy of patients with tuberculosis is aimed at increasing the body's defenses. Patients need vitamin therapy (C, A and group B). Patients should eat small meals every 3 hours.. The amount of fat is limited.
It is recommended to take flour products, meat, honey, raisins rich in minerals. With the appearance of edema, the amount of table salt is limited. Dishes used by patients should be separate. Intestinal tuberculosis due to impaired absorption of proteins, vitamins, calcium, iron is accompanied by a deficiency of these substances in the patient's body.
Diet therapy is aimed at replenishing them.. In addition, with chronic tuberculous intoxication, as a rule, the functions of the digestive organs are disrupted, so it is necessary to include easily digestible foods in the diet and follow a fractional diet with the exception of fried foods.. Eat food should be wiped, in small portions, 5-6 times a day. Spicy, fried, indigestible foods are excluded from the diet.
Thus, the following can be considered the main principles of therapeutic nutrition for patients with tuberculosis:.
The food regimen should be varied and in its chemical composition and energy value - adequate to the dynamics of the tuberculosis process and the general condition of the body.
Strict regimes and limited diets can be prescribed only for a short time (with complications and exacerbations of the disease).
At all stages of treatment (inpatient, sanatorium, outpatient) nutrition should be differentiated depending on the nature and stage of the tuberculosis process, the state of the digestive organs, the presence of complications and concomitant diseases Diet for tuberculosis.
In medical institutions for tuberculosis, diet No. 11 is traditionally used.. Currently, according to the system of standard basic diets and for this disease, a diet option with an increased amount of protein (high protein diet) is recommended..
Characteristics of a high protein diet (high protein diet). Limit salt (6-8 g / day), chemical and mechanical irritants of the stomach, biliary tract. When prescribing a diet for patients with diabetes, refined carbohydrates (sugar) are excluded. Dishes are cooked in boiled, stewed, baked, mashed and unmashed, steamed. Food temperature - 15-65 ° C.
Free liquid - 1.5-2 l. The rhythm of nutrition is fractional, 4-6 times a day.
Chemical composition: proteins - 110-120 (of which animals - 45-50 g), fats - 80-90 g (vegetable - 30 g), carbohydrates - 250-300 (monosaccharides - 30-40 g). Energy intensity of the diet - 2080-2690 kcal.
Indications for the appointment of diet number 11 is tuberculosis of the lungs, bones, lymph nodes, joints. Variants of diet No. 11 have been developed, taking into account the localization and nature of the tuberculosis process, the state of the digestive organs, and the presence of complications..
The first diet option number 11.
The first version of diet No. 11 is prescribed to patients with reduced reactivity of the body, general hyposthenia, subfebrile body temperature, with a sluggish course of the disease..
The chemical composition of the diet: proteins 100-110 g, fats 90 g, carbohydrates 350 g, energy value 2700-2800 kcal. The content of ascorbic acid is up to 300 mg, vitamin B1 is 5 mg (taking into account the intake of preparations of these vitamins). Culinary processing conventional. Fractional meals (5-6 times a day).
The second diet option number 11.
The second option of diet No. 11 is prescribed to patients during an exacerbation of the process, with pronounced tissue breakdown, significant inflammatory phenomena that occur with high temperature and exhaustion.
The chemical composition of the diet: proteins 120 g, fats 100 g, carbohydrates 400 g. Energy value 3000 kcal.
Due to the sharp intoxication, the reduction of oxidative processes in the body, it is necessary to introduce an excess amount of ascorbic acid.. The remaining vitamins are recommended within the physiological norm.. Calcium up to 1200 mg / day, table salt 8 g. It is advisable to introduce a large number of different drinks, raw juices, vegetables, fruits rich in minerals and vitamins..
During the period of exacerbation of the process, patients have a decrease in appetite, often there are disorders of the gastrointestinal tract, which should be taken into account when making a diet. All food is cooked in pureed form.. Feed fractional, every 2-3 hours.
List of recommended foods and dishes. Bread and bakery products: white bread, crackers, biscuits, biscuits.
Soups: pureed in meat broth.
Meat and fish dishes: beef, veal, chicken, turkey in the form of cutlets, souffle, pate: fresh river fish in boiled form.
Milk, dairy products and dishes from them: milk, curdled milk, kefir, sour cream, cheese, calcined cottage cheese, cottage cheese casserole.
Egg dishes: omelettes, whole soft-boiled eggs.
Dishes and side dishes from vegetables: boiled and mashed vegetables (white cabbage is excluded).
Dishes and side dishes from cereals: cereals with milk (oatmeal, buckwheat, rice, semolina).
Sweet dishes: kissels, mousses, jelly, pureed compotes. Fruit and berry juices, decoction of wild rose, blackcurrant. Fats: butter and vegetable oil.
The third option of diet number 11.
The third option of diet number 11 is prescribed for exudative phenomena. Food is prepared without the addition of table salt.
The chemical composition of the diet: proteins 100-110 g, fats 100 g, carbohydrates 300-350 g. Energy value 2700 kcal. Calcium content not less than 2000 mg. The amount of liquid is limited to 800-1000 ml.
The diet of tuberculosis patients with concomitant changes in the digestive system must necessarily be subjected to appropriate correction..
Baranovsky.
medbe. en.