Diet “Table 4” - Table “Do’s and Don’ts”

Treatment of diseases of the gastrointestinal tract should be comprehensive. Special dietary nutrition, which was developed by professor-gastroenterologist Manuil Pevzner in the twentieth century, takes first place in the treatment of these diseases. Each of his 15 diets is still successfully used today and is designed to help patients recover faster from various pathologies. Such diets are called “tables” and have their own serial numbers.

For acute intestinal diseases and digestive disorders, the fourth diet is prescribed. This nutrition system is divided into several options, each of which corresponds to a specific patient’s condition. Let's take a closer look at each point: how to observe them correctly, what you can eat, and what tasty things to cook if you can only use jelly.

Treatment table No. 4

Diet No. 4 is prescribed for intestinal diseases accompanied by frequent and loose stools, acute pain and flatulence. In addition, it is used for colitis and exacerbations of chronic gastrointestinal diseases (ulcers, gastritis, dysphagia). In such conditions, the patient develops dyspepsia, which is characterized by stool upset, abdominal pain, nausea, and cramps. Therefore, therapeutic nutrition should fully provide the patient during this period not only with nutrients, but also help reduce inflammatory reactions from the gastrointestinal mucosa.

Content:

• Treatment table No. 4
• Menu for table No. 4
• Treatment table 4a
• Treatment table 4b
• Treatment table 4v

The diet is also aimed at restoring microflora, relaxing muscles, and improving intestinal motility. The goal of a therapeutic diet is to ensure maximum relief of the digestive process, and then restoration of the gastrointestinal tract. For this, Manuil Pevzner created a therapeutic diet, which includes special foods and dishes, as well as food processing methods (sparing). Table No. 4 provides for a special menu with strict control of the food consumed. But, first of all, in such a diet it is important to take into account methods of sparing the gastrointestinal mucosa. We'll talk about them below.

Mechanical – grinding the dish, food is consumed in a grated, liquid form. This is necessary in order to restore the mucous membrane of the digestive system and speed up recovery. Eating food in pureed, mushy and liquid form does not irritate the walls of organs and the lining of the tract. In other words, the food should be similar to baby food.

Chemical. This means eating food that does not increase the secretion of gastric juice, bile and enzymes, and does not cause rotting or fermentation processes in the intestines. To better understand the chemical composition, below we will consider in detail the list of products. Table 4 is considered incomplete, since the amount of carbohydrates and fats must be reduced. The basis of the diet should be proteins. The amount of salt and sugar should be minimal.

Thermal sparing – involves maintaining a certain temperature of the served dish. Too cold or very hot food (and drink) irritates the mucous membrane. Patients who follow table number 4 are only given warm drinks and dishes. The optimal temperature is from 15 degrees to 45. Everything that is consumed by the patient should not irritate the oral cavity in any way. Food should be pleasant, soft and easy to swallow. The same rule applies to the composition of food: spicy, hot, sour, salty and pickled foods are excluded from the diet.

Basic rules of the diet: you need to eat in small portions and often, 4-6 times a day, it is strictly forbidden to go hungry and overeat. Fried and baked foods with a crust are completely excluded from heat treatment. Food can be boiled, steamed, baked in foil, or stewed. These rules apply to all diet options: No. 4, 4a, 4b, 4c.

When compiling a treatment menu, the following are excluded:

• rich broths, first courses with pasta and whole grain cereals;
• flour products (only white bread crackers are allowed);
• fatty meat, fish;
• dairy products;
• eggs in any form;
• all legumes;
• vegetables (only for decoctions);
• fresh and dried berries and fruits (small quantities of such products in jelly are allowed);
• sparkling water, coffee, strong tea;
• sauces and spices, marinades and canned food.

You can add to the menu:

• soups from lean fish, meat and vegetables;
• wheat crackers (100-200 g per day);
• steamed and baked rabbit meat, chicken fillet, turkey, lean veal and beef;
• semolina, oatmeal, rice and buckwheat (we are talking about pureed cereals);
• cocoa without milk, herbal infusions;
• butter (5 g per meal).

For a visual example, consider a sample menu and dietary recipes. You can create your own menu for the week by choosing from the lists provided.

Advantages and disadvantages

Menu for table No. 4

Menu for table No. 4

It is quite difficult to follow such a strict diet. The duration of the treatment course is determined by the doctor. As a rule, this is a short-term diet, so you will have to endure a little. After you feel better, the doctor prescribes a different diet. Let's look at some recipes that will help diversify your daily menu.

Rice cocoa recipe

To prepare you will need:

• 100 g rice;
• 1.5 liters of water;
• 50 g cocoa;
• a little sugar.

The washed rice should be completely boiled over low heat. Strain the resulting mass through cheesecloth. Grind cocoa with sugar until smooth. Pour cocoa into the rice broth and strain everything again. Serve the resulting drink warm. The recipe is suitable for all diet options and table No. 10.

Meat quenelles recipe

To prepare you will need:

• 100 g cottage cheese;
• 200 g beef (fillet without tendons and fascia);
• 1 chicken egg;
• 10 g butter.

The beef must be cut and minced twice. Rub the cottage cheese thoroughly through cheesecloth. Mix the minced meat and cottage cheese, add a little salt, beat in the egg, then add soft butter. Mix everything well and form quenelles. Steam for 20 minutes. The recipe is suitable for tables: 4, 4a, 4b, 4c.

Treatment table 4a

Diet 4a is prescribed for any intestinal dysfunction that is caused by increased gas formation, as well as for chronic colitis. To restore the digestive process, foods that cause oxidation are completely excluded from the treatment menu. This is the entire list of dishes and components for the 4th table. You should also limit the amount of chicken, fresh dairy products, completely eliminate raw vegetables and fruits, coffee, any sweets, and carbonated drinks.

The diet consists mainly of protein foods. Fats and carbohydrates are present in the diet in minimal quantities. As a rule, such a diet is prescribed for the first time of treatment, then the patient is transferred to another diet according to Pevzner. You should also strictly observe all three types of sparing. The rules for the diet are the same as in No. 4.

You can eat pureed, soft food warm. For flour products, soft noodles and white crackers are allowed. From dairy products you can eat low-fat and calcined cottage cheese, yogurt and kefir at night. Whole grain cereals are completely excluded, only crushed ones are allowed, from which it is easy to prepare mucous decoctions. Soups can be prepared using second fish and meat broths. It is better to draw up a complete list of products for colitis with a gastroenterologist, based on the patient’s condition.

Sample menu for the day for table 4a

For breakfast: sour cream cottage cheese, soft-boiled egg, tea.

For lunch: cream of meat soup, chopped vermicelli.

Afternoon snack: baked ripe apples.

For dinner: steamed meatballs from lean fish (hake, pike perch, cod).

A couple of hours before bedtime: 250 ml of kefir.

Calcined cottage cheese recipe

To prepare dietary cottage cheese, you will need calcium chloride or calcium lactic acid powder. For 0.5 liters of milk you need one and a half spoons of solution or 3 g of powder. The milk needs to be heated over low heat to about 400, without removing from the heat, add the powder or solution. As soon as the curd appears, it needs to be placed on cheesecloth to drain.

It is better to choose homemade milk, since store-bought cottage cheese may not produce at all, or it may produce too little. This cottage cheese is suitable for all four diet options.

Reviews and results

It must be remembered that this diet is therapeutic and is prescribed by a doctor. This is a rather complex diet that has many restrictions, but it is designed for a week and this period can be maintained; a few days of such nutrition are enough to restore normal intestinal function. Compliance with the recommendations is a guarantee of rapid improvement. This is evidenced by patient reviews.

• “... I suffer from chronic pancreatitis and often in the summer, when I eat a lot of vegetables and fruits, this condition occurs. Pain in the intestines and frequent stools with undigested food intensify. In such cases, I go on this diet and strictly adhere to it for a week, and after 2 weeks I begin to introduce sweet dishes and stewed vegetables. The condition immediately improves”;
• “... After treating severe pneumonia with antibiotics, terrible bloating, gas formation and unstable stools appeared and this lasted for about a month - getting worse and worse. I had to see a doctor because I couldn’t cope with this problem myself. I did stool tests and cultures and was diagnosed with dysbacteriosis (there were very few lactobacilli). In addition to Atsipol, a strict diet was prescribed. And only after two weeks it got better”;
• “... During my vacation in the summer, I felt what it was like. Apparently the heat, drinking too much and an abundance of poorly washed fruit had an effect. The holiday was ruined, although I didn’t feel very ill, but for a whole week I had to strictly follow a diet - no fruits, soda water or sweets were out of the question. I noticed that as soon as I ate a sweet bun or drank soda, it worsened again. Upon returning home, I took up nutrition more seriously.”

Treatment table 4b

If intestinal diseases are accompanied by disturbances in the functioning of the pancreas, liver, or stomach, a therapeutic diet 4b is prescribed. It is mainly used for mild inflammatory phenomena of the intestinal mucosa. Compared to previous options, this diet is more balanced.

The list of prohibited products remains almost the same, but less severe. Allowed are bread of the first and highest grade, soups with well-cooked cereals (except millet, barley and pearl barley), boiled porridge, mild cheese, boiled sausage. You can add a little sour cream, cream and milk to your dishes. There should be no more than 10 g of butter per day. Natural desserts are allowed: meringues, jelly, marmalade, marshmallows. Some vegetables are also allowed: potatoes, cauliflower, carrots. Otherwise, the patient will have to adhere to the same framework as in diet 4. You need to eat in small portions, the food should be warm and soft.

The menu for the week can be compiled from a sample list.

For breakfast:

• steam omelette of 2 eggs with herbs, fruit jelly;
• liquid semolina porridge with sweet jam;
• sandwich made of toasted bread and grated cheese, baked apple;
• oatmeal with water, grated apple.

For lunch:

• fish broth with potatoes and boiled rice;
• weak beef soup with herbs and sour cream, mashed potatoes, steamed cutlets;
• soup with barley and grated carrots, buckwheat porridge and meatballs;
• vegetable broth with breadcrumbs and sour cream, boiled veal.

Snacks:

• apple jelly, tea;
• dogwood or currant jelly;
• cocoa in water with breadcrumbs or dry cookies (100 g);
• baked pears, homemade compote;
• calcined cottage cheese.

For dinners:

• pike perch in foil, steamed cauliflower;
• boiled beef puree, dried bread, compote;
• boiled tongue, mashed boiled carrots;
• fish balls in sour cream, boiled rice;
• soft buckwheat porridge, steamed rabbit cutlets.

You should try to consume at least 2500 kcal per day; nutrition should be balanced and nutritious. That is, you need to eat enough, not starve, your diet should include porridge, soups, meat, and boiled pureed vegetables. They adhere to this nutrition system for 2-4 weeks, after which they are prescribed 4B or another diet. The recipes for rice cocoa and meat quenelles discussed above are also suitable for this table.

Fully or partially limited products

• Products containing simple carbohydrates are completely excluded: white cereals, mashed potatoes, pasta, sweet fruits, honey, jam, baked goods, sweets, butter cookies. Sugar is limited to 20 g per day.
• Fresh bread, pastries, and flour products (pancakes, dumplings, pancakes) cause fermentation in the intestines, so they are also excluded.
• Products that cause fermentation are excluded: bananas, grapes, sweet apples, cabbage of all types, legumes, cucumbers, carbonated drinks, whole milk. Milk in diluted form is acceptable as an additive to porridge.
• Porridges made from hard-to-digest cereals (millet, barley, pearl barley) are excluded during periods of exacerbation.
• Coarse fiber, wheat and rye bran, whole grain, rye and bran bread are excluded.
• Fatty meat and fish, rich fatty broths that enhance intestinal motility, sausages, and canned food are prohibited.
• Sour cream, cream and cheese can cause increased diarrhea.
• Kvass and carbonated drinks increase peristalsis and gas formation, so they are unacceptable for this disease.
• Do not use sauces or marinades.

Table of prohibited products