- Efficiency:therapeutic effect after 1-3 months
- At your place:from 1. 5 months to a year
General rules
It doesn't matter what techniquecholecystectomyused - laparoscopy or traditional open cholecystectomy, diet in the postoperative period is the most important component of the treatment and recovery period, and the first days after surgery are especially important.
After the operation it is strictly forbidden to drink any liquid for 4-6 hours. It is allowed only to wet the patient's lips with water, and a little later (after 5-6 hours) it is allowed to rinse the mouth with herbal infusions.
After 12 hours and until the morning of the day following the operation, it is allowed to drink plain water every 10-20 minutes in small portions (1-2 sips) with a total volume not exceeding 500 ml.
On the second day, low-fat kefir, unsweetened tea and gelatin are introduced into the diet (volume up to 1. 5 l/day). Serve – no more than ½ glass. Frequency of administration – 1 time/3 hours.
On the third/fourth day the patient is allowed to eat: semi-liquid mashed potatoes, pureed soups in vegetable broth, egg white omelette, grated boiled fish, fruit jelly and 1 teaspoon of low-fat sour cream. Meals up to 8 times a day, in portions of 150-200 g. From liquids you can drink juices (apple, pumpkin) and tea with sugar.
On the fifth day, biscuits and dry wholemeal bread (no more than 100 g) are introduced into the diet.
On days 6-7, pureed porridge (buckwheat, oatmeal), boiled minced fish and meat, low-fat pureed cottage cheese, vegetable puree and fermented milk products are introduced.
On the eighth day after laparoscopy of the gallbladder, depending on the severity and prevalence of symptoms of the main, concomitant or complicating disease,Diets no. 5A, 5, 5P(1 or 4 groups). Alternatively, it is assignedDiet no. 5SH(described in the "varieties" section).
Basic diet after gallbladder removal -Table no. 5and its variants. In case of severe inflammatory process, an anti-inflammatory option from table 5 can be prescribed for 3-4 days -5B diet. Its peculiarity is the limitation of the amount of food consumed. The calorie content of the diet is 1600-1700 kcal (55-65 g of protein, 40-50 g of fat, 250 g of carbohydrates).
All dishes are served exclusively pureed without broth or addition of butter: various types of slimy cereal soups, semi-liquid purees with the inclusion of a small amount of low-fat milk, gelatin, puree compotes, vegetable juices. Next, include in the diet in small quantities carefully blended steamed meat, boiled fish, low-fat cottage cheese, crackers or dried wholemeal bread.
Meals after gallbladder removal at least 5 times, in divided portions, approximately 200 g, without salt, with abundant liquids (approximately 2. 5 l/day). Subsequently, on days 8-10 the patient is prescribedDiet 5AThenDiet no. 5.
Diet no. 5 refers to physiologically complete nutrition and is aimed at normalizing the process of bile secretion and reducing the level ofcholesterolin the blood. Small, frequent meals (5-6 times a day) are recommended, which promote the outflow of bile. To improve bile secretion, vegetables are introduced in the form of vinaigrettes and salads, seasoned with unrefined vegetable oils.
Almost all easily digestible carbohydrates are severely limited in the diet, since their intake contributes to the development of bile stagnation (sweets, jam, sugar, honey) and vegetables that contain oxalic acid and essential oils in large quantities (sorrel, spinach, citrus fruits) .
To stimulate bile secretion, the diet includes vegetables, berries and fruits and chicken eggs (no more than one). The calorie content of the diet is 2800-3000 kcal (100 g of protein, 90 g of fat, 450 g of carbohydrates). Salt consumption at the level of 8-10 g, liquid - 1. 5 liters.
With cholelithiasis, concomitant diseases of adjacent internal organs - duodenum, pancreas, biliary tract often occur:duodenitis, cholangitis, pancreatitis, dyskinesia.And often in this context afterwardscholecystectomyit developspostcholecystectomy syndrome (sphincter of Oddi dysfunction), which is accompanied by the constant release of bile of low concentration into the lumen of the duodenum with the further addition of pathogenic microflora and the development of inflammation of its mucosa, leading to pain, digestive disorders and intestinal disorders. These consequences of bladder removal are also corrected by nutrition.
In this case it is necessary to reduce the process of bile secretion, which is achieved by reducing the amount of fat to 60 g by completely eliminating any solid animal fats and vegetable oils from the diet. Completely excluded from the diet are raw fruits and vegetables, fatty meat/fish, smoked and spicy foods, onions, radishes, garlic, radishes and strong meat/fish/mushroom broths. Consumption of extracts, easily digestible carbohydrates, coarse fiber, table salt and liquids is also reduced to 1. 5 liters per day.
For inflammation of the pancreas after cholecystomy, it is prescribedTable 5P. At the same time, the protein content in the diet is increased to 120 grams, and fatty and carbohydrate foods are limited. The total calorie content of the diet is reduced to 2500 Kcal. Avoid hot, sweet, spicy, acidic and highly fatty foods that stimulate the pancreas and foods containing a lot of fiber, purine bases and extractives.
Variety
After cholecystectomy withhypermotor dyskinesiabile ducts or with accompanimentpancreatitis, duodenitisa gentle diet (No. 5Sh) is prescribed. It is used for 14-21 days until the pain disappears anddyspeptic symptoms. The patient is then transferred inDiet no. 5.
General characteristics - reduced calorie intake to 2000-2200 Kcal by limiting the consumption of fats (vegetable oil but also foods rich incholesterol). The consumption of easily absorbable carbohydrates is also reduced in the diet.
Products containing purines, nitrogenous extracts and coarse fiber are completely excluded from the diet. Easily digestible proteins are not limited. The amount of salt does not exceed six grams. Food is prepared by steaming or boiling.
Consumption regime: up to 2 liters of liquids per day. Five meals a day, portions not exceeding 200 g with one fasting day per week. Chemical composition: 90 g proteins, 60 g fats (vegetable fats excluded), 300 g carbohydrates.
If bile stagnation occurs after laparoscopic cholecystectomy due tohypomotor dyskinesiathe patient is prescribed to improve intestinal motor function and stimulate bile secretionlipotropic-fatty diet (n. 5 L/F). The total calorie content of the diet is approximately 2600 kcal.
Dietary characteristics of this diet include a high fat content (50% should be vegetable oils), a reduced content of simple carbohydrates (up to 300 g) and a slight increase in protein (up to 100 g). The diet includes lipotropic protein products (lean meat, egg white, fish, cottage cheese), wheat bran, refined vegetable oils and vegetables.
Butter dough, whole milk, refractory animal fats and spices are completely excluded. The consumption of extractive substances (meat/fish broths) and foods containing cholesterol is strongly limited. Food is cooked or boiled, oils are added exclusively to prepared dishes, no chopping is required.
Directions
- diet no. 5B- with severe inflammation afterwardscholecystectomy;
- diet no. 5A- on the 8-10th day of treatment;
- diet number 5- in the recovery phase, afterwardsdiet 5A;
- diet no. 5SH- after cholecystectomy withhypermotor dyskinesiabile ducts or with accompanimentpancreatitis, duodenitis;
- diet no. 5 l/f— after cholecystectomy on the backgroundhypomotor dyskinesiato improve intestinal motor function and stimulate bile secretion;
- diet no. 5P- after cholecystectomy withacute pancreatitis.
Authorized products
Products and dishes permitted after surgery include: cereal/vegetable soups, stale wholemeal bread, wholemeal bread crackers, dry biscuits, cutlets, fish, lean meat (rabbit, beef, lean young lamb), steamed chicken, boiled chopped, fermented chicken cooked milk, kefir, low-fat whole milk, yogurt, low-fat cottage cheese and dishes based on it (lazy dumplings, casseroles), low-fat delicate cheese, chicken eggs or steamed white omelette (one per day), pasta boiled and cereals (oatmeal and buckwheat), pumpkin caviar, vegetable salads with vegetable oil, greens, vinaigrette, low-fat ham, doctor's sausage, fruit and berry juices, dried fruits, non-acidic fruits and berries, marshmallow, jam, black/green tea, rosehip infusion, natural mineral water.
Fats of animal and vegetable origin are added to prepared foods.
Table of permitted products
Proteins, gr | Fats, gr | Carbohydrates, g | Calories, kcal | |
---|---|---|---|---|
Vegetables and greens |
||||
eggplant | 1. 2 | 0, 1 | 4. 5 | 24 |
pumpkin caviar | 1. 2 | 7. 0 | 7. 4 | 97 |
cabbage | 1. 8 | 0, 1 | 4. 7 | 27 |
broccoli | 3. 0 | 0. 4 | 5. 2 | 28 |
bulb onions | 1. 4 | 0, 0 | 10. 4 | 41 |
carrot | 1. 3 | 0, 1 | 6. 9 | 32 |
cucumbers | 0, 8 | 0, 1 | 2. 8 | 15 |
pepper salad | 1. 3 | 0, 0 | 5. 3 | 27 |
parsley | 3. 7 | 0. 4 | 7. 6 | 47 |
radish | 1. 2 | 0, 1 | 3. 4 | 19 |
iceberg lettuce | 0. 9 | 0, 1 | 1. 8 | 14 |
tomatoes | 0, 6 | 0, 2 | 4. 2 | 20 |
dill | 2. 5 | 0, 5 | 6. 3 | 38 |
Fruit |
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bananas | 1. 5 | 0, 2 | 21. 8 | 95 |
apples | 0. 4 | 0. 4 | 9. 8 | 47 |
Nuts and dried fruit |
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peanuts | 15. 0 | 40. 0 | 20. 0 | 500 |
Raisins | 2. 9 | 0, 6 | 66. 0 | 264 |
dried apricots | 5. 2 | 0, 3 | 51. 0 | 215 |
almond | 18. 6 | 57. 7 | 16. 2 | 645 |
hazelnut | 16. 1 | 66. 9 | 9. 9 | 704 |
plums | 2. 3 | 0, 7 | 57, 5 | 231 |
Cereals and porridge |
||||
buckwheat | 4. 5 | 2. 3 | 25. 0 | 132 |
oatmeal | 3. 2 | 4. 1 | 14. 2 | 102 |
rice | 6. 7 | 0, 7 | 78, 9 | 344 |
Flour and pasta |
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pasta | 10. 4 | 1. 1 | 69, 7 | 337 |
pancakes | 6. 1 | 12. 3 | 26. 0 | 233 |
Bakery products |
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bran bread | 7. 5 | 1. 3 | 45. 2 | 227 |
whole grain bread | 10. 1 | 2. 3 | 57. 1 | 295 |
Dairy products |
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kefir 1, 5% | 3. 3 | 1. 5 | 3. 6 | 41 |
Ryazhenka | 2. 8 | 4. 0 | 4. 2 | 67 |
Cheeses and ricotta |
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ricotta 1% | 16. 3 | 1. 0 | 1. 3 | 79 |
Meat products |
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beef | 18. 9 | 19. 4 | 0, 0 | 187 |
rabbit | 21. 0 | 8. 0 | 0, 0 | 156 |
Sausages |
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boiled dietary sausage | 12. 1 | 13. 5 | 0, 0 | 170 |
boiled milk sausage | 11. 7 | 22. 8 | 0, 0 | 252 |
milk sausages | 12. 3 | 25. 3 | 0, 0 | 277 |
Bird |
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boiled chicken breast | 29. 8 | 1. 8 | 0, 5 | 137 |
boiled chicken leg | 27. 0 | 5. 6 | 0, 0 | 158 |
boiled turkey fillet | 25. 0 | 1. 0 | - | 130 |
Egg |
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hard boiled chicken eggs | 12. 9 | 11. 6 | 0, 8 | 160 |
Fish and seafood |
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flounder | 16. 5 | 1. 8 | 0, 0 | 83 |
Pollock | 15. 9 | 0. 9 | 0, 0 | 72 |
cod | 17. 7 | 0, 7 | - | 78 |
hake | 16. 6 | 2. 2 | 0, 0 | 86 |
Oils and fats |
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butter | 0, 5 | 82, 5 | 0, 8 | 748 |
olive oil | 0, 0 | 99, 8 | 0, 0 | 898 |
sunflower oil | 0, 0 | 99, 9 | 0, 0 | 899 |
Alcohol-free drinks |
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waterfall | 0, 0 | 0, 0 | 0, 0 | - |
green tea | 0, 0 | 0, 0 | 0, 0 | - |
*the data is intended for 100 g of product |
Products completely or partially limited
In case of gallbladder removal, the diet includes the exclusion from the diet of soups with meat/mushroom/fish broth, solid animal fats (lard, cooking fats), goose, duck, fatty pork, smoked meats, most sausages, fresh bread, canned food, pasta (butter, puff pastry), fried or hard-boiled chicken eggs, salted and fatty fish, fried pies, canned fish, whole milk 6% fat, cream, full-fat cottage cheese, cream sour, salty cheese, various seasonings and sauces.
Hard-to-digest plant foods are limited: all types of legumes, radishes, mushrooms, sorrel, radishes, garlic, green onions, spinach, canned and pickled vegetables. Spicy and fatty snacks, ice cream, sweets, chocolate, cocoa, drinks containing alcohol, berries, black coffee are excluded.
Table of prohibited products
Proteins, gr | Fats, gr | Carbohydrates, g | Calories, kcal | |
Vegetables and greens |
||||
canned vegetables | 1. 5 | 0, 2 | 5. 5 | thirty |
peas | 6. 0 | 0, 0 | 9. 0 | 60 |
Chickpeas | 19. 0 | 6. 0 | 61. 0 | 364 |
beans | 7. 8 | 0, 5 | 21. 5 | 123 |
spinach | 2. 9 | 0, 3 | 2. 0 | 22 |
Sorrel | 1. 5 | 0, 3 | 2. 9 | 19 |
Berries |
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grape | 0, 6 | 0, 2 | 16. 8 | 65 |
Mushrooms |
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mushrooms | 3. 5 | 2. 0 | 2. 5 | thirty |
Snacks |
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french fries | 5. 5 | 30. 0 | 53. 0 | 520 |
Flour and pasta |
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Vareniki | 7. 6 | 2. 3 | 18. 7 | 155 |
Ravioli | 11. 9 | 12. 4 | 29. 0 | 275 |
Bakery products |
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sliced loaf | 7. 5 | 2. 9 | 50. 9 | 264 |
sandwiches | 7. 9 | 9. 4 | 55, 5 | 339 |
Confectionery |
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cookie | 7. 5 | 11. 8 | 74. 9 | 417 |
Ice-cream |
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ice-cream | 3. 7 | 6. 9 | 22. 1 | 189 |
Chocolate |
||||
chocolate | 5. 4 | 35. 3 | 56, 5 | 544 |
Raw materials and condiments |
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mayonnaise | 2. 4 | 67. 0 | 3. 9 | 627 |
Dairy products |
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milk 4. 5% | 3. 1 | 4. 5 | 4. 7 | 72 |
cream 35% (fat) | 2. 5 | 35, 0 | 3. 0 | 337 |
Cheeses and ricotta |
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Gouda cheese | 25. 0 | 27. 0 | 2. 0 | 356 |
Parmesan cheese | 33. 0 | 28. 0 | 0, 0 | 392 |
Meat products |
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fatty pork | 11. 4 | 49. 3 | 0, 0 | 489 |
salò | 2. 4 | 89. 0 | 0, 0 | 797 |
Bacon | 23. 0 | 45. 0 | 0, 0 | 500 |
Sausages |
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smoked sausage | 9. 9 | 63. 2 | 0, 3 | 608 |
Bird |
||||
duck | 16. 5 | 61. 2 | 0, 0 | 346 |
goose | 16. 1 | 33. 3 | 0, 0 | 364 |
Fish and seafood |
||||
salmon | 19. 8 | 6. 3 | 0, 0 | 142 |
salmon | 21. 6 | 6. 0 | - | 140 |
trout | 19. 2 | 2. 1 | - | 97 |
Alcoholic beverages |
||||
white dessert wine 16% | 0, 5 | 0, 0 | 16. 0 | 153 |
dry red wine | 0, 2 | 0, 0 | 0, 3 | 68 |
vodka | 0, 0 | 0, 0 | 0, 1 | 235 |
beer | 0, 3 | 0, 0 | 4. 6 | 42 |
Alcohol-free drinks |
||||
soda water | 0, 0 | 0, 0 | 0, 0 | - |
Coca Cola | 0, 0 | 0, 0 | 10. 4 | 42 |
*the data is intended for 100 g of product |
Diet menu after gallbladder removal (Diet)
Below are some menu optionsTable no. 5. It can be changed by observing the processing methods and food preparation technology within the list of products allowed for consumption. Meals are eaten 6 times a day, the diet should alternate protein dishes (beef, turkey, chicken, fish, cottage cheese) and carbohydrate dishes prepared from various cereals.
option 1
Breakfast |
|
Lunch |
|
Dinner |
|
Afternoon snack | fruit foam |
Dinner |
|
For the night | Ryazhenka |
option 2
Breakfast |
|
Lunch | cooked apples with sugar |
Dinner |
|
Afternoon snack | Lazy ricotta dumplings |
Dinner |
|
For the night | kefir |
Option 3
Breakfast |
|
Lunch | lazy dumplings |
Dinner |
|
Afternoon snack | carrot juice |
Dinner |
|
For the night | acidophilic milk |
Dish recipes
Dietary food should be as varied and tasty as possible and include all permitted foods. Gallbladder removal recipes can be modified to suit your tastes and preferences. The main thing is to follow the cooking technology and use only approved products. Below are some healthy recipes.
First meal
Vegetarian oatmeal soup with vegetables
Potatoes, carrots, zucchini, oatmeal or instant cereal, butter/vegetable oil, sea salt.
Prepare the broth with finely chopped vegetables. Add the oatmeal and cook for another 5-10 minutes. Salt, add herbs and butter.
Chicken puree soup with vegetables
Any seasonal vegetables (broccoli, carrots, potatoes, aubergines), chicken fillet, aromatic herbs, salt, 10% sour cream.
Boil the chicken with vegetables. Grind the meat. Add sour cream to the resulting broth, beat with a blender until puree, add salt, add herbs and pieces of meat. Serve with toasted bread and finely grated cheese.
Second courses
Fish cutlets
White fish fillet, whole milk or cream, bread, eggs, salt.
Soak the bread in milk. Grind the fish until finely chopped, add the squeezed bread, egg white and salt. Mix the minced meat well. Form cutlets and bake in the oven or boil in a steam bath. As a side dish you can use mashed potatoes or stewed vegetables.
Steamed omelette with meat
Eggs, beef (chicken), milk, butter, salt.
Boil the meat until tender, pass through the meat grinder. Beat the eggs, pour in the milk and mix well, add the salt. Add the minced meat to the whipped mixture. Grease the mold with butter and pour in the egg and meat mixture. Steam.
Sweet
Casserole (ricotta with berry sauce)
Ricotta, eggs, sugar, semolina, butter.
Beat the cottage cheese in a blender, add the semolina, sugar, eggs, dried fruit. Mix everything. Grease the mold with butter, spread the prepared mass and bake in the oven for 30-40 minutes. For the sauce, beat the berries in a blender, add sugar. Serve with sauce or jam.
Baked apples with dried fruit
Sour apples, dried fruit, honey, butter.
Wash the apples and remove the apple core. Fill the cavity with chopped dried fruit, sprinkle with cinnamon, add a little butter and honey. Bake in the oven until cooked through.
Advantages and disadvantages
professionals | Downsides |
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|
|
Advise
After removal of the gallbladder, it is necessary to engage in reasonable physical activity: morning gymnastics, walking. In the first six months, intense loads on the abdominal muscles are not allowed. In the first month after laparoscopycholecystectomyIt is allowed to lift no more than two kilograms. After 6 months there are no particular restrictions for natural physical activity.
Treatment in a sanatorium is recommended no earlier than three months after cholecystectomy.
Many people complain about the frequencyconstipationafter the operation. In case of constipation, it is recommended to include 6-8 dried plums in the daily diet, which should be soaked in a glass of warm water and left overnight at room temperature, covered with a saucer. In the morning, drink all the water and eat the plums (you can do this in two doses).
Comments from nutritionists
After the first month, as a rule, the patient's diet expands, and many patients begin to break the diet, which leads them to make a serious mistake. A diet after cholecystectomy in the first three months is mandatory, since during this period the functional activity of the digestive organs changes.
After cholecystectomy, during the absence of food in the small intestine, the possibility of bile storage disappears. At the same time, due to the lack of opportunities for its concentration, the properties of bile change, which affects the function of the gastrointestinal tract. It is these characteristics that are taken into account in the diet program. Therefore the question of how long to follow this therapeutic diet can be answered: the minimum period is three months.
The consequences of not following the diet after cholecystectomy can be very serious. Most often, the patient developspostcholecystectomy syndromewith all the ensuing consequences.
In general, after gallbladder removal you cannot neglect your diet. Diet and diet must be changed forever. Of course, over time, many requirements are simplified, but the basic principles must be respected. This will allow you to optimally maintain liver function and bile secretion, normalize the functioning of the entire gastrointestinal tract and prevent the appearance ofconstipation,swelling, bitterness in the mouth, often found after cholecystectomy.
Many women trying to lose weight are interested in the question of whether it is possible to fast if the gallbladder is removed. No, therapeutic fasting is strictly contraindicated for people undergoing cholecystectomy. They desperately need split meals. In the absence of a gallbladder, there is no natural accumulation of bile: it constantly enters the intestinal lumen, and during fasting and the absence of a food substrate in the intestine, bile will damage the intestinal mucosa. Fasting is for healthy people.
Reviews and results
Reviews of an overwhelming number of patients after cholecystectomy confirm the need and beneficial effect of therapeutic nutrition on the state of the gastrointestinal tract. A therapeutic diet allows the patient to recover faster and normalize their lifestyle:
- ". . . I have been tormented by cholelithiasis for a long time. During a flare-up I went to the hospital, but then the stones increased in size and the colic became unbearable. They performed an operation and removed the bladder with stones. They said that the most important thing in treatment is diet during removal of the gallbladder by laparoscopy. And now it's been almost 3 months. Everything more or less returned to normal, however, if there is a sudden violation of the diet (overeating, eating fatty foods, drinking little), various complications begin. Although I understand that nutrition in the absence of a gallbladder must be constantly monitored";
- ". . . After I had my gallbladder removed, my diet was very strict. A month later I tried to expand it more or less, but I felt bad. The doctor said it was too early to move to a common table. And only after a year I was able to start eating normally";
- ". . . For more than a year I followed the necessary diet after surgery: I did not eat lard, salads with peas, tomatoes, any dishes with tomato juice, borscht, radishes. It's been 3 years since the surgery, I eat almost everything. There is no discomfort or pain - life without a gallbladder is quite normal";
- ". . . This diet was prescribed in the hospital. For people with a removed gallbladder, this is the solution. So I've been sticking to this for the second month now. I think I will gradually expand it later.";
- ". . . The food is healthy and healthy, it is not difficult to sit on it, you can bear it, the important thing for me is that there is no pain";
- ". . . I cook everything for my husband in a bain-marie, I visited the forum and found many recipes and useful advice. Now food has become varied and I have taught my children to eat like this too. That's beautiful";
- ". . . The doctor warned that therapeutic nutrition after cholecystectomy should last 5-6 months, so it is possible to slightly expand the diet. But for six months I could not stand it, and after 4 months I switched to a normal diet, but without fried foods"
Price of the diet
Dietary food includes the most accessible and economical products. Their acquisition is not very expensive.