Diet "4 table" - features, nutritional recommendations, menu. Diet “4 table” - features, nutritional recommendations, menu Must be excluded

Table No. 4 is indicated for acute intestinal diseases and exacerbations during the period of ongoing diarrhea. The goal of the diet is to provide the body with the necessary nutrients without irritating the intestines or causing fermentation in it. Table No. 4 refers to strict medical diets. It is prescribed for 2-5 days during periods of exacerbation of dyspeptic disorders, chronic intestinal diseases and after operations.

Table No. 4 assumes a sufficient amount of protein in the diet, but a reduction in carbohydrates and fats to the lower limits in order to reduce intestinal inflammation and prevent damage to its mucosa. To do this you need:

Reduce portion sizes.
Eat 5-6 times a day.
Boil or steam all foods.
Take food in liquid, semi-liquid, or ground form.
Exclude foods that cause fermentation in the intestines (fresh vegetables and fruits, sweets, legumes and coarse cereals, milk).
Avoid foods that stimulate bile secretion (spices, sauces, snacks).
Avoid cold and hot foods (calorizer). The food should be warm.

On diet No. 4 they limit, add,. According to new WHO rules, the amount of salt in the average person's diet should not exceed 5 g.

Restrictions on diet No. 4 apply to all foods that can mechanically, thermally or chemically damage the intestinal mucosa, cause fermentation processes and increase inflammation. This:

All flour and bakery products, except those permitted;
Soups with fatty broth, with vegetables or cereals;
All types of fatty meat, fish and poultry;
Ready meals: snacks, semi-finished products, canned food, smoked meats;
Coarse cereals: pearl barley, barley, millet and all types of legumes;
All fresh vegetables, fruits, berries;
All types of sweets, confectionery, carbonated drinks.

Flour products: stale white bread, white bread crackers.
Meat and fish: Lean parts of veal, beef, chicken or turkey, minced and cooked into steamed cutlets, soufflés or meatballs. Low-fat varieties of fresh fish, steamed or boiled in water.
Eggs: 1-2 eggs per day, soft-boiled or steamed into an omelet.
Dairy products: pureed cottage cheese, fresh calcined cottage cheese.
Cereals: rice, buckwheat or oatmeal, boiled and ground.
Vegetables and fruits: in the form of purees or decoctions.
Oil: vegetable, butter for dishes.
Drinks: tea, cocoa, water coffee, diluted juices, jelly, decoction of rose hips, currants, blueberries.

Table No. 4a

Table No. 4a is indicated for colitis with a predominance of fermentation processes.

The composition is the same as in diet No. 4, but they sharply limit foods and dishes containing large quantities of carbohydrates (porridge; bread no more than 100 g per day; sugar no more than 20 g per day); increase the protein content through meat dishes, pureed cottage cheese, etc.

Meals on diet No. 4a are fractional, but the portion size is smaller and the calorie content is lower than on No. 4. Table No. 4a is prescribed for the period of exacerbation of colitis, so the duration of such nutrition is 2-5 days, and then the patient is transferred to another medical diet.

Table No. 4b

Table No. 4b is indicated for chronic colitis in the stage of fading exacerbation. It is prescribed to patients whose intestinal diseases are accompanied by disorders of the stomach, biliary tract, liver or pancreas. The goal of the diet is to restore intestinal functions and the digestive process in case of non-acute disorders.

The nutritional rules are the same as on diet No. 4, but the following products are added to the composition:
Flour products: white bread, yesterday’s baked goods, savory cookies, dry biscuits.
Soups: cereal soups with weak fish or meat broth, broth with meatballs.
Cereals: heavily boiled or pureed porridge, except millet, barley, pearl barley, in water with the addition of 1/3 milk.
Vegetables and fruits: boiled and steamed vegetables, pureed. Boiled and chopped cauliflower, carrots, and potatoes are recommended. Ripe sweet fruits without peel are allowed. If the dynamics are positive, you can include a small amount of ripe tomatoes.
Dairy products: mild cheese, kefir, yogurt. You can add milk, cream, sour cream to food, and also prepare sauces based on sour cream. Béchamel sauce and dairy desserts with grated fruit are allowed.

The basis for the diet is the composition of table No. 4. Add , . Meals 4-6 times a day. Food is served warm.

Table No. 4b

Table No. 4c is indicated for acute intestinal diseases during the recovery period as a transition to a balanced diet; chronic intestinal diseases during the period of attenuation of exacerbation, as well as outside of exacerbation with concomitant lesions of other digestive organs.

The diet is prescribed to provide adequate nutrition in case of some insufficiency of intestinal function, which will help restore the activity of other digestive organs. This is a physiologically complete diet with a slight increase in protein content and moderate limitation of mechanical and chemical irritants of the intestines, excluding foods and dishes that increase fermentation and putrefaction in the intestines, sharply increase its secretory and motor functions, secretion of the stomach, pancreas, and bile secretion.

The basis of the table consists of products from diet No. 4 and 4b, but now it is allowed:

There is slightly dried or yesterday's bread.
Add finely shredded cabbage, green peas, beets, young beans, chopped vegetables and well-boiled cereal to soups.
Cook meat and poultry chopped, not minced, and bake fish.
There are crumbly porridges and small pasta.
Prepare sauces using fish or weak meat broth.
Add oranges and tangerines, sweet fruits and berries within 200 g per day, and finely chopped greens to your diet.
Marshmallows, marmalade, marshmallows.

Food is prepared uncut, steamed, boiled in water or baked. You need to eat small portions 5-6 times a day.

In addition to following the rules of nutrition for intestinal disorders, you need to drink - an average of 1.5 liters per day (calorizator). You should also promptly adjust your diet in case of intolerance to certain foods. A doctor should prescribe a diet and vitamins based on the patient’s tests and diagnosis.

Unfortunately, many people around the world suffer from diseases of the digestive system. During the period of their exacerbation, a person cannot eat regular food, he has to dodge and come up with something that does not cause heartburn, vomiting, diarrhea, bloating or other unpleasant symptoms.

But Pevzner at one time developed an excellent diet 4 for patients suffering from chronic gastrointestinal diseases. Diet 4 menus for the week can be compiled independently, guided by the supporting information given below.

What is diet table 4 for a week?

Diet 4 was developed by Dr. Pevzner as one of his 15 diets for “all occasions”, or rather for many diseases. Doctors recommend adhering to this diet for patients suffering from diseases of the gastrointestinal tract during an exacerbation of the disease in chronic stages, as well as for one-time diseases, that is, these can be various poisonings and so on.

Typically, a diet is prescribed for problems with the intestines (the appearance of diarrhea, bloating and digestive disorders). The allowed foods in the diet are selected so that dishes made from them do not cause irritation or other negative reactions of the intestinal mucous membranes, and often food during diet 4 has a certain calming effect on the intestines - it reduces fermentation processes and relieves inflammation.

Diet for children

The child may also experience intestinal disorders and unpleasant problems with diarrhea and bloating. In such cases, pediatricians, gastroenterologists and nutritionists recommend that even children adhere to this particular diet, since it is safe for the child’s body, the choice of products is really large, so for allergy sufferers it is possible to replace what directly causes the allergy, and, of course , in case of intestinal disorders, diet greatly saves patients.

If doctors have prescribed the fourth diet as a method of treatment, then you should not ignore it, and to completely heal your baby’s body, force him to follow the diet. For some moral support, diet with him. Any support from parents is very important for a child.

Features of diet table 4

The main distinguishing features of diet 4 is the presence of liquid food in the diet. To be more precise, the entire table of the fourth diet consists of liquid, semi-liquid or ground food. Meals should occur 5-6 times a day at the same time. Eat small and rationally; you cannot overload the intestines with work, otherwise it will cause pain, discomfort and unpleasant consequences. All dishes must be steamed or boiled in water.

Healthy recipes for diet

Beef broth

Ingredients: lean beef 150 grams, water 1 liter.

How to cook: cut lean beef into cubes (to cook faster and easier to chop), cook in water until tender. You cannot add onions, bay leaves, peppers and other spices to the broth. Boiled meat must be ground.

Cottage cheese casserole

Ingredients: cottage cheese 250 grams, egg.

How to cook: grind the cottage cheese through a sieve, add a pre-washed egg to it, mix thoroughly. Place the mixture in a baking dish (no need to grease with oil!). Bake until done.

Mashed potatoes

Ingredients: medium-sized potatoes (3-5 pieces), boiled water.

How to cook: Boil the potatoes until tender, then chop them using a blender or masher. Pour a little boiling water into the mashed potatoes, stir until the consistency of liquid sour cream.

These recipes are good for every day because they are very easy and quick to prepare.

Menu for the week

Monday

First breakfast: rosehip decoction (glass), oatmeal porridge with water (shallow plate), crackers for tea parties (stale, that is, they must sit for several days before consumption).

Second breakfast: banana puree.

Lunch: steamed chicken meatballs, weak tea (1 glass), mashed potatoes.

Afternoon snack: jelly (1 glass), baked apple.

Dinner: meat casserole, glass of water, pearl barley porridge with water.

An hour before bedtime, you can drink a glass of kefir.

Tuesday

Breakfast: grated cottage cheese, a glass of tea.

Second breakfast: marshmallows.

Lunch: rice porridge with water, chicken cutlet, tea (glass).

Afternoon snack: grated apples.

Dinner: mashed potatoes, turkey meatballs, jelly.

An hour before bedtime, a glass of kefir.

Wednesday

Breakfast: green tea (1 glass), homemade yogurt, applesauce.

Second breakfast: buckwheat porridge in milk.

Lunch: beef broth, crackers.

Afternoon snack: waffle, rosehip infusion.

Dinner: chicken casserole, mashed potatoes, water.

An hour before bedtime, a glass of jelly.

Thursday

Breakfast: homemade beef pate, tea.

Second breakfast: pear puree.

Lunch: millet porridge on water, homemade chicken sausage.

Afternoon snack: crackers, juice diluted with water.

Dinner: chicken broth, cheesecake, water.

An hour before bedtime, a glass of jelly.

Friday

Breakfast: mashed potatoes, tea.

Second breakfast: meat casserole.

Lunch: mashed bananas, apples and pears, green tea.

Afternoon snack: waffles and jelly.

Dinner: grated cottage cheese, green tea.

Saturday

Breakfast: cottage cheese casserole, jelly.

Second breakfast: chicken cutlet.

Lunch: beef broth, mashed potatoes.

Afternoon snack: bun, tea.

Dinner: baked apple, rice porridge with water, green tea.

An hour before bedtime, a glass of kefir.

Sunday

Breakfast: baked fruit, water.

Second breakfast: grated cottage cheese.

Lunch: beef patties, mashed potatoes, water.

Afternoon snack: marshmallows, jelly.

Dinner: chicken broth, pearl barley porridge with water, jelly.

Diet 4 goes very well with the recipes given above. They are great for daily use during similar diets.

Video on the topic

Dietary table 4 for indigestion: steam cutlets and chamomile tea

There are a large number of different diets, the action of which is aimed at restoring the proper functioning of human organs and systems in various diseases.

Nutrition system table 4 reduces inflammation in the intestines, normalizes the activity of the gastrointestinal tract, and provides the body with important nutrients.

What is this - the fourth table, and what products are included in the diet - this article will tell you about it.

Basic principles of diet table 4

Diet number 4 can be prescribed by a doctor if a person suffers from chronic or acute gastrointestinal diseases or diarrhea.

In the stage of exacerbation of the disease, this method of nutrition is simply necessary, as it helps restore the digestive organs without mechanical, temperature and biochemical effects on the mucous membrane.

For intestinal diseases, you need to eat liquid, pureed foods, in the form of purees.

For an effective result, you must strictly adhere to your diet - eat up to six times a day, in small portions, using only approved foods.

From the menu of a person with a violation of the digestive process, foods that cause increased secretion of gastric juice, fermentation processes in the intestines and increase peristalsis are excluded.

The temperature of the food should not exceed 50°C.

This nutritional system is low-calorie, as it limits the consumption of carbohydrates and fats.

Daily protein intake corresponds to the norms and physiological needs of the body.

The calorie content of the daily diet is 1900-2100 kcal per day. Therefore, the diet is not prescribed for a long period of time. To achieve improvements, you need to follow this nutrition system for about a week.

What products should you use in your menu daily?

What is not allowed: hard, fatty, smoked, fried foods containing coarse fibers.

What you can eat while following this diet: low-fat foods, cottage cheese, some types of cereals and certain fruits.

The table below of foods for diet No. 4 will tell you more:

Allowed

- Flour products: crackers from wheat bread. - Vegetables: in the form of ingredients for soup and puree. - Meat: lean beef, rabbit meat, chicken breasts, turkey. All without fat and skin, tendons and films. Soufflé, cutlets, meatballs with rice, steamed meatballs. - Fish: 1-2% fat content - pollock, pike, pike perch, grayling. Steamed cutlets, steamed, meatballs, fish souffle. - Soups: with diluted fish or meat broth, low-fat; using rice, semolina, oatmeal and buckwheat, steamed meatballs, grated meat. - Eggs: in the form of a steam omelet, soft-boiled.

– Cereals: in the form of mashed porridges. To prepare them, use water and diluted broth. Mucous decoctions of rice, oatmeal and buckwheat.

– Dairy products: pureed cottage cheese, 0% fat, curd soufflé.

– Fruits: jelly and jelly from bird cherry, pear, blueberry and dogwood. Baked apples.

– Drinks: green and black tea, cocoa with water. Vitamin compotes are made from dried currants, bird cherry, and blueberries.

– Butter up to 3-5 grams per day (added to porridge).

Forbidden

– Cereals: pearl barley, millet, barley, pasta and legumes.

– Soups: fatty, rich meat and fish broths. Soups cooked with milk, with the addition of various cereals and pasta.

– Meat: fatty meat, sausage and smoked meats.

– Eggs: all cooking methods, except steam omelet and soft-boiled eggs.
– Fish: varieties of fish with a fat content of more than 2%, canned food, caviar, salted fish.

– Dairy products: milk, dairy products, except low-fat cottage cheese.

– Vegetables: fresh vegetables.

– Fruits: all dried fruits, jam and everything except those allowed.

- Honey.
– Drinks: carbonated drinks, kvass, cold and hot, with milk.

- Spices.

The first day of the diet allows the consumption of only water and tea, wheat crackers and 50 grams of slimy porridge, preferably rice.

Fourth table: sample menu for the day

Breakfast: semolina porridge with water, baked apple, berry juice;

Snack: pear jelly;

Lunch: pureed rice and carrot soup, steamed pollock fillet cutlets, green tea;

Afternoon snack: blueberry compote;

Dinner: cottage cheese casserole with rice, jelly;

At night: chamomile tea;

What to cook for breakfast or lunch and how can you diversify the menu?

Cottage cheese with pear puree, pike perch balls with rice, oatmeal soup with chicken fillet meatballs, rice soup with potatoes and semolina, boiled rabbit - these are only a small part of the dishes that can be consumed on this seemingly modest diet.

If there are indications for compliance with the strict diet that is required for this diet, then you should not neglect it.

The fourth table can be tolerated very easily with regular meals at certain hours.

The diet copes well with diarrhea and normalizes stool, relieves inflammation of the gastrointestinal tract and improves condition and well-being.

The table system 4B and 4B is designed specifically for the postoperative regimen of patients or for people suffering from acute and chronic intestinal diseases. This diet is also indicated in case of intestinal disease with diarrhea syndrome. The dishes allowed in it reduce the load on the stomach and intestines, cleanse and speed up the recovery of the body.

Characteristics of diet table 4B

Dietary meals contain the necessary and sufficiently high amount of protein, but the level of fats and carbohydrates is reduced to normal. The goal of this diet is to “unload” the body as much as possible, so only those products are selected that are completely absorbed.

Key diet rules

Like any food restrictions, the 4 “B” diet contains a number of rules, compliance with which forms the basis of proper dietary nutrition:

The required amount of water is 1.5 liters per day. Precisely pure water, not tea, milk or juices;
The amount of salt is reduced to a minimum, that is, no more than 8 grams per day;
Meals are divided into small parts. You need to eat six times during the day;
Fried foods should be excluded. Food only boiled or steamed.

Also, in case of intestinal diseases, it is necessary to exclude any products that cause fermentation or putrefactive processes in the body.

Allowed dishes on the menu

Despite the fairly strict restrictions, the 4 “B” diet table provides a wide variety of delicious foods, which can be presented in table form:

Lean meat, preferably beef, rabbit or chicken. Boiled. Be sure to remove the skin and cut out the tendons. Once a week you can allow yourself a couple of milk sausages, diet sausage or boiled tongue;

Soft-boiled eggs or egg dishes are allowed no more than one egg per day;
Low-fat fish can be baked, and a small amount can even be fried. But you can't cook breaded fish. You should also refrain from eating caviar;
Vegetable soups or soups with lean meats are one of the main dishes of the diet. However, they should be very liquid and unsalted. You can also add cereals to the broth, everything except millet, potatoes, a small amount of pasta or noodles, carrots, cauliflower, zucchini, lean minced meatballs;
Liquid porridge, with a small amount of sugar, possibly with the addition of honey or jam;
Vegetables should make up the majority of the diet. It is recommended to consume vegetables steamed, boiled, in the form of jure or various casseroles. The best options are zucchini, potatoes, carrots, pumpkin, a little (no more than one hundred grams per day) well-boiled peas and beets, or ripe tomatoes;
Fruits should be the main dessert. Fresh or baked apples will be useful. It is not recommended to consume more than one hundred grams of berries, and only ripe ones. Strawberries, raspberries, pears, thoroughly seeded watermelon, peeled grapes. Oranges and tangerines are allowed, but only in small quantities;

In drinks, it is advisable to opt for compotes, juices heavily diluted with water and plain water. Coffee and cocoa are allowed, with a small amount of low-fat milk;
In spices and sauces, it is better to limit yourself to cinnamon, dill and parsley, a small amount of vanillin and bay leaf. Suitable sauces include fruit and sour cream.

Prohibited dishes on the menu

Butter and puff pastries, fresh or rye bread;
Soups with fatty broth or with the addition of legumes, rassolnik and okroshka;
Smoked sausages and any canned food;
Dairy products;
Mushrooms and dishes made from them;
Fried egg dishes;
Garlic, onion and radish;
Chocolate, ice cream, cakes;
Horseradish and mustard, hot sauces.

Approximate menu for the week table 4B

For lunch, low-fat soup with meatballs, some buckwheat, boiled meat and compote for dessert are suitable. For dinner, mashed potatoes, some fish and tea are recommended. At night you should drink a glass of kefir.

On Wednesday morning you need to start with oatmeal porridge, a glass of tea with lemon and an omelet. For second breakfast you should eat cottage cheese. It is better to have lunch with broth, such as chicken broth, mashed potatoes with chicken and compote. Potato casserole and a little milk are good for dinner. Before going to bed, you can drink a glass of yogurt.

Thursday should start with tea, cottage cheese casserole and a small amount of sour cream for it. Cottage cheese is suitable for second breakfast. For lunch, we recommend some vegetarian borscht, rice porridge and compote. You can have meatloaf and mashed potatoes for dinner. Before going to bed - a little fermented baked milk.

Friday breakfast should consist of oatmeal, tea and a piece of milk sausage. For second breakfast - cottage cheese. For lunch, you can treat yourself to jelly, chicken broth and cottage cheese casserole. For dinner, steamed fish cutlets and mashed potatoes are suitable. At night - a glass of yogurt.

On Saturday, boiled noodles with tea and a little mild cheese are recommended for the first breakfast. On the second - cottage cheese. For lunch, vegetarian beetroot soup and buckwheat with meatballs and compote are suitable. For dinner, a little liquid tea and mashed potatoes with meat, before bed - a glass of kefir.

On the last day of the week, it is better to eat rice porridge with butter and drink tea for breakfast. Later - cottage cheese. For lunch, meat borscht, oatmeal and lean meat stew are suitable. For dinner - buckwheat porridge and boiled meat, before bed - a glass of fermented baked milk.

Useful videos

The “4 table” diet is a specially developed nutritional system prescribed for acute as well as aggravated chronic intestinal diseases - colitis, gastroenterocolitis at the onset of the disease (after days of fasting), enterocolitis, dysentery, etc. Its creator is one of the founders of dietetics M.I. Pevzner. Despite the fact that this diet was developed back in the thirties of the last century, it has not lost its relevance to this day and is actively used in sanatoriums and hospitals, and is also prescribed to patients undergoing treatment at home.

Features of the “4 table” diet

The nutrition prescribed for this diet reduces and prevents the further occurrence of fermentation and putrefactive processes, creates all the conditions for neutralizing inflammatory processes and helps restore impaired intestinal functions. A special diet can reduce or even eliminate the likelihood of injury to the gastrointestinal mucosa and improve their ability to recover.

Diet number 4 involves limiting the amount of fat (especially animal fat) and carbohydrates in the diet, so its energy value is low. From its menu it is completely excluded food that is difficult to digest and provokes increased secretion of the stomach, as well as food that can cause fermentation and putrefactive processes and irritate the inflamed area of the gastrointestinal tract.

During the period of following the 4-a-day diet, it is recommended to eat at least five times, and the portion size should be small. It is advisable to eat food at the same time, this will improve its absorption and normalize the functions of the gastrointestinal tract. All food and drinks consumed should be at a comfortable temperature, since food that is too cold or, conversely, very hot can trigger an attack.

When preparing food, frying should be avoided; the recommended methods of processing foods are boiling and steaming. Any food should be consumed only in liquid, pureed or mashed form.

The diet for colitis and other intestinal diseases does not allow the consumption of smoked, fatty and spicy foods, as well as solid foods containing insoluble fiber or too dry foods. Salt and sugar should be significantly limited in the diet. To make it clearer what food you should avoid first, we present a list of prohibited foods:

Smoked products, canned food, semi-finished products, pickles, sauces, marinades, snacks, fast food.
Fatty types of meat and poultry, strong meat broths, sausages, sausages.
Fatty fish, caviar, dried and salted fish.
Hard-boiled, fried and raw eggs.
Any fresh baked goods, whole grain and rye bread, bran, pancakes, pancakes, baked goods, pasta.
Animal and vegetable fats.
Hard cheese, whole milk, kefir, cream, sour cream.
Raw berries, fruits, and dried fruits.
Vegetables.
Barley and pearl barley, legumes, millet, buckwheat kernels.
Spices, spices.
Jam, honey, sweets, cakes and other sweets.
Carbonated drinks, coffee, grape juice, kvass, fruit juices.

Despite the rather impressive list of foods that diet number 4 prohibits from consuming, you won’t have to eat sparingly, much less starve, while sticking to it, since the list of foods recommended for consumption is also quite large.

This diet is built on the same principle as diet number 4, but is still somewhat different from it. During the period of observance, food can be consumed not only in pureed form, but also in crushed form. Stewing and baking are allowed, but the rough crust must be removed from food prepared in this way. In addition, the list of foods that can be consumed is expanding. In addition to those allowed by Diet 4, you can also add the following products to your menu:

Dry biscuits, savory pies and buns with apples, eggs, boiled meat, cottage cheese.
Black and chum caviar.
A couple of eggs a day, but only as part of other dishes, baked, cooked in the form of an omelet and soft-boiled.
Mild cheese.
Boiled noodles and vermicelli.
Pumpkin, carrots, zucchini, cauliflower, potatoes in small quantities, but only heat-treated and pureed. Ripe tomatoes in small quantities. At the same time, eating mushrooms, onions, spinach, sorrel, cucumbers, rutabaga, turnips, beets, cabbage, radishes, radishes is prohibited.
Soups with the addition of vermicelli or noodles.
Cinnamon, vanilla, parsley, bay leaf, dill.
Sweet types of fruits and berries, but only ripe ones, for example, tangerines, pears, apples, strawberries. At the same time, berries with coarse grains, watermelons, melons, plums, apricots, grapes and peaches must be discarded.
Coffee.
Pastille, marshmallows, marmalade, meringues, jams from sweet fruits and berries.

All other prohibited foods should be avoided.

Dietary table 4B

This diet is prescribed after the 4B diet as a transition to normal nutrition, for chronic enterocolitis during remission, acute intestinal diseases in the recovery stage and when combined with diseases of other digestive organs.

While following the 4B diet, foods no longer need to be washed or chopped. Eating fried foods is still not recommended, but is sometimes acceptable. In addition to previously permitted products, you can also enter the following into the menu:

Fresh bread and baked goods, fatty poultry, strong broths, fatty fish, raw eggs, fatty meats, smoked meats, pickles, canned food, snacks, fast food, animal fats and other foods that were previously prohibited and not allowed by diet number 4B, you need must be excluded from the diet.

Diet 4 for intestinal diseases is positioned as one of the options for therapeutic nutrition. Recommended for patients with colitis, digestive disorders, dysentery, enterocolitis.

General rules

This type of diet is prescribed to patients during the treatment of digestive system disorders and intestinal pathologies accompanied by diarrhea. Its main task is to eliminate the pathological processes accompanying these diseases.

The diet completely excludes dishes that can stimulate the secretory functions of the stomach and activate the functioning of the gallbladder. Heat treatment involves cooking and steam cooking. Dishes are served in liquid, semi-liquid and pureed form.

General dietary rules:

six meals a day;
preparation of products is allowed only by boiling and steaming;
Solid foods, thick, hot and cold foods are completely prohibited.

Diet types #4

Table No. 4 is divided into three subtypes - 4A, 4B, 4B. The main difference is the food set.

This therapeutic nutrition option is prescribed in the acute period of the disease. The diet menu is monotonous and excludes many foods. It is recommended to be observed for two to five days. Energy value – 1600 Kcal.

Table 4B is prescribed during the period of exacerbation of chronic gastrointestinal pathologies - for diseases of the liver, kidneys, biliary tract, pancreas. Table 4B is physiologically complete, so it can be practiced for a long time. Energy value – 2900 Kcal.

The diet is practiced during the first 7 days after surgery, as well as after the end of the acute period of intestinal disease. Used as a transition from the treatment table to the general one. Energy value – 3140 Kcal.

Indications for use

acute period of intestinal disease, accompanied by severe diarrhea;
severe exacerbation of chronic pathologies.

Allowed food basket

The list of products approved by nutritionists for use in developing a daily menu is quite extensive. It is represented by the following positions:

Already dried (day before yesterday) wheat bread, homemade crackers. The permissible norm for 24 hours is no more than 200 grams of product. Additionally, dry cookies (biscuits) are allowed.
Puree porridge. They are the basis of the patient’s diet. Semolina, white rice, buckwheat, and oatmeal are allowed. They are prepared either in water or in fat-free (skimmed) meat broth.
Butter. Use only 50 grams per day.
Soups. When cooking, you need to take the removed (second) one from under the fish/meat. To fill, take cereals, a minimum of vegetables, pureed or processed with a blender/meat grinder, boiled meat, dumplings, eggs, meatballs.
Meat. Only dietary varieties are allowed - veal, beef, chicken breast, turkey, rabbits. Before cooking, the skin must be removed and the tendons cut out.
Steamed cutlets, meatballs, quenelles. When collecting minced meat, bread must be replaced with semolina or boiled rice. It is allowed to prepare meat pate by adding a minimum amount of salt.
Low-fat fish. Serving in the form of a whole boiled/steamed piece is allowed. If it is a chopped version, then it can be dumplings, cutlets, meatballs. Cooking or steam cooking is allowed.
Eggs. The norm is 2 pieces per day. Served soft-boiled, in the form of a steam omelette. It is allowed to be mixed into soups (you get hearty egg flakes) and soufflés.
Low-fat pureed cottage cheese. Used for making casseroles and soufflés.
Vegetables. It is allowed to be used exclusively in pureed form, adding a small amount when cooking soup. The volumes are minimal.
Fruits - apples (fresh, in the form of puree), jelly (blueberries, bird cherry, dogwood, quince, pears), fruit drinks.
Juices from sweet berries (previously diluted with boiled water in equal proportions). Grape, plum and apricot fruits are prohibited.

As a drink, it is allowed to use: herbal teas, rosehip uzvar, infusion of bird cherry berries, tea (green or black varieties), still water (no more than 1.5 liters per day).

Prohibited Products

Table No. 4 completely excludes the consumption of foods containing fiber.

The list of prohibited products includes:

Vegetables. They can be added to soups in small quantities and pureed.
Bread. Whole grain, rye, bran, cereal. It is difficult to digest and can injure the mucous membrane.
Fresh pastries, pancakes/pancakes. They provoke the processes of fermentation and rotting.
Jam, honey, jam, dried fruits, sweets. During the day you are allowed to use 50 grams of granulated sugar.
Porridge – millet, barley, barley, legumes.
Pasta.
Fatty broths. They contribute to increased intestinal motility and worsening of the condition.
Fatty meats and fish.
Canned food, pickles and fish in particular.
Whole milk, cream, sour cream, cheese. May cause increased diarrhea. Milk must be diluted with water. It is used only for cooking porridges and puddings.
Cocoa, coffee with milk, sweet soda, kvass.
Sauces, marinades.
Smoked meats, ham, sausages.

These products can stimulate gastrointestinal motility and cause bloating.

Sample weekly menu

It is necessary to organize six meals a day. Be sure to alternate dishes to avoid monotony.

Monday

1st breakfast: oatmeal with a piece of butter, a soft-boiled egg, a drink.

2nd breakfast: pureed apple (fresh or pre-cooked in the oven).

Lunch: soup with rice cereal and the addition of minced meatballs, homemade croutons, buckwheat with chicken cutlets (stewed in water or steamed), apple-pear drink.

Afternoon snack: jelly with biscuits or homemade croutons.

Dinner: semolina (without adding granulated sugar), a portion of boiled fish, a drink.

Late dinner: jelly.

Tuesday

1st breakfast: rice porridge (sweetened) with a piece of butter, crackers, rose hip broth.

2nd breakfast: a few spoons of cottage cheese.

Lunch: meat broth thickened with semolina, steamed dumplings of minced chicken/turkey, side dish - boiled rice, homemade croutons, jelly.

Afternoon snack: an apple baked in the oven and chopped in a blender.

Dinner: egg, buckwheat porridge, drink.

Late dinner: compote of allowed dried fruits with biscuits.

Wednesday

1st breakfast: thoroughly boiled oatmeal with a piece of butter, a pureed piece of boiled meat, a little cottage cheese, tea, biscuits.

2nd breakfast: fruit puree.

Lunch: chicken broth with rice cereal and egg flakes, grated buckwheat porridge, meatballs, fruit drink.

Afternoon snack: jelly with biscuits.

Dinner: minced fish meatballs (you can use hake), garnished with well-cooked rice, sweet black tea.

Late dinner: jelly.

Thursday

1st breakfast: buckwheat porridge with a piece of butter, a soft-boiled egg, a little cottage cheese, a fruit drink.

2nd breakfast: jelly with wheat bread dried in the oven.

Lunch: soup with meatballs, thickened with semolina, homemade croutons, thoroughly boiled rice cereal, garnished with steamed minced fish balls, jelly.

Afternoon snack: rosehip broth, homemade crackers.

Dinner: cottage cheese-buckwheat pudding, meat soufflé, drink.

Late dinner: pear broth.

Friday

1 breakfast: rice pudding, low-fat cottage cheese, tea,

2nd breakfast: berry broth.

Lunch: fish broth with fish balls and rice, homemade croutons, minced chicken cutlets (steamed), garnished with grated buckwheat, berry broth.

Afternoon snack: unsweetened decoction of rose hips with biscuits.

Dinner: steam omelette, sweet semolina porridge, tea.

Late dinner: decoction of dried fruits (apples and black currants).

Saturday

1st breakfast: buckwheat pudding with cottage cheese, baked apple puree, tea.

2nd breakfast: pear and apple compote.

Lunch: broth with semolina and stirred egg, veal cutlets (steamed), garnished with pureed rice porridge, pear compote.

Afternoon snack: berry compote with biscuits.

Dinner: oatmeal with sugar-free butter, soft-boiled egg, black tea.

Late dinner: jelly.

Sunday

1st breakfast: thoroughly boiled oatmeal with a piece of butter and steamed minced chicken/turkey cutlets, a drink, homemade white wheat bread croutons.

2nd breakfast: a few spoons of low-fat cottage cheese.

Lunch: beef broth with meatballs, thickened with semolina, pureed buckwheat porridge with lean fish meatballs, fruit jelly.

Afternoon snack: black tea with homemade crackers.

Dinner: rice porridge with a piece of butter, a soft-boiled egg, a drink.

Late dinner: compote of allowed dried fruits.

Recipes

We offer several recipes for dishes that may be included in diet menu No. 4.

Fish meatballs

Components:

water – 55 ml;
rice – 55 grams;
butter – 15 grams;
fish fillet – 300 grams.

Preparation:

Prepare sticky rice.
Pass it through a meat grinder at least twice, adding fish.
Stir the butter into the resulting mass, add water and add a little salt.
Prepare meatballs from the kneaded minced meat and steam.

Hake balls (steam)

Ingredients: egg, hake fillet – 300 grams; semolina grits – 50 grams; salt to taste. Preparation: Grind the fish through a meat grinder. Place semolina, salt and egg into the minced meat. Mix. Form into balls and steam.

Beef steamed cutlets

Ingredients: beef – 710 grams, onion – 1 piece, chicken eggs – 2 pieces, rice flour – 110 grams, salt. Preparation:

Grind the beef and onions using a meat grinder.
Mix eggs, flour and salt into the minced meat.
Knead the mixture and place it on the refrigerator shelf for 1 hour.
Cook the formed cutlets in a double boiler for half an hour.

Ingredients:

eggs – 2 pieces;
milk – 1.5 cups.

Steam omelet is one of the options for serving eggs

Preparation:

Pour milk over the eggs and beat the mixture thoroughly. Add some salt.
Place a container filled with the mixture into the multicooker bowl. Cook in “steam” mode.
You can also use a steam bath.

Buckwheat-curd pudding

Ingredients: buckwheat – ¼ cup, fat-free/low-fat cottage cheese – 155 grams, egg, granulated sugar – 1 spoon. Preparation:

Boil the buckwheat and grind.
Mix it with cottage cheese. Add the yolk, sweeten, mix again and add the thoroughly beaten white.
Transfer the mixture to a greased pan and steam.

Diet No. 4 for children

In childhood, it is prescribed for the development of severe diarrhea. The first day is fasting. The child should drink herbal infusions and teas within 24 hours. Mineral water without gases is allowed. Daily fluid intake is no more than 1 liter. Drinks should be given often, but in small portions, so as not to cause vomiting. From the second day the child is transferred to diet No. 4.

The child can receive:

dried wheat bread;
slimy rice concoctions;
“second” broths made with chicken or beef - they can be thickened with semolina or oatmeal;
steam-cooked fish and meat dishes;
pureed porridge from buckwheat, rice, oatmeal;
soups - you can put chopped meat or meatballs in them;
steam omelette;
cottage cheese – can be served in its natural form or as a casserole.

Kissel should only be prepared at home; packaged versions are not recommended, especially for children.

Butter can only be used as an additive to a dish. Allowed drinks are decoctions of blueberries, rose hips, quince fruits and jelly. Baked goods, soups - prepared with vegetables or milk, smoked meats, sausages, canned food, fatty meats, sour cream, milk, vegetables (fresh and cooked), fresh fruits, grape juice are completely prohibited.

The diet provides for six meals a day. Duration – 6 days. Then it can be expanded. It is allowed to introduce a small amount of vegetables - zucchini, potatoes, carrots, cauliflower, pumpkin, small vermicelli, porridge cooked with milk. You can add a little sour cream to the soup.

Therapeutic diet No. 4 is a nutritional system recommended for acute/chronic gastrointestinal diseases accompanied by severe diarrhea. Dishes are allowed to be changed at your own discretion, but it is important to follow the basic principles of preparation and recommendations for food baskets.

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 nutritional 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 possible.

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.

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 inferior, since the quantity must be reduced. The basis of the diet should be. The quantity 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, strong;
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 meat, chicken fillet, lean and;
, and (talking about pureed cereals);
cocoa without, herbal decoctions;
(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.

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

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);
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 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, noodles from soft varieties and white crackers are allowed. From dairy products, you can eat low-fat and calcined cottage cheese 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.

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.

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 for, and), boiled porridge, mild cheese, boiled sausage. You can add a little 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: , . 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.

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;
jelly from or currants;
cocoa in water with breadcrumbs or dry cookies (100 g);
baked pears, homemade;
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.

Treatment table 4v

Diet 4b is prescribed during the recovery period after diseases of the gastrointestinal tract or after their exacerbation. The purpose of this diet is to gradually return the patient to a normal diet. This is a physiologically complete diet. Mechanical sparing is not so strict - it is not necessary to grind the food too much. Meat, vegetables and fruits are finely chopped, porridge is well boiled. Thermal sparing remains the same: food and drinks must be warm. Chemical sparing is significantly reduced.

It is prohibited, until the patient has fully recovered, to eat: fried, too sour, highly salted, fatty, pickled, smoked and canned. Raw, unprocessed vegetables, fruits, and berries are also limited (up to 200 g per day). Exclude legumes and white cabbage in any form. Coffee, carbonated and alcoholic drinks are also prohibited.

You can introduce more dairy products (if tolerated) and fruit juices diluted 1:1 with water. The weekly menu for table 4b is also suitable for this diet, but the diet can be further diversified. You can add milk to porridge, a little fresh sweet fruit to oatmeal and semolina. You can add more finely chopped vegetables to soups. Meat and fish are allowed to be eaten unchopped. For snacks, you can make sandwiches with dried bread, pate, cheese and sausage. Berries and fruits are used to make purees, compotes, puddings, and jellies. Recipes will be more varied and easier to prepare.

The diet is followed until the patient's health is restored. This diet is periodically recommended for healthy people to prevent gastrointestinal diseases.

The entire cycle of the fourth diets according to Pevzner is aimed at restoring the complex process of digestion. Strict adherence to the rules will be the key to a speedy recovery and return to the usual menu. To avoid digestive problems in the future, the basic rules of diet should become a way of life. Small meals, healthy and high-quality food, a minimum of fried and fatty foods, soups for lunch. Minimum requirements for the prevention of complex and extremely unpleasant diseases.