Bilirubin is formed upon decay hemoglobin в erythrocytes, who completed the cycle of their lives (destroyed in 120 days). In norm for a day 80-85% of bilirubin is formed. The bilirubin released into the plasma binds firmly to albumin. The liver plays an important role in the further exchange of bile pigments. She absorbs them and accumulates inside the cells, binds (or conjugates and this prevents the release of bilirubin into the blood) and leads to bile. It is this last phase that is disrupted by damage to the liver cells – bile in the bile enters a small amount of bound bilirubin and the unbound bilirubin returns from the liver cells to the bloodstream, where it is present in elevated amounts (hyperbilirubinemia).
The diet provides for moderate shivering of the liver, improvement of fatty and pigmental metabolism, and outflow of bile. Contains a reduced amount of fat (by reducing refractory), table salt, restricts the consumption of foods rich in purines (liver of animals, young bird meat, smoked sprat, sardines, baker’s yeast, tuna, sprats, herring, salmon caviar, dried ceps, shrimps , mussels).
Diet with elevated bilirubin should include increased content pectins and fiber (vegetables, berries, fruits). To activate the outflow of bile in the diet there are cholagogue products: vegetable oils, bran, juices (cabbage, beetroot). The diet is rich in lipotropic substances (beef, lean fish, cottage cheese, soybeans, whey, buckwheat), which protect the liver from fatty degeneration and reduce the risk of cholesterol stones. Lipotropic action is also possessed by cellulose and polyunsaturated fatty acids (vegetable oils are rich in them).
Chemical shaking of the liver is provided by stewed, boiled or baked dishes. In the diet is strictly prohibited the use of fried foods, but the dishes can not be wiped. Important is the principle of fractional nutrition in small portions – it does not overload the liver and other organs of the gastrointestinal tract, and also contributes to the outflow of bile. The key products in the diet are vegetables and their composition is quite diverse. They, as well as fruits and berries can be consumed in any form.
The choice of meat is also varied – beef, veal and low-fat pork, as well as chicken and turkey. It is advisable to give preference to nonfat fish, which should be consumed 3 times a week. In general, the diet is full and balanced (protein contains 100 g, carbohydrates – 400 g, fat – 80-90 g). The drinking regime should be abundant – up to 2,5 liters per day. Drink follows table water without gas, compotes.
- products with preservatives, dyes;
- fatty meat, fried foods, liver, brains, canned food, smoked products, kidneys, stew (contains extractives), sausages, fat, culinary fats;
- products that enhance fermentation (legumes, millet, sometimes – white cabbage, if its poor tolerability);
- stimulants of gastrointestinal tract secretion (horseradish, vinegar, pickled vegetables, mustard, spices, mushrooms, pickled and salted foods);
- products with essential oils (onion green, garlic, turnip, all kinds of radishes, radishes);
- broths from legumes, fish, mushrooms, meat;
- cream, fatty sour cream, fatty cottage cheese;
- sour fruits (plums, cranberries, citrus fruits);
- cocoa, drinks with gas, coffee, chocolate, ice cream, cream confectionery.
Diet with Gilbert syndrome does not differ from the above described, but in this disease, as with any other, it is very important not to allow large breaks in food intake. In these patients, hunger is accompanied by an increase in the level of unconjugated bilirubin. In order to detect this disease, even carry out a test with starvation. During 2 days, the patient receives a low-calorie diet (400 kcal). After 2 days, bilirubin is determined and compared with the indices before the start of the study. The sample is considered positive if the bilirubin level is increased by 50-100%. In addition, patients with this syndrome must comply with the water load, which is the prevention of thickening of bile. In addition, micronutrients and fat-soluble vitamins are added to the diet in the form of preparations.