Ding Dong! You have a recipe for patients with upper gastrointestinal bleeding. Please check it.

Author: Yang Li, The Fifth Medical Center, PLA General Hospital

Reviewer: Jin Bo, Chief Physician, Fifth Medical Center, PLA General Hospital

Improper diet is one of the main causes of upper gastrointestinal bleeding complicated by cirrhosis. Therefore, dietary care is very important. Different stages of bleeding have different dietary requirements. See the figure below for details.

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So, what are the dietary types, their applicable scope and requirements for patients with upper gastrointestinal bleeding?

1. Liquid diet

Liquid diet, also known as liquid food, is a fluid diet in which the food is liquid or easily dissolves into liquid in the mouth and contains more water.

1. Scope of application: patients with high fever, difficulty chewing and swallowing in the oropharynx, acute gastrointestinal inflammation, patients after major surgery and critically ill patients.

2. Dietary requirements

(1) Food should be fluid, easy to digest and swallow, and should be given an appropriate taste to increase appetite.

(2) Eat small meals frequently, 6 to 7 meals a day, with each meal containing 200 to 250 ml.

(3) Food selection: ① Foods that can be used include general liquid foods, such as rice soup, various rice pastes, soy milk, soft tofu pudding, various broths, fruit juice, milk, malted milk, etc.; clear liquid foods, such as liquid foods without residue and without gas; thick liquid foods, such as milk powder mixed with malted milk, milk, and various rice pastes. ② Foods that should not be used include irritating foods, strong-flavored condiments, and foods that easily cause bloating, etc.

3. The liquid diet recipe is shown in the figure below. Note that the sugar intake of diabetic patients in the following recipes should be adjusted according to the range of blood sugar fluctuations.

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(1) General liquid diet: It is widely applicable and easier to swallow and digest than semi-liquid diet. The following is a reference recipe for a general liquid diet.

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(2) Clear liquid diet: Choose liquid foods that do not contain any food residue and do not produce gas, such as sieved beef soup, pork rib soup, sieved vegetable soup, rice soup or thin lotus root powder. Milk, soy milk and overly sweet foods are not clear liquids. See the figure below for a reference recipe for a clear liquid diet.

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(3) Thick liquid diet: It can be eaten through a straw. Thick foods without residue are preferred, such as thin egg batter, thick lotus root starch, milk powder mixed with malted milk, milk, etc. See the figure below for a reference recipe for thick liquid diet.

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2. Semi-liquid diet

Semi-liquid diet is between soft food and liquid diet. It is softer than soft food, contains less fiber, has higher nutrition, and has a semi-liquid appearance.

1. Scope of application: Semi-liquid diet is used for patients in the recovery period of bleeding, those with high fever, weak body, digestive tract diseases or those with difficulty chewing and swallowing (such as those with oral diseases, ear, nose and throat surgery), as well as women who have just given birth.

2. Dietary requirements

(1) Provide soft, semi-fluid food that is high in nutrients, easy to chew, easy to digest, and low in fiber.

(2) Follow the principle of small and frequent meals: Eat small and frequent meals, 5 to 6 meals a day, with the total volume of food for each meal being about 300 ml.

(3) Food selection: ① Applicable food. Staple foods include steamed bread, noodles, dough slices, bread, soft steamed cakes and whole grains; various porridges, such as white rice porridge, minced meat porridge, minced meat and vegetable porridge, minced chicken porridge, sweet red bean paste porridge, jujube paste porridge, etc.; vegetables include general vegetables that should be chopped and softened, and some vegetables with less coarse and hard fiber, such as carrots, spinach, winter melon, cabbage, etc., can also be softened; eggs include steamed egg custard, egg drop soup, poached eggs, soft-boiled eggs, preserved eggs, salted eggs, cakes, etc.; milk includes milk, cheese, yogurt, etc.; meat includes tender shredded meat, minced meat, diced meat (pork, chicken, duck, etc.), fish balls, shrimp balls, etc.; beans include soy milk, tofu brain, tofu soup, egg stewed with tofu, various fermented bean curd, etc. You can also choose appropriate fruits, vegetables, meat, cereals, etc. according to the condition, and use a wall breaker to beat one or several ingredients into a flow or paste. ② Prohibited foods include rice, dumplings, pies, flatbreads and other coarse, hard, and difficult to digest staple foods; large pieces of meat, large pieces of vegetables, foods high in crude fiber (such as leeks, celery, lotus root, etc.) and fried foods.

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3. Recipe example: The reference recipe for a semi-liquid meal for one day is shown in the figure below.

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3. Soft food

Soft food is an intermediate diet from semi-liquid diet to normal diet. Compared with normal diet, attention must be paid to the cooking method of food. It requires low dietary fiber and the food must be chopped and cooked thoroughly for easy chewing and digestion.

1. Scope of application: Soft food is suitable for patients with stable gastrointestinal bleeding and normal body temperature or mild fever, indigestion, intestinal diseases and after anorectal surgery. It is also suitable for the elderly with oral diseases and chewing difficulties and children aged 3 to 4 years old.

2. Dietary requirements

(1) Food should be soft and easy to digest: Food should be soft and easy to chew, and should be limited to foods with high dietary fiber and animal muscle fiber. Food should be chopped and cooked before consumption, 4 to 5 meals a day.

(2) Pay attention to supplementing vitamins and minerals: Because the vegetables and meat in the diet are chopped and cooked, long-term consumption will cause some vitamin and mineral deficiencies, so pay attention to supplementation and drink more fresh fruit and vegetable juices rich in vitamin C and minerals.

(3) Food selection: ① Rice and noodles should be cooked softer and more tender than ordinary food; meat should be thin and tender lean meat, and chicken, fish, shrimp, animal liver, etc. should be chosen as much as possible; vegetables should be tender leaves, cut into small pieces before cooking, and vegetables and fruits with less crude fiber can be eaten more; soy products can be tofu, tofu pudding, soy milk, fermented tofu, etc. ② Foods to avoid include fried foods, overly greasy foods, raw and cold foods, vegetables with high fiber content, nuts, and strong irritating condiments.

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3. Recipe example: See the figure below for a one-day reference recipe for soft food.

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4. Low-fat diet

1. Scope of application: Low-fat diet is suitable for patients with liver, gallbladder, pancreatic diseases, diarrhea or diarrhea recovery period, fat absorption disorder, hyperlipidemia and obesity.

2. Dietary requirements

(1) Limit fat intake according to the condition: daily fat intake <40 g; for those who need to be strictly restricted, daily fat intake is 20-30 g or no fat (applicable to acute pancreatitis). Avoid fatty meat, animal oil, and high-fat snacks, and use vegetable oil instead of animal oil.

(2) Choose the appropriate cooking method: Use oil-free or low-oil cooking methods such as steaming, boiling, stewing, and cold dressing to reduce the amount of cooking oil used.

3. Food Choices

(1) Acceptable foods: including cereals, lean meat that is not fried in oil, poultry, fish, skim dairy products, eggs, beans, potatoes, various vegetables and fruits.

(2) Avoid: Foods high in fat, such as fatty meat, pork belly, whole milk and its products, peanuts, sesame seeds, pine nuts, walnuts, egg yolks, puff pastry and foods fried in heavy oil.