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Kefir for pancreatitis
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Diet is important for any gastrointestinal disease, especially with the development of pancreatitis. On the effect of kefir in pancreatitis, there are conflicting interpretations. Some sources speak of its contraindication, other authors insist on the undoubted benefit of kefir for patients with pancreatitis. Where is the truth?
The word kefir comes from the Turkish word keyif, which means “feeling good” after using it (Lopitz-Otsoa et al., 2006; Tamime, 2006).  Kefir drink comes from the Caucasus Mountains, a traditional product widely consumed in Eastern Europe, Russia, and Southwest Asia (Tamime, 2006).
Kefir is characterized by its characteristic taste typical of yeast, and the effervescent effect felt in the mouth. The main products of kefir fermentation are lactic acid, ethanol and CO2, which give this drink viscosity, acidity and low alcohol content. Minor components may also be detected, including diacetyl, acetaldehyde, ethyl, and amino acids that contribute to the flavor composition (Rattray and O'Connel, 2011). This drink is different from other dairy products, as it is not the result of the metabolic activity of one or more types of microorganisms (Farnworth and Mainville, 2008).
In kefir, homoenzymatic lactic acid bacteria, including Lactobacillus, such as L. Delbrueckii subsp. Bulgaricus, L. Helveticus, L. Kefiranofaciens subsp. Kefiranofaciens, L. Kefiranofaciens subsp. Kefir granum and L. Acidophilus; Lactococcus spp. L. Lactis subsp. Lactis and L. Lacti s subsp. Cremoris and Streptococcus thermophilus, as well as heteroenzymatic lactic acid bacteria, including L. Kefiri, L. Parakefiri, L. Fermentum and L. Brevis (Leite et al., 2012; Rattray and O'Connel, 2011) and citrate-positive L. Strains. Lactis (L. Lactis subsp. Lactis biovar diacetylactis), Leuconostoc mesenteroides subsp. Cremoris and Leuconostoc mesenteroides subsp. Mesenteroids (Leite et al., 2012; Lopitz-Otsoa et al. 2006; Rattray and O'Connel, 2011).
In kefir, lactic acid bacteria are mainly responsible for the conversion of lactose present in milk into lactic acid, which leads to a decrease in pH. Other microbial components of kefir include lactose fermenting yeast, which produce ethanol and CO2. Lactose non-fermenting yeast and acetic acid bacteria are also involved in this process (Magalhães et al., 2011; Rattray and O'Connel, 2011).
Can I drink kefir with pancreatitis?
Pancreatitis requires special nutrition, this is one of the components of treatment. You can start eating solid food one to two days after an episode of acute pancreatitis, but doctors recommend starting with a meal that is easily digested and low in fat. 
In order to correctly answer patients asking if it is possible to drink kefir with pancreatitis, an analysis should be carried out for compliance with dietary principles. Looking ahead, it can be argued that kefir with pancreatitis is needed, but not any, but that meets several criteria. Pros and cons of the drink:
- The soft texture does not mechanically irritate the walls of the digestive tract.
- At room temperature it does not have any thermal irritation.
- A hot drink turns into cottage cheese with hard lumps, a cold one is also harmful.
- Fatty kefir enhances gastric secretion, which is very undesirable for inflammation.
- There is also a strong drink that forms on the third day; and weak is understood as a fresh product (one-day).
Summing up, you can choose the right option: weak, non-greasy room temperature. Fat-free home-made yogurt is allowed. Such a product normalizes digestion, stimulates metabolism, synthesizes vitamins and proteins. Drink 200 ml - in the evening, shortly before bedtime, or use in salads - vegetable and fruit.
In the acute stage, kefir is contraindicated; upon exiting it, it is gradually included in the diet, starting from 50 ml. Increase portion depending on well-being; It is important to wait for a steady absence of pain in the area of localization of the pancreas.
You can not drink the product with high acidity and the presence of diarrhea. And it’s understandable why: even in a fresh drink there is acidity, and it also has a laxative effect. Both that, and another superfluous in this case.
Kefir in acute pancreatitis
Sour milk product is a supplier of valuable components. Kefir with pancreatitis is a source of animal protein, which is needed for the daily work of the pancreas.
In the acute stage, the first 2 days the patient is prescribed a starvation diet, with drinking water and rosehip tea. Then prescribe a special gentle diet.
- In acute pancreatitis, kefir is included in the patient’s menu about a week and a half after the attack.
The drink should be with minimal fat, room temperature. Dose - 50ml (1/4 cup). If the drink is well tolerated by the body, and the patient's condition is confidently improving, the amount is increased and brought to 200 ml. Daily supplement - up to 15ml.
- Why is this seemingly 100 percent dietary product not prescribed at the beginning of the acute form and during the exacerbation of the chronic?
Gastroenterologists explain that in the inflamed state, the channels and ducts of the glandular organ are clogged, because of which the enzymes do not exit, but accumulate inside. This leads to his death. And since kefir promotes the production of enzymes, then inflammation and all the dangerous consequences associated with this are further enhanced.
It is more useful to use kefir in the evening, 30-60 minutes before bed, and this also has a logical explanation:
- serves a light dinner;
- prevents hunger, but does not overload digestion;
- Ca is more actively absorbed at night.
Kefir with exacerbation of pancreatitis
Pancreatitis is acute and chronic, each has a particular course, treatment, diet. This is what causes the indications or contraindications of kefir for pancreatitis. One thing is certain: the pancreas is keenly responsive to inappropriate nutrition - pain, frustration, discomfort.
- The main thing in the nutrition system is not to provoke bouts of illness. There are especially many restrictions at first: fats, fiber, sugar, fried are excluded.
Tasty, but harmful products will have to be forgotten for a long time, perhaps forever. Then the diet expands, but the principles of proper nutrition for a person with pancreatic problems should become an everyday rule. The consumption of protein products increases, multivitamins are included.
- Low-fat kefir with exacerbation of pancreatitis is prescribed to the extent that the process subsides.
At the peak of development, a hungry diet is recommended, and then a gradual introduction of food, with an even distribution of calories and load throughout the day. Fractional nutrition, up to six times. The more carefully the diet is followed, the sooner recovery will come.
Low-fat kefir is served for a second breakfast, after the main course (cereal, steam cutlets, omelet), several times a week. Or for a future dream, like a daily light dinner.
Use a fresh weak drink, with a minimum of fat, without preservatives or other additives. They do not keep it in the refrigerator so that the temperature is comfortable for digestion. With daily use, the portion is gradually increased: start with 50 g, add 10, and eventually bring to 200 g of glass.
Kefir with pancreatitis and cholecystitis
A healthy pancreas secretes digestive juice, which breaks down the food components in the duodenum 12 into simple compounds that are absorbed by the small intestine. The body also produces insulin and lipokine, which are necessary for carbohydrate metabolism and prevent liver degeneration.
- Among the causes of inflammation of the gland in the first places - an excess of fatty foods in the diet and alcohol abuse. Kefir with pancreatitis is included in the diet according to a special technique, depending on the stage of the pathological process.
Bile is a natural emulsifier used to break down lipids. It divides the whole fat film into separate drops to speed up the digestion and absorption of fats. It is produced in the liver, and accumulates in a special bladder that has a conclusion to the 12 duodenal ulcer. With problems that arise in this debugged system, the bladder becomes inflamed and cholecystitis develops. Contributes to this junk food with a predominance of fatty foods.
- Both organs are often inflamed at the same time; a special component of therapy in this case is diet No. 5, which serves to facilitate the digestion of food.
Kefir with pancreatitis and cholecystitis is necessary for therapeutic nutrition. As with pancreatitis, it normalizes the microflora, enriches with animal proteins, vitamins, trace elements, improves the digestive system and the general condition of the patient.
The benefits of kefir
Kefir is a tasty pleasant drink, a source of easily digestible proteins, Ca, minerals. With pancreatitis, it is allowed to eat when other foods are prohibited. Use of kefir:
- normalizes beneficial microflora and prevents the multiplication of pathogenic microbes and rot;
Santos et al. (2003) observed the antagonistic behavior of lactobacilli isolated from kefir grains against E. Coli, L. Monocytogenes, Salmonella Typhimurium, S. Enteritidis, Shigella flexneri and Y. Enterocolitica.  Silva et al. (2009) observed inhibition of Candida albicans, Salmonella Typhi, Shigella sonnei, Staphylococcus aureus and E. Coli with kefir cultivated in brown sugar. On the other hand, Chifiriuc et al. (2011) observed that kefir had antimicrobial activity against Bacillus subtilis, Staphylococcus aureus, E. Coli, E. Faecalis and S. Enteritidis, but did not inhibit P. Aeruginosa and C. Albicans.
All these studies show that the antimicrobial activity of kefir is associated with the production of organic acids, peptides (bacteriocins), carbon dioxide, hydrogen peroxide, ethanol and diacetyl. These compounds can have a beneficial effect not only on reducing the number of foodborne pathogens and destructive bacteria during the production and storage of beverages, but also on the treatment and prevention of gastroenteritis and vaginal infections (Farnworth, 2005; Sarkar, 2007).
- restores acid-base balance;
- has a mild calming effect;
- improves appetite;
- supports the strength of the patient;
- strengthens the immune system. 
Stimulation of the immune system occurs due to the action of exopolysaccharides found in kefir grains (Farnworth, 2005; Furukawa et al., 1992). Medrano et al. (2011)  found that kefiran is able to alter the balance of immune cells in the intestinal mucosa. Vinderola and others. (2005) demonstrated the immunomodulatory ability of kefir in the immune response of the intestinal mucosa of mice.
100 g of product contains about 3 g of protein, 4 g of carbohydrates, up to 2.3 g of fat. There are various vitamins, minerals. Calorie content is from 30 to 53 kcal.
If possible, kefir with pancreatitis is prepared independently. This is a simple procedure that is easily performed in the home kitchen. Recipe:
- In 900 ml of pasteurized milk pour 100 g of kefir or yogurt and a little sugar. Knead, cover tightly, keep warm for a day. Stir before use, keep the rest in the cold; Leave 100 g to prepare the next dose.
Kefir has historically been recommended for the treatment of a number of clinical conditions, such as gastrointestinal problems, hypertension, allergies, and coronary heart disease (Farnworth and Mainville, 2008; Rattray and O'Connel, 2011). However, the variability inherent in the production conditions of kefir in various analyzes makes it difficult to make comparisons between published scientific results (Farnworth, 2005; Farnworth and Mainville, 2008; Rattray and O'Connel, 2011).
Fermentations of kefir grains from various substrates were evaluated (Farnworth, 2005; Magalhães et al., 2010a; Öner et al., 2010), and a wide range of biologically active compounds such as organic acids, CO 2, H 2 O 2, ethanol were observed, bioactive peptides, exopolysaccharides (kefiran) and bacteriocins. These compounds can act independently or together, creating various health benefits associated with the consumption of kefir (Garrote et al., 2010; Rattray and O'Connel, 2011). According to Marquina et al. (2002)  consumption of kefir significantly increased the number of lactic acid bacteria in the intestinal mucosa and decreased the populations of enterobacteria and clostridia. The healing and anti-inflammatory activity of kefir was observed after a seven-day treatment with kefir gel (Rodrigues et al., 2005). 
The anticarcinogenic role of  fermented dairy products can be explained, as a rule, by the suppression of tumors in the early stages, the delay of enzymatic activity that turns carcinogenic compounds into carcinogens, or the activation of the immune system (Sarkar, 2007). 
Possible mechanisms proposed for the hypocholesterolemic activity of lactic acid bacteria may include inhibition of absorption of exogenous cholesterol in the small intestine, binding and incorporation of cholesterol into bacterial cells and absorption of cholesterol, and suppression of bile acid reabsorption by enzymatic deconjugation of bile salts (Wang et al., 2009). 
The antidiabetic effects of kefir are proved. 
Despite the undoubted benefit of kefir, with pancreatitis, it should not be taken as you please, but according to the recommendations of doctors.
Buckwheat with kefir for pancreatitis
The recipe for buckwheat with kefir for pancreatitis is recommended because the products enhance the beneficial properties of each other. Buckwheat acts as a delicate cleaner, stimulant of the pancreas, which produces hormones. Kefir normalizes the acid-base balance in the digestive tract, inhibits the harmful and supports the beneficial microflora.
- Buckwheat, infused with kefir, is easily digested and gives a feeling of satiety. Proteins, calcium, fiber present in the dish have a positive effect not only on digestion, but also on the body as a whole. The bactericidal, tonic, restorative effect of the dish is manifested.
In order for kefir with pancreatitis in combination with buckwheat to bring maximum benefit, it is better to take not whole but crushed cereals washed with warm and then cold water. Fat-free sour-milk product is poured zeon about 3 cm on top and incubated for 10 hours. The optimal ratio of daily servings is 1 cup of buckwheat per 2 kefir.
It is convenient to do this in the evening, to eat half in the morning, and leave the rest for dinner. Such actions are repeated for 10 days. If a second course is required, then take a 10-day break first.
You can enter kefir-buckwheat dish in the menu only during remission. With exacerbation, dairy products are completely prohibited. But in any case, these appointments should be made by the doctor, and not by the patient himself.
Pancreatitis kefir pies
Nutrition for pancreatitis is the most important factor in therapy. Mistakes can cause another attack or aggravate the course of the disease. Kefir with pancreatitis is used not only in the form of a drink, but also for baking flour sweets. Pancakes, cakes, kefir pies with pancreatitis diversify the menu and raise the mood of the patient. The main thing is that the bakery is home-made, with quality fresh products.
Baked vegetables, fish, apples are suitable for filling pies. Jelly and yogurt products are allowed. A good pie - from shortcrust pastry and fresh apples, layered in layers, with a minimum or without sugar, juicy charlotte without any fats. For those who react poorly to eggs, select recipes without them.
- Apple pie is not recommended for acute form and during exacerbations. In remission, charlotte is allowed once a week, one serving for dessert, completely cooled. Bakery products are allowed in small quantities and slightly dried up.
Risks arise if the dish is not cooked at home, without quality guarantees, with too greasy fillings or creams. Fresh baking, yeast products are not allowed, because they cause fermentation and activate the pancreas. Fresh berries can provoke mucosal irritation.
Pies, even baked according to dietary rules, can be harmful to health - if they are abused or included in the diet prematurely. In this case, short-term taste pleasure will be replaced by nausea, pain, heaviness in the stomach.
With the competent use of kefir with pancreatitis, there are no contraindications. Harm can occur only in violation of the dosage or method of use.
The product is not recommended for acute form and exacerbation of chronic, with diarrhea, high acidity, individual intolerance to fermented milk products.
Risks and possible complications
For any serious illness, risks and possible complications arise with independent or illiterate treatment.
The use of kefir for pancreatitis is provided by the diet as a sparing product that is exclusively useful for the digestive tract. Subject to the regimen and dosage, the risks of its use are reduced to zero.
Kefir is a dynamically fermented dairy product with many different factors that influence the benefits associated with its consumption. These factors include various types of yeast and bacteria, as well as metabolites such as kefiran and other exopolysaccharides. As with other fermented dairy products, kefir is associated with a number of health benefits, such as cholesterol metabolism and inhibition of angiotensin converting enzyme (ACE), antimicrobial activity, suppressing tumor growth, increasing wound healing speed and modulating the immune system, including reducing risk the development of allergies and asthma. 
In order for the pancreas to serve for a long time and reliably, it does not need to be overloaded with aggressive food and alcohol. Moderation is the guarantee that you don’t have to go on diets, and even drink harmless drinks by the hour and in therapeutic doses, like kefir with pancreatitis. Our health is in our hands!