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Types of medical fasting and its stages

, medical expert
Last reviewed: 16.10.2021
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The choice of the type of RTD and the duration of fasting is a very important point, which depends on many factors. At the same time, the diagnosis, although it is considered the decisive factor in prescribing treatment, is in fact only a starting point, because each person’s body has its own characteristics and that which helps one patient may negatively affect the state of another. That is, we are talking about an individual approach, when not only the disease itself is taken into account, but also the patient's readiness for prolonged starvation, comorbidities, and the general condition of the body.

Regardless of the type of fasting, each course should be conducted in 3 stages. Consider the main  stages of therapeutic fasting :

  • Stage 1 - preparation for fasting. The preparatory period implies: an explanation of the technique, an awareness of the need for fasting, training, direct preparation of the body (psychological help, cleansing procedures, diet).
  • Stage 2 - unloading period. This is the time when a person will have to refuse food (and possibly water), the period during which there is a change in the form of food. In other words, it is precisely in this time interval that the transition from external (exogenous) to internal (ekndogennoe) nutrition, the restructuring of various systems of the body and preparation for self-healing. Inside it can be distinguished the period of the struggle with hunger (the stage of increasing food excitation), the period of increasing ketoacidosis and acidotic crisis, which symbolizes the beginning of the stage of compensated ketoacidosis. The duration of each individual stage will differ with different approaches to treatment by hunger. So, with dry fasting, all 3 stages replace each other within 1-3 days, and with a wet 3 days it takes only that the appetite declines.

Already at this stage, the recovery of individual impaired functions, improvement of health, but the fasting continues until the deadline set by the doctor.

  • Stage 3 - the recovery period. Debuts the end of fasting and a gradual transition to a normal diet. Doctors consider this period the most responsible, because in its essence it is the consolidation of the result obtained and the prevention of possible complications.

In the framework of the RTD, doctors consider the following  types of therapeutic fasting :

  • Full starvation, it is wet. It implies a refusal to eat, but the amount of water consumed remains the same, may be increased or decreased according to certain indications. The duration of wet starvation does not have clearly defined boundaries and is set by the doctor with emphasis on the recommended timeframe for each disease, the characteristics of the individual patient’s body, his psychological readiness and directly on the doctor’s personal experience.

In most cases, wet therapeutic fasting covers the period from 1 to 21 days. But if necessary, the period may be extended to 30 or more days. With a long duration of the fasting period, it can be conducted by courses, while the duration of one course and the interval between them is set individually.

The onset of acidotic crisis with a wet variant of therapeutic fasting can be expected after 4-9 days from the start of treatment, after which a noticeable relief of symptoms occurs.

  • Absolute, it is dry fasting. It provides for a complete rejection of eating and drinking water. The recommended period of such fasting is 1-3 days, then the dehydration of the organism begins, which is especially dangerous if a person is hungry at home.

Absolute fasting can be "soft" and "hard." With “soft” fasting, water ingestion is excluded, but rinsing the mouth and various water treatments are allowed. With “hard” fasting, any contact with water, including cleansing enemas, washing and other hygienic procedures, is not allowed.

Acidotic crisis with a dry variant of medical fasting occurs for 2-3 days. With a hard starvation, its appearance can be expected by the end of the first day.

  • Combined fasting. In this case, there is a consistent application of methods of dry and wet starvation. First, the patient is included in the dry fasting, and then immediately without an interval goes to the wet, its duration is much longer than the dry. At the same time, in the first few days of wet starvation, the amount of water consumed is limited (no more than 10-12% of the total body weight). Next, the patient can drink water in the quantities that his body needs, based on the feeling of thirst.

This is the best option to reduce the duration of therapeutic fasting by accelerating the transition to endogenous nutrition, as indicated by the rapid onset of acidotic crisis. But, like absolute starvation, the combined version of RTD has more contraindications. In particular, its use is limited in case of increased blood clotting, hypertension and some other diseases.

  • Step starvation. Usually carried out on the basis of wet starvation, recalling course starvation. A feature of the stepwise version of the RTD is that it is carried out in several stages (steps, there are usually 3-4), while the unloading period of each step is limited to the appearance of the first symptoms of an acidotic crisis, i.e. Even before the full transition to internal nutrition. As usual, a recovery period follows the discharge period, but in its duration it is 2 times shorter than the discharge period.

Such fasting can be prescribed to patients who do not tolerate long-term withdrawal from food. This technique is also indicated for patients with obesity, which can act as a major disease, as well as comorbidities.

The stepped fasting option can also be applied to the absolute rejection of food and food. It is suitable in cases where a short course of dry fasting is not expected to give the expected result, but an increase in its duration may adversely affect the patient's condition.

  • Fractional starvation. A special method of fasting, calculated for a period of 6 months. The fasting period of such fasting is about 2 weeks, after which the 30-34-day recovery period begins. Usually 3 such courses are assigned, with the interval between discharge periods being 62 days (for example, 34 days of the recovery period and 28 days of rest).

A fractional starvation is carried out on the basis of a wet one, therefore an acidotic crisis is expected at the same time.

We considered those variants of therapeutic fasting, which today are considered in the framework of unloading and diet therapy. But there are also methods of incomplete fasting, when a person refuses food, but herbal tea and herbal infusions, juices, infusions of rice and wheat grains, filtered vegetable broths, etc. Can be used as liquid.

Preparation for therapeutic fasting

Many people do not understand the difference between ordinary hunger (forced or planned) and medical starvation. Some view both the one and the other as violence against the body. Others are willing to mindlessly carry out any experiments on themselves, just to achieve their goal. And finally, there are those who agree to starvation only to improve their health, approaching this issue deliberately, agreeing on the methods and risks with their physician, following his recommendations.

It must be said that the last category of people is very few. And the reason - all the same misunderstanding of the difference between methods and procedures. And the difference can be seen already at the preparatory stage.

Preparation for therapeutic fasting  is a well-developed scheme of various effects on a person, which help to successfully survive the proper time of refusal from food and increase the therapeutic effect of the chosen treatment method. Yes, medical fasting should be considered as one of the methods of treatment, which is usually used in combination with other medical methods and procedures. But it will be such only when the patient himself realizes the need for such treatment, i.e. Independently decide to start fasting and will be ready for it.

To help the patient realize all the benefits and the need to temporarily refuse food is the task of the attending physician. If a person is not morally or physically ready for this, the treatment will not be successful, because actually fasting requires some volitional effort, a willingness to endure the painful hunger of the first 3 days, when all thoughts converge to eat, and acidosis is serious. Body strength test. The doctor should familiarize the patient with all these moments and difficulties before the start of treatment.

Usually, doctors insist that medical fasting should be carried out in a hospital where medical monitoring of the patient’s condition and monitoring of the functioning of organs and systems is possible. But preparation for the procedure must begin before the person is placed in a hospital or sanatorium. The appointment of medical fasting by a doctor of a clinic or hospital is based on the indications for its conduct, i.e. On the patient's diagnosis.

But this technique also has a lot of contraindications (we will talk about them later), which simply can not be ignored. And for this you have to go through additional diagnostics to clarify the presence of associated diseases. If necessary, the attending physician will prescribe consultations of narrow specialists: a gynecologist for women, a urologist, an ophthalmologist, a dentist and other doctors, which is very important from the point of view of preventing possible complications.

So, the consultation of the dentist with subsequent dental treatment (if necessary) is important from the point of view that infectious lesions of the teeth and gums can worsen during fasting, moreover, under conditions of restructuring and weakening of the immune system, pathogens can easily penetrate into the body, causing various complications. If a person has crowns or dentures of teeth, the dentist will talk about methods of gum massage and some other procedures that will need to be carried out in parallel with therapeutic fasting.

If there are absolute contraindications, starvation will have to be abandoned. If there are relative contraindications, the procedure will either have to be postponed for some time until the patient's condition stabilizes (you may have to undergo a course of medication and / or physiotherapy), or the doctor will have to make certain adjustments to the intended treatment plan.

By the way, the treatment plan is also negotiated with the patient, on the basis of his readiness for a long fast (if necessary) and condition. If a person feels that he will not be able to do without food for a long time, he is not ready to endure the symptoms of an acidotic crisis, which usually occurs for 4-7 days, he may be prescribed a stepwise treatment. In most cases, doctors practice wet starvation, and only when necessary, dry, leaning towards a short-term course of 1-3 days, which in intensity of its action is equal to 7-9 days wet starvation.

When lung sarcoidosis and some other pathologies also practice fractional starvation, which is carried out in 3 or more stages. But in any case, the decision on the method of fasting should be made jointly by the doctor and the patient, but the duration of the course is determined by the doctor independently (individually).

An important point in preparing for therapeutic fasting is explaining the patient's behavior during the procedure (adherence to the prescribed regimen, the inadmissibility of smoking and drinking alcohol) and proposing methods that help you not to fail at the initial stage of the discharge period (the eating behavior of relatives and the patient). All these conditions are effective and safe treatment, because the same bad habits can lead to tragic consequences.

Special attention is paid to the psychological mood of the patient, both on the therapeutic starvation itself and on the active assistance of the doctor. With a negative attitude towards the result, the patient simply will not withstand starvation and will refuse it at the first unpleasant symptoms, citing deterioration of his condition. It is very difficult, and often impossible, to convince such people that the deterioration of well-being is a physiologically conditioned and stipulated by the doctors moment after which an improvement is necessary, especially since the patient is constantly under medical supervision in the hospital.

Some patients, especially those whose diseases are based on the neuropsychic factor, agree with the need for fasting, but later tend to not fulfill the requirements, can be broken at different stages of fasting, show psychopathic symptoms, encountering difficulties. These patients need a special approach involving a psychologist or psychiatrist (various methods of psychotherapy, autogenic training are used).

In sanatoriums and specialized clinics at the preparatory stage, it is customary to teach the patient how to self-massage certain areas of the body (depending on the diagnosis), the effects on the biologically active points, full breathing, and, if necessary, static physical exercises (active movements during therapeutic fasting should be limited). The possibilities of the patient's motor activity are considered by the doctor individually, taking into account the diagnosis.

Particular attention is paid to clarifying the methods of cleaning procedures (usually we are talking about cleansing enemas). True, during their stay in the hospital, the medical staff cleans the intestines of patients, but the patient should know what is required of him and how to carry out the procedure correctly, which may be useful during the preparatory period, and sometimes after fasting.

A positive impact on the patient’s attitude and on the result of the treatment is provided for the patient’s acquaintance with people who were able to cope with their illness or alleviate their symptoms due to therapeutic fasting. For the first time days, and in the subsequent period, the benevolent positive situation in the ward is very important, where there are patients undergoing the course of therapeutic fasting.

With regard to nutrition and the need for cleaning procedures on the eve of starvation, various techniques can put forward their own requirements. Thus, it is more expedient to consider this aspect of the preparatory stage of therapeutic fasting in relation to specific methods.

trusted-source[1], [2], [3], [4], [5]

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