Dietetic recommendations after bariatric procedures in the light of new guidelines regarding metabolic and bariatric surgery

The frequency of obesity occurrence is constantly increasing all over the world and becoming global epidemic. Facing the lack of the efficiency of conservative treatment, patients with II and III degree of obesity are qualified for surgical treatment; however, the efficiency of surgical treatment is connected with permanent change of nutritional habits and previous lifestyle of the patient. Modification of the way of nutrition, regardless of the type of bariatric procedure, should especially include the lowering of food energetic value and change of type, consistency and size of consumed food. Nutritional treatment after bariatric procedures is multistage. It includes clear liquid diet, full liquid diet, pureed diet, mechanically altered soft diet and regular diet. Gradual expanding of the diet protects gastrointestinal tract from chemical, mechanical and thermal irritation by the food. It also should prevent nutritional deficiencies. Significant influence on the result of surgical treatment of obesity has also regular intake of food, consuming products with high nutritional value, avoiding confectionery and fat products, consuming proper amounts of protein (60-80 g/day) and vitamin-mineral supplementation.Częstość występowania otyłości zwiększa się na całym świecie przyjmując rozmiar globalnej epidemii. Wobec braku skuteczności leczenia zachowawczego, osoby z otyłością II i III stopnia poddawane są leczeniu chirurgicznemu. Warunkiem efektywności leczenia chirurgicznego jest trwała zmiana nawyków żywieniowych i dotychczasowego stylu życia pacjenta. Modyfikacja sposobu żywienia niezależnie od rodzaju zastosowanego zabiegu operacyjnego polega w szczególności na znaczącym obniżeniu wartości energetycznej diety oraz zmianie rodzaju, konsystencji i wielkości spożywanych posiłków. Leczenie żywieniowe po operacjach bariatrycznych jest wieloetapowe. Obejmuje ono: dietę płynną, dietę półpłynną, dietę papkowatą, pokarmy miękkie rozdrobnione oraz zbilansowaną dietę niskoenergetyczną. Stopniowe rozszerzanie diety ma na celu ochronę przewodu pokarmowego przed drażnieniem chemicznym, mechanicznym i termicznym spożywanych pokarmów. Ma jednocześnie zapobiegać niedoborom żywieniowym. Istotny wpływ na skuteczność chirurgicznego leczenia otyłości ma także regularne spożywanie posiłków, spożywanie produktów o wysokiej wartości odżywczej, unikanie słodyczy oraz produktów i potraw tłustych, spożywanie odpowiedniej ilości białka (60-80 g/dobę) oraz stosowanie suplementacji preparatami mineralno-witaminowymi

Assessment of the presence of pancreatic intraepithelial neoplasia in various diseases of this organ

Purpose: Pancreatic intraepithelial neoplasia (PanIN) is one of the most commonly occurring precancerous lesion in pancreas which leads to development of pancreatic ductal adenocarcinoma (PDAC). We assessed the presence and grade of pancreatic intraepithelial neoplasia in the course of various diseases of the pancreas and its correlations with chosen clinicopathological parameters. null Results: A total of 276 foci of PanIN were identified in 94 patients. The most common lesions were PanIN 1a and PanIN 1b which together constituted 68.2 % of all lesions, whereas the PanIN 2 was present in 21.7% and PanIN 3 in 10.1% of patients. No statistical differences were observed in gender tendency for the development of PanINs. There was correlation between age of patients and degree of PanIN (p=0.034). There is no statistical difference in PanIN frequency among patients with pancreatic ductal adenocarcinomas, neuroendocrine tumors, chronic pancreatitis and pancreatic cysts (p=0.592). Conclusions: Our study showed that important factor in development of pancreatic intraepithelial neoplasia is age and the presence of PanIN in nonneoplastic diseases in older people should be included to the group with increased risk of cancer development

Assessment of the presence of pancreatic intraepithelial neoplasia in various diseases of this organ

Purpose: Pancreatic intraepithelial neoplasia (PanIN) is one of the most commonly occurring precancerous lesion in pancreas which leads to development of pancreatic ductal adenocarcinoma (PDAC). We assessed the presence and grade of pancreatic intraepithelial neoplasia in the course of various diseases of the pancreas and its correlations with chosen clinicopathological parameters. null Results: A total of 276 foci of PanIN were identified in 94 patients. The most common lesions were PanIN 1a and PanIN 1b which together constituted 68.2 % of all lesions, whereas the PanIN 2 was present in 21.7% and PanIN 3 in 10.1% of patients. No statistical differences were observed in gender tendency for the development of PanINs. There was correlation between age of patients and degree of PanIN (p=0.034). There is no statistical difference in PanIN frequency among patients with pancreatic ductal adenocarcinomas, neuroendocrine tumors, chronic pancreatitis and pancreatic cysts (p=0.592). Conclusions: Our study showed that important factor in development of pancreatic intraepithelial neoplasia is age and the presence of PanIN in nonneoplastic diseases in older people should be included to the group with increased risk of cancer development