Dietary taboos for tuberculosis patients

There are only four absolute taboos for tuberculosis patients - alcohol, undercooked meat/eggs/aquatic products, irritating foods that can cause severe coughing, and highly sweet foods with more than 20% added sugar. The rest of the taboos such as "fat foods" and "cold foods" spread online are not universal, and there is no need to blindly follow them.

I have been in the respiratory department for almost 6 years, and I have seen too many patients make mistakes in their diet. The most regrettable thing is the 24-year-old boy who returned to the hospital two months ago. Most of the lesions have been absorbed after taking medicine for more than two months. He went out with friends to celebrate his birthday and drank half a box of cold beer. The next day, his skin turned yellow, and the aminotransferase test increased to 8 times the normal value. He stopped taking medicine for half a month to protect his liver. To be honest, alcohol is really not allowed to be touched in half a mouthful. Anti-tuberculosis drugs themselves have certain liver toxicity. Alcohol will give the liver a heavy blow, which may delay the treatment progress or cause acute liver damage. This is a red line that all clinicians will repeatedly emphasize, and there is no room for negotiation.

In addition to alcohol, many people tend to ignore the risks of raw or half-cooked food. The immunity of tuberculosis patients is lower than that of healthy people. Foods such as soft-boiled eggs, medium-rare steaks, and raw pickled seafood may contain salmonella and listeria. Ordinary people may have diarrhea for two days after eating them. However, if it happens to them, it may cause systemic infection or even disseminated tuberculosis. There is really no need to take this risk just for one bite. It is not too late to eat after the medicine is completely stopped.

Oh, by the way, there is another pitfall that many family members tend to do bad things with good intentions: they always feel that they need to moisten their lungs, so they stew rock-sugar snow pear and sweet tremella soup with half a can of sugar in the patient every day, and every meal is rice-treasure porridge with added sugar. High sugar will increase the viscosity of respiratory secretions, causing phlegm to become blocked in the airways and unable to be coughed out. Not only will the cough be uncomfortable, but it will also easily breed secondary bacterial infections, which will slow down recovery. There was an aunt who used to buy expensive rock sugar and bird's nest supplements for her daughter every day. After half a month of eating, her phlegm was worse than when she was first admitted to the hospital. Later, she stopped all sugar and it was relieved in three days.

As for whether the most controversial "fat food" on the Internet can be eaten, in fact, there is currently no unified clinical conclusion. In the theory of traditional Chinese medicine, there is indeed a saying that "consumption of food should be avoided". It is believed that foods such as chicken, sheep, and seafood will aggravate the deficiency of heat and affect the healing of the lesions. ； However, the view of modern clinical nutrition is just the opposite. Tuberculosis is a chronic wasting disease, and patients need about 30% more protein every day than healthy people. These so-called "hair products" happen to be the best source of high-quality protein. The advice we give patients now is to "depend on individual reactions": If you have not been allergic to shrimp before, and you don't feel itchy throat or aggravate your cough after eating it, then you can eat it with confidence. Steamed fish, boiled shrimp, lean beef, etc. are much more cost-effective than nutritional supplements worth hundreds of yuan. I have met the most exaggerated patient. He heard from his hometown that he didn’t even dare to eat eggs. He ate vegetables and white porridge every day. When he came for a review, he lost 20 pounds, and the lesions were not absorbed at all. Later, he adjusted his diet to two eggs and a cup of milk every day, and ate fish two or three times a week. When he was reviewed again after two months, the lesions shrank significantly.

There is another point that is rarely mentioned in the guide, but that you really need to pay attention to in practice: if you have a history of hemoptysis, or are in the stage of hemoptysis, it is best not to eat food that is too hot or too hard with residue. Freshly cooked hot pot and hot milk tea will dilate the blood vessels of the airway mucosa and easily induce bleeding. ； Crispy bones, deep-fried steamed bun slices, etc., if they scratch the airway mucosa, may also cause hemoptysis. It is not troublesome to eat them after they are warmed and cooked until soft.

In fact, there is really no need to memorize dietary taboos like the college entrance examination. There are two core principles: first, don’t touch anything that will definitely conflict with the treatment and harm the body; second, you will feel comfortable after eating it, and you can eat as much as you like. After all, tuberculosis is a real "disease of wealth". Eating well and sleeping well to build up immunity is much more effective than worrying about whether you can eat this or not.