Diet Therapy for Gastrointestinal Disorders
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Questions and Answers

What is an appropriate first step in managing diarrhea according to medical nutrition intervention?

  • Treat the underlying disease (correct)
  • Start with solid foods immediately
  • Use high-fat diets
  • Increase dietary fiber intake

What has replaced the old recommendation of being NPO (nothing by mouth) for diarrhea patients?

  • High-fiber diet with fruits and vegetables
  • Strict low-residue diet with no fluids
  • Oral rehydration solutions and feeding (correct)
  • Immediate antibiotic therapy

What characterizes steatorrhea?

  • Reduced stool volume
  • Absence of fat in stool
  • Fat in the stool (correct)
  • Increased nutrient absorption

Why might steatorrhea lead to pale colored fatty stool and jaundice?

<p>Blockage of the biliary tract (D)</p> Signup and view all the answers

What percentage of fat is typically absorbed in a healthy individual?

<p>90-98% (A)</p> Signup and view all the answers

Which type of fatty acids can enter the portal venous blood without resynthesis in the intestinal cells?

<p>Medium and short chain fatty acids (D)</p> Signup and view all the answers

What distinguishes medium chain fatty acids (MCFA) from long chain fatty acids (LCFA) in terms of absorption?

<p>MCFA are transported in portal blood directly to the liver. (C)</p> Signup and view all the answers

What is the recommended medical nutrition intervention for a patient with steatorrhea?

<p>Use medium-chain triglycerides (MCT) oil carefully (A)</p> Signup and view all the answers

Which symptom is NOT typically associated with gastritis?

<p>Severe diarrhea (D)</p> Signup and view all the answers

What is MCT primarily derived from?

<p>Coconut and palm kernel oil (A)</p> Signup and view all the answers

What is a potential consequence of prolonged gastritis?

<p>Atrophy of stomach parietal cells (C)</p> Signup and view all the answers

Where do peptic ulcers commonly occur?

<p>At the pyloric sphincter and duodenum (D)</p> Signup and view all the answers

Which of the following is NOT a defense mechanism of the gastric and duodenal mucosa?

<p>High acidity environment (D)</p> Signup and view all the answers

What characterizes epigastric pain from a peptic ulcer?

<p>It tends to worsen at night. (B)</p> Signup and view all the answers

Which type of ulcer is specifically located in the stomach?

<p>Gastric ulcer (C)</p> Signup and view all the answers

Which group is more likely to suffer from peptic ulcers?

<p>Males more than females (A)</p> Signup and view all the answers

What is the most common symptom of a hiatal hernia?

<p>Heartburn (C)</p> Signup and view all the answers

Which of the following is NOT recommended for individuals with a hiatal hernia?

<p>Heavy meals before bedtime (A)</p> Signup and view all the answers

What dietary modification is suggested for managing hiatal hernia symptoms?

<p>Eating foods high in protein, vitamin C, and zinc (D)</p> Signup and view all the answers

Which condition may lead to acid reflux associated with a hiatal hernia?

<p>Obesity (D)</p> Signup and view all the answers

Which of the following foods should be avoided to prevent mucosal irritation?

<p>Orange juice (A)</p> Signup and view all the answers

What is a common complication of a hiatal hernia?

<p>Food capture and vomiting (D)</p> Signup and view all the answers

Which chronic disorder is characterized by intestinal inflammation and mucosal injury?

<p>Inflammatory bowel disease (C)</p> Signup and view all the answers

Which statement regarding the mucosa is correct?

<p>It is the lining of the gastrointestinal tract. (B)</p> Signup and view all the answers

What is the primary goal of a diet aimed at managing symptoms of Irritable Bowel Syndrome (IBS)?

<p>Achieve fewer, smaller bowel movements (D)</p> Signup and view all the answers

Which of the following is a risk factor associated with Irritable Bowel Syndrome (IBS)?

<p>Low fiber consumption (D)</p> Signup and view all the answers

Which dietary group should individuals with IBS avoid to prevent triggering their symptoms?

<p>FODMAPs (fermentable oligorsaccharides) (D)</p> Signup and view all the answers

What management strategy is recommended to help alleviate symptoms of IBS?

<p>Reduce psychological stress (A)</p> Signup and view all the answers

Which symptom is commonly characterized by Irritable Bowel Syndrome (IBS)?

<p>Alternating constipation and diarrhea (C)</p> Signup and view all the answers

What is NOT a symptom associated with Crohn's Disease (CD)?

<p>Continuous inflammation of the innermost layer (C)</p> Signup and view all the answers

During which phase of Inflammatory Bowel Disease (IBD) does immune cell activation occur?

<p>Phase II: Acute Intestinal Inflammation (D)</p> Signup and view all the answers

Which of the following statements about Ulcerative Colitis (UC) is accurate?

<p>Bleeding is more common in UC. (B)</p> Signup and view all the answers

What is a nutritional problem commonly associated with IBD?

<p>Weight loss and anemia (B)</p> Signup and view all the answers

Which of the following organs can be affected by Inflammatory Bowel Disease (IBD)?

<p>The eyes (C)</p> Signup and view all the answers

In which phase of IBD does tissue destruction primarily occur?

<p>Phase IV: Tissue Destruction (B)</p> Signup and view all the answers

What is one of the main consequences of corticosteroid use in children with IBD?

<p>Decreased bone mineral density (C)</p> Signup and view all the answers

Which factor is NOT involved in the Pre-disease stage of Inflammatory Bowel Disease (IBD)?

<p>Tissue destruction (A)</p> Signup and view all the answers

What is a major objective of medical nutrition intervention for individuals with Inflammatory Bowel Disease (IBD)?

<p>To prevent nutritional deficiencies (A)</p> Signup and view all the answers

Which nutrient deficiency can lead to peripheral neuropathy in individuals with IBD?

<p>Vitamin E (A)</p> Signup and view all the answers

What condition is associated with low vitamin D levels in patients with IBD?

<p>Osteomalacia and osteoporosis (C)</p> Signup and view all the answers

What type of nutritional assessment is recommended for patients with Inflammatory Bowel Disease?

<p>A detailed assessment including dietary intake and anthropometric evaluation (B)</p> Signup and view all the answers

Which of the following deficiencies can result in anemia for patients with IBD?

<p>Low iron, B-12, and folate (C)</p> Signup and view all the answers

During a flare of Inflammatory Bowel Disease, which symptoms might patients experience?

<p>Partial obstructions, nausea, and diarrhea (A)</p> Signup and view all the answers

What is a characteristic of energy needs in patients with IBD?

<p>Energy needs remain constant unless weight gain is desired (D)</p> Signup and view all the answers

Which nutrient deficiency is likely to cause glossitis in individuals with IBD?

<p>Both B-12 and thiamine (C)</p> Signup and view all the answers

Flashcards

Diarrhea Medical Nutrition Intervention

Treating diarrhea involves restoring fluid and electrolyte balance, sometimes using IV therapy or rehydration solutions. Treating the underlying disease might include antibiotics. Medications to address symptoms and prevention strategies are also part of the intervention.

Diarrhea Treatment - Old Approach

Older recommendations for diarrhea treatment sometimes involved a period of nothing by mouth (NPO) or clear liquids. However, current practice now often includes feedings to aid recovery.

Oral Rehydration Solutions

Solutions containing sodium, chloride, potassium, and glucose, often used to treat diarrhea and rehydrate patients.

Steatorrhea Definition

Steatorrhea is an excessive amount of fat in the stool, causing bulky, floating, oily, and foul-smelling stools, and signifies the body's inability to fully absorb fat.

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Factors Affecting Fat Absorption

Fat absorption requires bile from the liver and gallbladder, pancreatic lipases, and proper intestinal function.

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Steatorrhea Causes

Persistent steatorrhea can originate from issues in the biliary tract, pancreas, or intestines; temporary cases can result from dietary changes or infections.

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Steatorrhea Treatment - Calorie Increase

Steatorrhea treatment often focuses on increasing calories, particularly from protein and carbohydrates, while cautiously managing fat intake.

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Medium-Chain Triglycerides (MCT)

Man-made fats from coconut and palm kernel oil used in medical nutrition for steatorrhea to deliver calories, especially when regular fat absorption is compromised to meet needs.

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MCFA absorption

Medium-chain fatty acids (MCFA) are absorbed more efficiently than long-chain fatty acids (LCFA).

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LCFA transport

Long-chain fatty acids (LCFA) are incorporated into chylomicrons and transported through the lymphatic system.

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Gastritis definition

Gastritis is inflammation of the stomach, which can be acute or chronic.

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Acute gastritis

Rapid onset of gastritis inflammation and symptoms.

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Chronic gastritis

Gastritis that occurs over months or decades, with recurring symptoms.

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Peptic ulcer location

Peptic ulcers occur in the stomach (gastric ulcer) or the duodenum (duodenal ulcer).

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Peptic Ulcer Symptoms

Symptoms include epigastric pain (especially at night), nausea, vomiting, and weight loss.

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Gastric protection

Normal stomach lining is protected by mucus, bicarbonate, blood flow (removing acid), and quick cell repair.

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Hiatal Hernia

A condition where a portion of the stomach pushes through the diaphragm opening into the chest cavity.

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Acid Reflux

Gastric acid flowing back into the esophagus.

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Heartburn

A common symptom of hiatal hernia, caused by acid reflux.

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Dietary Considerations (Hiatal Hernia)

Small, frequent meals, avoiding trigger foods and eating 3 hours before bed in an upright position.

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Inflammatory Bowel Disease (IBD)

A chronic disorder involving intestinal inflammation and mucosal injury.

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Crohn's Disease (CD)

One form of inflammatory bowel disease (IBD).

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Ulcerative Colitis (UC)

Another form of inflammatory bowel disease (IBD).

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Gastric Acid Production

The process of producing stomach acid.

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IBD Phase I

The pre-disease stage of IBD where genetic and environmental factors, impaired intestinal barrier function, and bacterial translocation play a role.

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IBD Phase II

The acute intestinal inflammation phase of IBD characterized by immune cell activation and cytokine production.

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IBD Phase III

The chronic inflammation phase of IBD where the body's regulatory mechanisms fail to control the inflammation.

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IBD Phase IV

The tissue destruction and manifestation phase of IBD where the chronic inflammation leads to damage and symptoms.

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Fistula

An abnormal connection between the intestine and other organs, a common complication of Crohn's disease (CD).

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Abscess

A collection of pus, a common complication of CD.

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Stricture

An area of narrowing in the intestine that can lead to blockage, a complication of CD.

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UC Inflammation Location

Ulcerative colitis (UC) inflammation affects only the innermost layer of the intestinal lining, usually starting in the rectum and lower colon and potentially spreading.

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What is Irritable Bowel Syndrome (IBS)?

IBS is a disorder affecting the digestive system, causing symptoms like abdominal pain, bloating, diarrhea, and constipation. It's more common in women and can start in early adulthood.

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What are FODMAPs?

FODMAPs are a group of carbohydrates that can trigger IBS symptoms. They include fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

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IBS MNT: High Fiber Diet?

Contrary to common thought, a high-fiber diet can help manage IBS symptoms. It helps regulate bowel movements and reduce bloating.

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IBS MNT: Reduce Total Fat

Reducing fat can reduce IBS symptoms, especially if you experience diarrhea. Smaller meals are also recommended.

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IBD: Calcium and Vitamin D

People with IBD often have low calcium and vitamin D levels due to insufficient intake and absorption.

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IBD: Protein-Energy Malnutrition

Inadequate nutrient intake in IBD can lead to protein-energy malnutrition, a condition where the body doesn't get enough protein and calories.

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IBD: Anemia

Low levels of iron, vitamin B12, and folate in IBD can cause anemia, a condition where the blood doesn't carry enough oxygen.

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IBD: Osteoporosis and Osteomalacia

Low vitamin D and K levels in IBD can lead to bone problems like osteoporosis (weak bones) and osteomalacia (softening of bones).

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IBD: Peripheral Neuropathy

Low levels of vitamin E in IBD can lead to nerve damage, causing tingling, numbness, or weakness in the extremities.

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IBD: Night Blindness

Low vitamin A levels in IBD can lead to night blindness, difficulty seeing in low light.

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IBD: Beriberi, Stomatitis, Glossitis

Low levels of thiamine (vitamin B1) and other B vitamins in IBD can lead to beriberi (nerve problems), stomatitis (mouth sores), and glossitis (inflammation of the tongue).

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IBD: Medical Nutrition Intervention Goals

The main goals of medical nutrition intervention for IBD are to restore and maintain nutrition, improve immunity and healing, manage symptoms, prevent deficiencies, and support normal growth (in children).

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Study Notes

Diet Therapy for Gastrointestinal Disorders

  • Small Intestine Diseases:

    • Celiac disease
    • Inflammatory bowel disease
    • Crohn's disease
    • Intestinal obstruction
    • Irritable bowel syndrome
    • Peptic ulcers

  • Large Intestine Diseases:

    • Colorectal cancer
    • Colonic polyps
    • Ulcerative colitis
    • Diverticulitis
    • Irritable bowel syndrome

Common Intestinal Symptoms

  • Intestinal gas and flatulence
  • Constipation
  • Diarrhea
  • Steatorrhea (fat in stool)
  • Gastrointestinal obstruction

Constipation

  • Defined as infrequent or difficult bowel movements
  • Not a disease, but a symptom
  • Accompanied by abdominal discomfort, headaches, backaches, and flatulence
  • Causes: Fluid and electrolyte imbalances, hormonal imbalances, chronic laxative abuse, lack of physical activity, medications (including antacids and anti-hypertensives), pregnancy, and aging

High-Fiber Diet Guidelines

  • Increase whole-grain consumption (6-11 servings daily)
  • Increase vegetable, legume, fruit, nut, and seed consumption (5-8 servings daily)
  • Consume high-fiber cereals, granolas, and legumes to reach 25g fiber intake for women or 38g for men daily
  • Drink at least 2 liters of fluids daily

Diarrhea

  • Watery stool with increased frequency
  • Not a disease but a symptom
  • Foul-smelling in some cases
  • May include blood
  • Accompanied by abdominal pain and cramping
  • Leads to dehydration and electrolyte/acid-base imbalances

Steatorrhea (Fat in Stool)

  • Medical term for fat in stool
  • Stool is often bulky, floats, oily, greasy, and foul-smelling
  • Caused by digestive tract's inability to absorb fat
  • Can be temporary (due to diet changes) or persistent (diseases in the biliary tract, pancreas, or intestines)
  • Diagnosed by detecting fat in the stool (and potential accompanying symptoms)
  • Fat absorption in the body depends on bile and pancreatic lipases, and normal intestine function

Medical Nutrition Intervention for Diarrhea

  • Treat underlying disease (e.g., antibiotics)
  • Restore fluid, electrolyte, and acid-base balance (IV therapy, rehydration solutions)
  • Medications for symptom relief
  • Suggest prevention strategies

Steatorrhea: Medical Nutrition Intervention

  • Increase calories, especially protein and carbohydrates
  • Limit foods with high fat to tolerable levels
  • Use medium-chain triglycerides
  • Vitamin and mineral supplements (fat-soluble vitamins with extra Ca, Mg, Zn, Fe)

MCTs (Medium-Chain Triglycerides)

  • Used as medicine
  • Man-made from coconut or palm kernel oil
  • Absorbed efficiently, transported directly to the liver, and not incorporated into chylomicrons
  • Often recommended in cases of steatorrhea

Gastritis and Peptic Ulcers

  • Gastritis: inflammation of the stomach, caused by a variety of factors, including H. pylori bacteria, and stress
  • Peptic ulcers: sores that occur in the lining of the stomach and/or duodenum, often caused by infection with H. pylori bacteria
  • Symptoms: Nausea, vomiting, anorexia, hemorrhage, epigastric pain
  • Can lead to pernicious anemia
  • Risk factors include: H. pylori infection, genetics, environmental triggers (alcohol use, smoking, certain medications), age, and ethnicity
  • MNI: remove gluten, vitamin B12 status, low-acid foods, and potentially prescribe antacids

Hiatal Hernia

  • Esophagus opening in the diaphragm
  • Portion of the stomach can swell through the opening
  • Symptoms: heartburn (most common)
  • Risk Factors: pregnancy, obesity, aging, and congenital weakness
  • MNI: small, frequent meals with a balanced diet, avoid food which irritates the mucous membranes

Inflammatory Bowel Disease (IBD)

  • Chronic disorder involving inflammation of the gastrointestinal tract
  • Crohn's disease and ulcerative colitis are its two common forms
  • Locations and patterns of inflammation vary; Crohn's can occur anywhere along the GIT and has "skip lesions", whilst ulcerative colitis is typically restricted to the colon and affects the lining in a continuous pattern
  • Symptoms: abdominal pain, nausea, vomiting, diarrhea, and weight loss

IBD: Etiology and Pathogenesis

  • Complex factors, likely a combination of:
    • Genetic susceptibility
    • Environmental triggers
    • Immune response

IBD: Nutritional Assessment

  • Require detailed dietary assessments, anthropometric evaluations, and biochemical measurement of key vitamins and trace elements

IBD: Nutritional Intervention

  • Restore and maintain the nutrition status of the patient, promote immune function and healing, control signs and symptoms of the disease, prevent nutritional deficiencies, and maintain normal growth in children

Celiac Disease

  • Characterized by malabsorption of nutrients
  • Due to heredity
  • Symptoms vary from infancy to adulthood, often appearing after gluten-containing cereal consumption
  • Triggered or unmasked by GI surgery, stress, pregnancy, or viral infections
  • Often, diagnosed due to evaluation for another problem (i.e., constipation, abdominal pain, unexplained anemia)
  • Results in flattening of villi and elongation of secretory cells which results in malabsorption
  • The disease occurs when gluten peptides trigger an inflammatory response in the intestinal lining in individuals with a genetic predisposition
  • MNI: Remove gluten from the diet

Diverticular Disease

  • Pockets form in the wall of the large intestine
  • Diverticulosis: pouches without inflammation
  • Diverticulitis: inflamed pouches (symptoms: fever, abdominal pain, GI bleeding, elevated WBC)
  • Modifiable Risk Factors: low fiber intake, history of constipation, increased colonic pressure, increased inflammatory response, obesity, sedentary lifestyle, steroid use, alcohol/caffeine intake, and cigarette smoking
  • Non-modifiable Risk Factors: genetics, age (over 40 years)
  • MNT: High-fiber diet

Irritable Bowel Syndrome (IBS)

  • Functional GI disorder causing altered intestinal motility and heightened sensitivity of the GI tract
  • Symptoms: alternating constipation and diarrhea, abdominal pain, and bloating
  • Associated with Low Fiber intake, psychological stress, infections, and certain medications.
  • MNT: Rest and stress reduction, avoid FODMAPs (fermentable oligo-, di-, mono-saccharides, and polyols), high fiber diet, avoid gas-forming foods, and avoid irritating foods to the patient.

Additional Notes

  • The provided notes summarize information from the provided documents.
  • Consult healthcare professionals for diagnosis and personalized dietary interventions.

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Diet Therapy: Gastrointestinal Disorders PDF 2023/2024

Description

Explore the dietary management of various gastrointestinal disorders, including conditions affecting the small and large intestines. This quiz covers essential topics such as symptoms, causes of constipation, and high-fiber diet guidelines to improve digestive health.

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