Gastritis and Peptic Ulcers Quiz
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Questions and Answers

What is the primary cause of chronic inflammation of the gastric mucosa?

  • Genetic predisposition
  • Excessive alcohol consumption
  • Bacterial infections
  • Helicobacter pylori (correct)

    • Which of the following is an important evaluation in medical nutrition intervention for gastritis?

  • Vitamin C status
  • Vitamin A status
  • Folic acid levels
  • Vitamin B12 status (correct)

    • Which is considered a risk factor for developing peptic ulcers?

  • High intake of fiber
  • Regular exercise
  • Plant-based diet
  • Helicobacter pylori infection (correct)

    • How can smoking affect the development of peptic ulcers?

    <p>It inhibits mucus and bicarbonate secretion.</p> Signup and view all the answers

    What dietary component is no longer considered medicinal for coating the stomach in peptic ulcer management?

    <p>Milk or cream</p> Signup and view all the answers

    Which of the following medications is associated with increased risk of peptic ulcers?

    <p>Aspirin</p> Signup and view all the answers

    What is the role of gastric acid in nutrient absorption?

    <p>It enhances the absorption of iron and calcium.</p> Signup and view all the answers

    What pH range do commonly used soft drinks typically fall within?

    <p>2.8 to 3.5</p> Signup and view all the answers

    What is the primary difference in the absorption and transportation of medium-chain fatty acids (MCFA) compared to long-chain fatty acids (LCFA)?

    <p>MCFA are transported directly to the liver, while LCFA are transported through lymph.</p> Signup and view all the answers

    What defines acute gastritis?

    <p>Rapid onset of inflammation and symptoms.</p> Signup and view all the answers

    Which symptom is NOT typically associated with gastritis?

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

    Where does a peptic ulcer commonly occur?

    <p>At the end of the stomach and the upper part of the duodenum.</p> Signup and view all the answers

    What is one potential consequence of prolonged gastritis?

    <p>Atrophy and loss of stomach parietal cells.</p> Signup and view all the answers

    What mechanism protects the gastric and duodenal mucosa from digestive acids?

    <p>Secretion of mucus and production of bicarbonate.</p> Signup and view all the answers

    Which of the following is a characteristic symptom of peptic ulcer disease?

    <p>Nighttime burning or severe pain.</p> Signup and view all the answers

    What commonly complicates symptomatic peptic ulcer disease?

    <p>Breakdown of the normal defense and repair mechanisms.</p> Signup and view all the answers

    Which of the following symptoms is NOT associated with Celiac Disease?

    <p>Gastrointestinal bleeding</p> Signup and view all the answers

    What defines non-celiac gluten sensitivity?

    <p>Symptoms after consuming gluten without intestinal damage</p> Signup and view all the answers

    Which micronutrient deficiency is commonly associated with Celiac Disease?

    <p>Folate</p> Signup and view all the answers

    What is a potential complication of Diverticular Disease?

    <p>Bowel obstruction</p> Signup and view all the answers

    Which food item should be avoided on a gluten-free diet for Celiac Disease?

    <p>Rye</p> Signup and view all the answers

    What is a common gastrointestinal symptom of Celiac Disease?

    <p>Steatorrhea</p> Signup and view all the answers

    Which of the following is NOT a nutritional problem associated with Celiac Disease?

    <p>Excess calcium absorption</p> Signup and view all the answers

    What is a consequence of pressure inside the colon in Diverticular Disease?

    <p>Formation of diverticula</p> Signup and view all the answers

    Which statement accurately describes the location and pattern of Inflammatory Bowel Disease (IBD)?

    <p>Crohn's Disease (CD) often affects the ileum and can extend to the colon in a transmural and discontinuous pattern.</p> Signup and view all the answers

    What distinguishes the nature of inflammation between Ulcerative Colitis (UC) and Crohn's Disease (CD)?

    <p>UC presents with mucosal inflammation while CD shows submucosal inflammation.</p> Signup and view all the answers

    Which of the following risk factors is accurate for Crohn's Disease (CD) and Ulcerative Colitis (UC)?

    <p>Gender does not influence the development of either disease.</p> Signup and view all the answers

    Which statements about the familial patterns of Inflammatory Bowel Disease (IBD) are true?

    <p>10-20% of IBD patients have relatives with the same condition.</p> Signup and view all the answers

    Which statement reflects the differences in smoking's impact on Crohn's Disease (CD) and Ulcerative Colitis (UC)?

    <p>Smoking is associated with a more severe form of Crohn's Disease.</p> Signup and view all the answers

    What is the primary environmental factor associated with the etiology of Inflammatory Bowel Disease (IBD)?

    <p>Environmental triggers that influence immune response.</p> Signup and view all the answers

    What is a characteristic pattern of inflammation seen in Ulcerative Colitis (UC)?

    <p>Continuous inflammation affecting the colon.</p> Signup and view all the answers

    In terms of demographic distribution, which statement is accurate regarding Inflammatory Bowel Disease (IBD)?

    <p>Ulcerative Colitis is found more frequently in western Europe and the US.</p> Signup and view all the answers

    What is a potential complication of diverticula that may lead to serious infection?

    <p>Abscess formation</p> Signup and view all the answers

    Which symptom is specifically associated with diverticulitis?

    <p>Fever</p> Signup and view all the answers

    Which of the following is a non-modifiable risk factor for diverticular disease?

    <p>Age over 40 years</p> Signup and view all the answers

    What is the primary dietary recommendation for managing diverticulosis?

    <p>High-fiber diet</p> Signup and view all the answers

    Which condition describes the presence of diverticula without inflammation?

    <p>Diverticulosis</p> Signup and view all the answers

    What dietary change is suggested for patients recovering from diverticulitis?

    <p>Clear liquid diet</p> Signup and view all the answers

    What can happen if diverticula rupture?

    <p>Peritonitis</p> Signup and view all the answers

    Which of the following conditions can result from increased pressure inside the colon?

    <p>Gastrointestinal bleeding</p> Signup and view all the answers

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

    <p>To have fewer, smaller bowel movements each day</p> Signup and view all the answers

    Which of the following is NOT considered a risk factor for Irritable Bowel Syndrome?

    <p>High protein diet</p> Signup and view all the answers

    Which dietary approach is recommended to manage Irritable Bowel Syndrome symptoms?

    <p>Avoid foods high in FODMAP</p> Signup and view all the answers

    What is one of the recommended management strategies for reducing symptoms of IBS?

    <p>Avoiding large meals and eating frequently</p> Signup and view all the answers

    Which of the following symptoms is commonly associated with Irritable Bowel Syndrome?

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

    Study Notes

    Diet Therapy for Gastrointestinal Disorders

    • This document details diet therapy for various gastrointestinal disorders.

    Diseases of the Small Intestine

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

    Diseases of the Large Intestine

    • Colorectal cancer
    • Colonic polyps
    • Ulcerative colitis (ulcers of the colon and rectum)
    • Diverticulitis (inflammation or infection of pouches in the colon)
    • Irritable bowel syndrome

    Common Intestinal Symptoms

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

    Constipation

    • Definition: Infrequent or difficult bowel movements, a symptom, not a disease.
    • Accompanied by: Abdominal discomfort, headaches, backaches, gas (flatulence).
    • Causes: Fluid/electrolyte imbalance, hormonal imbalance, chronic laxative abuse, lack of physical activity, certain medications (antiacids, antihypertensives), pregnancy, aging.

    High-Fiber Diets

    • Increase consumption of whole grains (6-11 servings daily)
    • Increase consumption of fruits, vegetables, legumes, nuts, and seeds (5-8 servings daily)
    • Increase fiber intake to 25g (women), 38g (men), or more daily.
    • Increase fluid intake to at least 2 liters (or approximately 2 quarts) daily.

    Diarrhea

    • Definition: Watery stool, increased frequency, a symptom not a disease.
    • Associated symptoms: Foul smelling stool, blood, abdominal pain/cramping, dehydration, weight loss, electrolyte/acid-base imbalance.

    Medical Nutrition Intervention (for Diarrhea)

    • Treat underlying diseases (e.g., antibiotics)
    • Restore fluid, electrolyte, acid-base balance (e.g., IV, rehydration solutions)
    • Medications to treat symptoms
    • Prevention strategies

    Steatorrhea

    • Definition: Fat in the stool, causing bulky, oily/greasy appearance, and foul smell.
    • Cause: Impaired fat absorption by the digestive tract
    • Related conditions: Problems with the biliary tract, pancreas, or intestines.
    • Diagnosis aids: Pale colored fatty stool, jaundice.
    • Cause of absent pancreatic lipases: diseased pancreas, cystic fibrosis, birth abnormalities.

    Medical Nutrition Intervention (for Steatorrhea)

    • Increase calories, especially protein and carbohydrates.
    • Control fat intake (as tolerated).
    • Use medium-chain triglycerides (MCT) oil cautiously to meet caloric needs.
    • Vitamin and mineral supplements (especially fat-soluble vitamins like Ca, Mg, Zn, Fe).

    MCT Facts

    • Man-made fat from coconut and palm kernel oils.
    • More efficient absorption than long-chain fatty acids (LCFAs)
    • Transported directly to the liver, unlike LCFAs.
    • Used as a medical intervention.

    Gastritis and Peptic Ulcers

    • Gastritis: Nonspecific inflammation of the stomach;
    • Acute: Rapid onset of inflammation and symptoms
    • Chronic: Occurs over months to decades, with recurring symptoms
    • Peptic ulcer: Ulcer in the stomach (gastric ulcer) or upper duodenum (duodenal ulcer).
    • Risk factors: Helicobacter pylori, genetics/ethnicity, age, environment (alcohol, smoking, certain medications like aspirin, steroids, non-steroidal anti-inflammatory drugs).
    • Symptoms: Nausea, vomiting, anorexia, hemorrhage, epigastric pain.
    • Prolonged gastritis: atrophy of stomach parietal cells, loss of HCl secretion, and intrinsic factor (pernicious anemia)
    • Importance of normal gastric and duodenal mucosa: mucus, bicarbonate, normal blood flow, renewal, repair of epithelial cell injury.
    • Peptic ulcer symptoms: epigastric discomfort/burning, worse at night, 1–3hrs post-eating, nausea, vomiting, gastrointestinal discomfort, flatulence, significant weight loss.
    • Medical nutrition intervention (MNI): Vitamin B12 evaluation, importance of low acid states on nutrient absorption, protein foods to buffer stomach acids.
    • Diet therapy for peptic ulcers: Milk/cream is no longer considered helpful, the pH in food has little therapeutic value for patients without mouth/esophagus lesions.

    Hiatal Hernia

    • Definition: Portion of the stomach swells through the diaphragm opening.
    • Symptoms: Heartburn (most common).
    • Causes: Pregnancy, obesity, age, congenital weakness of the diaphragm.
    • Complication: Esophageal reflux, iron deficiency anemia, food mixing with acid/pepsin; vomiting.
    • Treatment: Antacids, surgery.

    Dietary Modification (for Hiatal Hernia)

    • Small, frequent meals.
    • Avoid foods that irritate or increase acid secretion.
    • No food within three hours of bedtime.
    • Remain upright after eating.

    Inflammatory Bowel Disease (IBD)

    • IBD: Chronic disorder affecting the gastrointestinal tract, causing intestinal inflammation and mucosal injury; Increased expression of cytokines.
    • Types: Crohn's disease (CD), ulcerative colitis (UC)

    IBD Place and Pattern of Occurrence

    • Crohn's disease (CD): Often (but not always) in the ileum. Can spread to the colon.
    • Ulcerative colitis (UC): Typically in the colon. Sometimes spreads to the entire intestine.

    IBD Nature of Inflammation

    • Crohn's disease (CD): Inflammation involving the mucosa and submucosa (transmural).
    • Ulcerative colitis (UC): Inflammation is limited to the mucosa.

    IBD Etiology and Pathogenesis

    • Multifactorial, likely involving environmental triggers and genetics, and immune response.

    IBD Risk Factors

    • Race: Crohn’s Disease is more common in some Western races, Ulcerative Colitis is more common in some Western countries (Europe, North America)
    • Age: Young adulthood.
    • Gender: Equally affected.
    • Smoking

    IBD Nutritional Problems

    • Weight loss and anemia
    • Poor growth in children, due to malnutrition,corticosteroids.
    • Decreased bone mineral density.
    • Vitamin D deficiency; calcium intake and absorption issues
    • Macro/Micro nutrient deficiencies
    • Vitamin and energy deficiencies

    IBD Medical Nutrition Intervention

    • Restore and maintain nutritional status; promote immunity and healing.
    • Control signs and symptoms.
    • Prevent nutrient deficiencies.
    • Maintain normal growth (children)
    • Nutritional assessment

    IBD Dietary Intervention

    • Adjust the diet during remission and flares
    • Recognize triggers (foods that cause symptoms like bloating, gas, diarrhea).

    Calories and Macronutrients (for IBD)

    • Energy needs are not generally increased (unless weight gain desired)
    • Protein needs may increase depending on severity/disease stage, treatment
    • Inflammation/corticosteroids often cause negative nitrogen balance (muscle loss)

    IBD Route of Delivery

    • Enteral Nutrition (EN): Not as effective as corticosteroids for adults, but more effective for children.
    • Parenteral Nutrition (PN) used for insufficient bowel function.
    • The preference is for Enteral Nutrition, when bowel function length is adequate.

    IBD During Flares

    • Lower fiber/de-caffeinated drinks for adequate hydration
    • Lactose, fructose, and high-fat intake may cause abdominal problems (cramps, gas, diarrhea; steatorrhea).
    • Small, frequent feedings are better tolerated than large meals.

    Celiac Disease

    • Characterized by malabsorption of nutrients; thought to be hereditary.
    • Symptoms can appear in infancy or adulthood. Trigged during GI surgery, stress, pregnancy, or viral infection issues.
    • Symptoms: Nausea, vomiting, abdominal cramps, distention, diarrhea, steatorrhea, brain fog, bulky stool that's greasy/watery, micronutrient deficiencies, and growth failure.

    Celiac Disease—Etiology and Pathogenesis

    • Often triggered by gluten consumption.
      • Gluten peptides resistance to digestion may reach small intestine
      • Response involving immune system and inflammation that triggers small intestine damage.
      • Leading to the atrophy of villi and microvilli; low surface area; malabsorption.

    Gluten Sensitivity vs Intolerance

    • Gluten sensitivity might not involve gluten-related intestinal damage,
    • Gluten intolerance (non-celiac gluten sensitivity) is where people experience symptoms even without significant gluten-related intestinal damage.

    Celiac Disease—Medical Nutrition Interventions (MNI)

    • Gluten-Free Diet
      • Eliminate all wheat, rye, and barley.
      • Read labels carefully for hidden gluten.

    Diverticular Disease

    • Pouches (diverticula) develop in the colon wall.
    • Diverticulosis: Pouches, but not inflamed.
    • Diverticulitis: Inflamed pouches, with associated symptoms.
    • Risk factors: Low fiber intake, constipation, increased pressure.

    Diverticular Disease (Diverticulosis) Management

    • High-fiber diet: Increase stool volume, decrease pressure within the colon, less time for bacteria to grow.

    Diverticular Disease (Diverticulitis) Management

    • Clear liquid diet, followed by a low-residue diet.
    • Reduce symptoms of diarrhea, bloating, gas, and cramping.

    Irritable Bowel Syndrome (IBS)

    • Functional disorder affecting the digestive system, marked by altered intestinal motility/sensitivity of gastrointestinal tract, increased visceral awareness, abdominal pain, and bloating, which can include either diarrhea or constipation.
    • More common in women, and can start in early adulthood.
    • Risk factors: Psychological stress, infection (gastroenteritis), certain medications.

    Irritable Bowel Syndrome (IBS)—Management

    • Relaxation, stress-reduction techniques.
    • Avoid triggering foods (FODMAPs, high-fiber foods, which may cause gas/bloating, high-fat foods).

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    Diet Therapy: Gastrointestinal Disorders PDF 2023/2024

    Description

    Test your knowledge on chronic inflammation of the gastric mucosa, the evaluation of medical nutrition interventions, and the risk factors associated with peptic ulcers. This quiz covers critical aspects of digestive health, including symptoms, dietary components, and the impact of medications. Prepare to enhance your understanding of gastritis and related gastrointestinal conditions.

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