Medical Nutrition Chapter 30: Lower Gastrointestinal Tract Disorders
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Questions and Answers

What percentage of fat is normally absorbed in the body?

  • 50-60%
  • 70-80%
  • 40-50%
  • 90-98% (correct)

    • What happens to medium and short chain fatty acids in the body?

  • They enter the portal venous blood for direct transport to the liver (correct)
  • They are excreted with the feces
  • They are transported through the lymph
  • They are resynthesized into TG in the intestinal cells

    • What is the main benefit of using MCT oil in dietary management?

  • It helps in the absorption of carbohydrates
  • It increases the absorption of protein
  • It helps in the absorption of long chain fatty acids
  • It meets kcal needs with caution (correct)

    • What is the characteristic of MCFA compared to LCFA?

    <p>MCFA is more efficiently absorbed than LCFA</p> Signup and view all the answers

    What is the effect of adverse reaction to gluten in Celiac Disease?

    <p>Malabsorption of nutrients</p> Signup and view all the answers

    What is the gluten-sensitive enteropathy also known as?

    <p>Celiac Disease</p> Signup and view all the answers

    What is the recommended dietary modification for Steatorrhea?

    <p>Control fat level and give only the level tolerated</p> Signup and view all the answers

    What is the primary goal of nutritional care for patients with Short Bowel Syndrome?

    <p>To provide a high-calorie diet with key vitamins and minerals</p> Signup and view all the answers

    What is a common symptom of Short Bowel Syndrome?

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

    What is the main difference between diverticulosis and diverticulitis?

    <p>Presence of fever and abdominal pain</p> Signup and view all the answers

    What is the role of glutamine in the nutritional management of Short Bowel Syndrome?

    <p>To provide energy for the gut</p> Signup and view all the answers

    What is the purpose of adding extra Ca, Mg, Zn, and Fe in Steatorrhea?

    <p>To compensate for malabsorption of these nutrients</p> Signup and view all the answers

    What is the primary cause of Short Bowel Syndrome?

    <p>Removal of more than two thirds of the small intestine</p> Signup and view all the answers

    What is a potential complication of Short Bowel Syndrome?

    <p>All of the above</p> Signup and view all the answers

    What is the role of vitamin B12 in the nutritional management of Short Bowel Syndrome?

    <p>To treat anemia</p> Signup and view all the answers

    What is the goal of medication therapy in Short Bowel Syndrome?

    <p>To slow down the normal movement of the intestine</p> Signup and view all the answers

    What is the primary function of microvilli in the small intestine?

    <p>To increase the surface area for digestion and absorption</p> Signup and view all the answers

    What is the most common symptom of diarrhea?

    <p>Watery stool and increased frequency</p> Signup and view all the answers

    What is the primary goal of nutritional management in diarrhea?

    <p>To restore fluid, electrolyte, and acid-base balance</p> Signup and view all the answers

    What is the role of pectin in the management of diarrhea?

    <p>To solidify stools</p> Signup and view all the answers

    What is the most common nutrition implication of diarrhea?

    <p>All of the above</p> Signup and view all the answers

    Who is at the greatest risk of nutrition complications in diarrhea?

    <p>Infants and elderly</p> Signup and view all the answers

    What is the primary treatment for diarrhea?

    <p>Restore fluid, electrolyte, and acid-base balance</p> Signup and view all the answers

    What is the recommended rehydration solution for diarrhea?

    <p>Rehydration solutions with set formula</p> Signup and view all the answers

    Study Notes

    Lower GI Tract Disorders

    • The lower GI tract includes the small intestine, which is divided into the duodenum, jejunum, and ileum.
    • The small intestine has folds of Kerckring, villi, and microvilli (brush border) to increase its surface area for digestion and absorption.

    Common Intestinal Symptoms

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

    Diarrhea

    • Characterized by watery stool and increased frequency
    • May be foul-smelling, contain blood, and cause abdominal pain and cramping
    • Can lead to dehydration, weight loss, electrolyte and acid-base imbalances

    Treatment of Diarrhea

    • Need to solidify stools
    • Pectin (found in apples, bananas) can be helpful
    • World Health Organization provides guidance on fluid and electrolyte replacements
    • Gatorade can also be useful

    Treatment of Lower GI Tract Disorders

    • Treat underlying disease
    • Use antibiotics as needed
    • Restore fluid, electrolyte, and acid-base balance
    • IV therapy and rehydration solutions may be necessary
    • Medications can be used to treat symptoms
    • Prevention strategies should be suggested

    Nutrition Implications of Lower GI Tract Disorders

    • Fluid losses can lead to dehydration, hyponatremia, and hypokalemia
    • Metabolic acidosis can occur
    • Malnutrition is a risk, especially for infants and the elderly

    Nutrients Absorption and Steatorrhea

    • Normally, 90-98% of fat is absorbed
    • In steatorrhea, about 20% of fat is excreted with the feces
    • Medium and short chain fatty acids can be directly absorbed into the portal venous blood

    Dietary Modification for Steatorrhea

    • Increase kcal intake to meet needs, especially protein and carbohydrates
    • Control fat level by giving only tolerated amounts
    • Use MCT oil to meet kcal needs with caution
    • Vitamin and mineral supplements are necessary, including fat-soluble vitamins and extra Ca, Mg, Zn, and Fe

    MCT (Medium-Chain Triglycerides)

    • Dietary TG are usually long-chain fatty acids
    • MCT is used as medicine and is made from coconut and palm kernel oil
    • MCFA are absorbed more efficiently than LCFA and are transported directly to the liver

    Celiac Disease (Gluten-Sensitive Enteropathy)

    • Adverse reaction to gluten (gliadin fraction)
    • Intestinal mucosa is damaged, leading to malabsorption of nutrients
    • Complications include iron deficiency, osteomalacia, growth failure, and projectile vomiting

    Short Bowel Syndrome

    • Occurs when more than two-thirds of the small intestine is removed
    • Causes weight loss, diarrhea, decreased transit time, malabsorption, dehydration, and electrolyte imbalances

    Symptoms of Short Bowel Syndrome

    • Diarrhea
    • Fatigue
    • Pale, greasy stools
    • Swelling (edema)
    • Foul-smelling stools
    • Weight loss
    • Dehydration

    Nutritional Care for Short Bowel Syndrome

    • Initial management: parenteral nutrition only for most patients
    • Gradually introduce enteral nutrition, including glutamine to support gut health
    • High-calorie diet with key vitamins and minerals, carbohydrates, proteins, and fats
    • Vitamin B12, folic acid, and iron supplements to treat anemia
    • Medicines to slow down intestinal movement and increase nutrient absorption
    • Tube feeding through a vein (parenteral nutrition) if necessary
    • Small bowel transplantation in some cases

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    Description

    This quiz covers medical nutrition therapy for lower gastrointestinal tract disorders, including anatomy of the small intestine and digestion.

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