Tema 3. Fisiopatología del aparato digestivo

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Questions and Answers

¿Cuál de las siguientes opciones describe mejor la relación entre la salud bucodental y la elección de alimentos?

Una buena salud bucodental permite la elección de alimentos blandos y fáciles de masticar.

Tener una dentadura completa garantiza la preferencia de alimentos más nutritivos.

Una mala salud bucodental puede llevar a elegir alimentos menos nutritivos y más fáciles de masticar. (correct)

La salud bucodental influye poco en la elección de los alimentos, ya que las personas eligen mayormente por gusto.

Si una persona sufre de falta de salivación, ¿qué tipo de problemas puede experimentar al ingerir alimentos?

Dificultad para percibir los sabores y aumento de la digestión.

Problemas infecciosos y limitaciones severas en la ingesta. (correct)

Incremento en la producción de enzimas digestivas y mayor apetito.

Mayor absorción de nutrientes y mejora de sensibilidad dental.

¿Qué factor NO es esencial para el desarrollo de la caries dental?

La existencia de bacterias que utilizan carbohidratos.

La presencia de un diente susceptible.

La ausencia de flúor en la dieta. (correct)

La producción de sustancias ácidas.

¿Cuál de las siguientes recomendaciones dietéticas es la MENOS adecuada para una persona que sufre de reflujo ácido?

Ingerir líquidos abundantemente mientras se comen sólidos. Signup and view all the answers

En el proceso de formación de la caries, ¿qué sustancia es la que disuelve el esmalte dental?

Los ácidos producidos al metabolizar las bacterias los carbohidratos. Signup and view all the answers

Una persona que recientemente se sometió a una cirugía gástrica necesita adaptar su dieta. ¿Cuál de las siguientes pautas NO se recomienda después de una cirugía gástrica?

Consumir líquidos junto a las comidas para ayudar a la digestión. Signup and view all the answers

¿Cuál de las siguientes afirmaciones relaciona correctamente la fisiopatología con la gastritis y la úlcera péptica?

La infección por Helicobacter pylori puede aumentar las secreciones ácidas, contribuyendo a ambas patologías. Signup and view all the answers

¿Cuál es el síntoma principal que indica la afectación de la pulpa dental por caries, también conocida como pulpitis?

Sensibilidad a alimentos fríos o calientes y dolor intenso. Signup and view all the answers

¿Cuál de estos factores NO agrava los síntomas del reflujo ácido?

Mantener una actividad intestinal regular para evitar el estreñimiento. Signup and view all the answers

Después de una cirugía gástrica, ¿cuál de los siguientes problemas NO es una secuela probable?

Aumento de la absorción de nutrientes. Signup and view all the answers

¿Cuál de los siguientes factores no influye directamente en la afectación del esmalte dental?

El nivel de actividad física del individuo. Signup and view all the answers

En el contexto de la prevención de la caries dental, ¿qué recomendación dietética sería menos efectiva si se aplicara de forma aislada?

Consumir alimentos ricos en hierro para fortalecer el esmalte. Signup and view all the answers

Respecto a la enfermedad periodontal, ¿cuál de las siguientes afirmaciones describe con mayor precisión la progresión de gingivitis a periodontitis?

La gingivitis se caracteriza por la inflamación de la encía, y si esta persiste, puede evolucionar a periodontitis con destrucción del tejido y resorción ósea. Signup and view all the answers

¿Cuál es el mecanismo principal que causa la acalasia esofágica?

Una contracción permanente del esfínter esofágico inferior que no se relaja ante la deglución. Signup and view all the answers

En cuanto al tratamiento dietético de la acalasia, ¿cuál de las siguientes pautas es menos recomendable?

Consumir alimentos muy líquidos para facilitar su paso por el esófago. Signup and view all the answers

¿Cuál de las siguientes NO es una complicación sistémica típica asociada al síndrome de dumping?

Hipertensión Signup and view all the answers

En la fase inicial posterior a una resección intestinal, ¿qué característica NO se asocia típicamente con la diarrea profusa?

Aumento en la absorción de nutrientes Signup and view all the answers

Si un paciente con síndrome del intestino corto no absorbe adecuadamente las sales biliares, ¿qué problema puede NO presentarse como consecuencia directa?

Hiperglucemia Signup and view all the answers

¿Cuál de los siguientes nutrientes es MENOS probable que se absorba adecuadamente en un paciente con síndrome del intestino corto, especialmente después de una resección importante?

Vitamina B12 Signup and view all the answers

En la enfermedad celíaca, ¿qué componente específico del gluten desencadena la reacción inmunitaria?

Gliadina Signup and view all the answers

¿Cuál es la principal fracción del gluten considerada más tóxica para los individuos con enfermedad celíaca?

Gliadina α Signup and view all the answers

En la forma clásica de la enfermedad celíaca, ¿qué característica específica presentan las heces?

Voluminosas, blancas-grisáceas, brillantes y oleosas Signup and view all the answers

¿Cuál de las siguientes opciones describe correctamente la presentación de la enfermedad celíaca atípica?

Las manifestaciones digestivas son escasas o inexistentes, presentando alteraciones como anemias. Signup and view all the answers

En el contexto del tratamiento para la enfermedad celíaca, ¿qué se debe evitar principalmente en la dieta?

Alimentos que contengan trigo, cebada, centeno o triticae. Signup and view all the answers

¿Qué característica distintiva presenta la enfermedad de Crohn en relación a las lesiones en el intestino?

Las lesiones presentan forma segmentada, alternando zonas sanas con enfermas. Signup and view all the answers

¿Cuál de los siguientes laxantes actúa principalmente reteniendo agua en el intestino por efecto osmótico?

Sorbitol. Signup and view all the answers

En el tratamiento del estreñimiento, ¿qué acción NO se considera una medida complementaria?

Interrumpir la ingesta de grasas. Signup and view all the answers

Un paciente presenta un megacolon adquirido a edad temprana. ¿Cuál de las siguientes manifestaciones clínicas es menos probable que experimente?

Dolor abdominal. Signup and view all the answers

¿Cuál de las siguientes causas está menos asociada con la aparición de divertículos en el colon?

Alta ingesta de fibra. Signup and view all the answers

En un caso de diverticulitis, ¿qué síntoma es menos probable encontrar en un paciente?

Estreñimiento. Signup and view all the answers

¿En qué situación específica se desaconseja una dieta rica en fibra para pacientes con diverticulosis?

En casos de diverticulitis aguda o diarrea. Signup and view all the answers

¿Cuál de los siguientes factores NO se considera una causa o agravante del síndrome del intestino irritable?

Consumo excesivo de fibra. Signup and view all the answers

Durante el tratamiento dietético inicial de la pancreatitis edematosa, ¿qué tipo de alimentos se deben introducir en la dieta del paciente en la primera fase?

Líquidos libres de grasa como caldos o zumos. Signup and view all the answers

¿Cuál de las siguientes características distingue la pancreatitis necrohemorrágica de la edematosa?

Presencia de necrosis grasa tanto intra como peripancreática y hemorragia. Signup and view all the answers

Además del alcoholismo, ¿cuál es otra causa común de pancreatitis aguda mencionada?

Litiasis biliar. Signup and view all the answers

¿Cuál de las siguientes deficiencias nutricionales es menos probable que se observe en un niño con enfermedades inflamatorias intestinales, según la información proporcionada?

Aumento en la asimilación de ácidos grasos omega-3. Signup and view all the answers

Según el texto, ¿qué medida dietética no se recomienda durante la fase aguda de un brote de enfermedad inflamatoria intestinal?

Incrementar el consumo de alimentos integrales y fruta fresca. Signup and view all the answers

En el tratamiento nutricional del estreñimiento atónico, ¿cuál de las siguientes estrategias nutricionales NO está directamente respaldada por la información del texto?

Restricción de la ingesta de lactosa para evitar la producción de gases. Signup and view all the answers

En el contexto de la colitis ulcerosa, ¿cuál de las siguientes manifestaciones no se considera una complicación directa de la enfermedad, según el texto?

Diarrea. Signup and view all the answers

¿Cuál de las siguientes opciones describe con mayor precisión el propósito principal del equilibrio entre los ácidos grasos omega-3 y omega-6, según la información proporcionada?

Prevenir la exacerbación de procesos inflamatorios. Signup and view all the answers

Study Notes

Fisiopatología del Aparato Digestivo

Cavidad Oral: Oral health issues affect food choices. Individuals with missing teeth opt for easier-to-chew foods, potentially missing out on more nutritious options. Maintaining good oral health is crucial. Culinary techniques can modify foods for easier ingestion and nutrient intake if problems are extensive. Salivary deficiencies can lead to infections and limitations. Many oral diseases exist.

Fisiopatología Digestiva en la Cavidad Oral

Caries: An infectious disease preventable. Affects tooth enamel, potentially dentin and pulp. A major cause of tooth loss. Formation is tied to three factors: susceptible tooth, bacteria consuming carbohydrates, and acid production from bacteria metabolizing carbohydrates. Saliva's buffering capacity and tooth susceptibility influence enamel damage.
- Factors influencing caries:
  - Endogenous: Genetics, oral microbiota, tooth structure, saliva type
  - Exogenous: Diet (sugar intake), dental hygiene
Diet recommendations for preventing caries:
- Limit sugary foods.
- Increase fiber intake (enhances teeth cleaning).
- Decrease acidic foods (weakens enamel).
- Increase fluoride intake (from fluoridated water or toothpaste).
- Maintain good dental hygiene (brushing after meals).
Periodontitis: Inflammation of the gums due to bacteria. Prolonged inflammation can lead to tissue destruction, bone resorption, and tooth loss. Gingivitis and Periodontitis are distinct forms. Periodontitis also involves the joint between teeth and bone.
- Causes: Bacterial activity, smoking, age, immune system issues

Esófago/Estómago

Esófago: Diseases primarily affect motor function during ingestion. Includes Achalasia and Gastroesophageal Reflux Disease (GERD).
- Achalasia: Impaired esophageal motor activity. Persistent contraction of the lower esophageal sphincter (LES), failing to relax during swallowing. Motor deficiency results from reduced intrinsic nerve cells. Causes may be immune, infectious, or genetic. Leads to esophageal obstruction. Symptoms: dysphagia, chest pain, vomiting, nocturnal regurgitation, and severe weight loss. Treatment: Surgical.
  - Dietary guidelines for Achalasia:
    - Proper hydration, avoid aspiration by thickening liquids.
    - Small, ambient-temperature meals.
    - Avoid acidic, irritating, spicy, and sticky foods.
    - Avoid easily fragmented foods.
    - Choose smooth, cohesive, soft-consistency foods (creams, yogurts, puddings).
- GERD: Reduced pressure between cardia and stomach. Due to basal hypotonia or transient LES relaxation. Symptoms include stomach contents regurgitation, causing heartburn (esophageal burning). Can be present in healthy individuals following large meals or lying down. Disease develops when esophageal defenses are compromised. Treatment often includes antacids, mucosal protectors, or acid-secreting inhibitors.
  - Food triggers for GERD to avoid:
    - Citrus fruits
    - Coffee (stimulates stomach acid)
    - Fats, alcohol, chocolate (affect submucosal and myenteric plexuses)
    - Large meals
    - Liquids with meals
    - Lying down after eating
Stomach: Conditions include gastritis, peptic ulcers, and gastric surgery.
- Gastritis: Inflammation of the stomach lining, acute or chronic. Acute gastritis: stress, irritants, bacterial infections (e.g., Helicobacter pylori). Chronic gastritis: often autoimmune, or caused by Helicobacter pylori.
- Peptic Ulcers: Damage to the stomach or duodenal lining due to acid and pepsin. Common causes: genetics, increased stomach acid, Helicobacter pylori infection.
- Gastric Surgery: Leaves lasting effects on stomach function, hindering digestion and affecting nutritional status. Possible complications: recurrent ulcers, dumping syndrome (early or late), small stomach syndrome, diarrhea, gallstones, cancer, anemia, or bone disorders. Treatment: strict nutritional management.
  - Dietary recommendations for gastritis and ulcers:
    - Smaller, more frequent meals.
    - Decreased milk/dairy intake.
    - Slow, mindful eating.
    - Balanced nutrition.
    - Avoid spicy/acidic foods (e.g., coffee, tea, carbonated drinks, citrus juices, alcohol)
    - No snacking between meals.

Intestino Delgado

Short Bowel Syndrome: Loss of absorption due to surgery, congenital defects, or diseases. Characterized by impaired nutrient absorption. The most common intestinal failure in adults occurs when absorption is below 1.5 kg of wet weight.
- Etiology (origin): Associated with surgical resection, trauma, gastroschisis, jejunal fistula, etc. depending on age.
- Assessment: Intestinal length is relative to the individual; short bowel occurs if it's below 50% of the original length.
- Phases after resection: Diarrhea, adaptation, and adaptation completion
  - Diarrhea: Characterized by acceleration of bowel transit, digestion challenges, reduced nutrient absorption. Early-onset diarrhea can negatively impact overall health and function.
  - Adaptation: Functional and morphological changes in the gut improve absorption, initially accompanied by less severe diarrhea. Includes mucosal surface expansion, increased enterocyte enzyme activity.
  - Complete Adaptation: Typically involves 3-24 months and leads to full gut functionality.
- Nutritional Deficiencies: Vitamin B12 and bile salts are commonly affected and need supplements.
- Dietary Recommendations:
  - Frequent, small meals.
  - Reduced fat intake.
  - Increased protein, avoiding high-fat meats.
  - Avoid simple sugars. Emphasize complex carbs (rice, pasta, bread).
  - Avoid spices.
  - Avoid milk/dairy initially.
Celiac Disease: Autoimmune condition affecting the small intestine lining. Triggered by gluten (wheat, rye, barley). Results in poor nutrient absorption due to damage to the microvilli. Eliminating gluten from the diet reverses the clinical condition. Caused by environmental, immunological, and genetic factors. Gluten is a complex protein, including soluble gliadin and insoluble glutenin fractions. Gliadin fractions (α, β, ω) exhibit varying toxicity.
Symptoms and forms:
- Classic: Severe malabsorption. Common in childhood (1-5 years). Symptoms: diarrhea, vomiting, psychological changes, anorexia, abdominal distension, growth retardation, malnutrition. Stools are large, pale-gray, oily, and frothy. Muscle wasting, pale/dry skin, and poor/brittle hair can appear. Celiac crisis is severe and requires urgent medical care.
- Atypical/Ominsymptomatic: Less obvious symptoms, common in adults. Symptoms may include anemia, growth issues, puberty problems, and arthritis.
- Asymptomatic: Silent celiac disease, latent celiac disease, and potential celiac disease.
Dietary Management: Permanent gluten-free diet. Nutritional intake needs to be balanced and varied to maintain good nutritional health.
Diagnosis: Dietary review, serological tests for antibodies, genetic tests, small intestine biopsy, and gluten challenge test under medical supervision.
Inflammatory Bowel Disease (IBD): An immune response in genetically predisposed individuals. Symptoms: chronic inflammation, typically diarrhea, fever, anorexia, nausea, weight loss. Crohn's disease is the most significant presentation. Symptoms manifest based on inflammation location.

Colon

Ulcerative Colitis: Chronic, inflammatory, ulcerative disease affecting the colon. Characterized by the expulsion of bloody, mucous, and purulent discharge. Symptoms include diarrhea, tenesmus (rectal urgency and incomplete evacuation sensation), abdominal pain, fever, and weight loss. Potential complications: severe bleeding, toxic megacolon, colonic perforation, intestinal strictures (blockages), anal fissures, anal fistulas, and colorectal cancer.
Constipation: Impaired intestinal motor activity resulting in slow transit, hardened stools, and difficult expulsion. Characterized by fewer than three bowel movements per week, involving small, hardened stools. Prevalence is high (20%) in women more than men. Can be related to diverticular disease, colorectal cancer, appendicitis, or anal issues
- Types of Constipation: Physiological (temporary) vs Chronic (persistent)
Types of chronic:* Atonic, spasmotic, proctal
Dietary management for constipation:*
- Atanoic: Increased fiber and liquids. Encourage intestinal secretion via cellulose and lactose (lactic acid stimulates peristalsis). Increase consumption of fats (stimulates peristalsis, and digestion products promote bile secretion aiding in motility). Fats lubricate and improve intestinal movement.
- Spasmotic: Similar to atonic. Eat fiber, water and fat.
- Proctal: Treat cause of poor bowel evacuation mechanisms. Resolve anal issues, fissures, or hemorrhoids.
Megacolon: Increased colon diameter: Congenital (Hirschsprung's disease) or acquired.
Congenital (Hirschsprung's disease):* segmental lack of ganglion cells (aganglionosis), typically in the sigmoid colon and rectum. Reduced anal relaxation. Delay in meconium expulsion, occasional intermittent constipation, sometimes symptoms manifest after infancy. Abdominal distension, nausea, vomiting, weight loss, and reduced growth are common. Treatment: surgery.
Acquired:* Secondary to constipation. Other causes: Chagas disease, generalized chronic intestinal pseudo-obstruction. In children: constipation, fecal impaction, and incontinence (loss of control with massive accumulation). In adulthood: Constipation and abdominal pain, without incontinence. Treatment: emptying intestines (often requiring manual extraction). Surgery as final option.
Diverticular Disease: Formation of small pouches (diverticula) in the colon's walls. Diverticulosis (without symptoms) vs. diverticulitis (with symptoms). Associated reasons: genetics, wall structure, movement disorders, increased intraluminal pressure, low dietary fiber intake. Low fiber results in hard stools, straining during defecation, mucosal protrusions (where blood vessels breach).
- Dietary Management: High fiber diet in diverticulosis. Avoid seeds with diverticulitis or diarrhea.
Irritable Bowel Syndrome (IBS): Chronic gastrointestinal motility disorder involving abdominal pain/discomfort, defecation problems, and abdominal distention. Higher prevalence in women. Stress plays a substantial role. Causes are unclear, possibly related to abnormal motility, gut hypersensitivity, increased bowel contractions, stress, visceral hypersensitivity, atypical brain processing, and issues in colon motility and evacuation, abnormal gas propulsion, food intolerances, genetic predisposition, or psychosocial/psychiatric factors. Symptoms often subside after defecation. Varying abdominal intensity and localization. Treatment: Dietary changes, low fat intake, increased carbs and protein, avoid gassy, stimulating, or spicy foods and carbonated drinks.

Pancreas Exocrine

Pancreatitis (Acute and Chronic): Inflammation of the pancreas. Acute typically resolves without lasting issues.
- Acute Pancreatitis: Edematous (interstitial) or necrohemorrhagic. Edematous: edema, fat necrosis, and peripancreatic inflammation, usually short-term. Necrohemorrhagic: fat necrosis; intra and peripancreatic, often severe with longer duration and higher mortality risk. Causes include gallstones and alcoholism. Mechanism: uncontrolled enzyme production causing autodigestion. Symptoms: severe abdominal pain, usually after large meals/alcohol consumption, abdominal distension, vomiting, nausea, and potentially jaundice.
  - Dietary Management (Acute):
Edematous:* Gradually introduce foods, starting with fat-free liquids, moving towards lean proteins (especially fish) then cooked vegetables and lean meats. Avoid frying, breading, and high-fat preparations.
Severe:* Nutritional support via enteral or parenteral nutrition (based on tolerance) when oral intake isn't feasible.
- Chronic Pancreatitis: Chronic inflammation causing irreversible anatomical changes. Causes: Alcoholism, malnutrition, smoking, and genetic factors (depending on type of chronic pancreatitis). Symptoms: pancreatic exocrine insufficiency (maldigestion), abdominal pain, and pancreatic endocrine insufficiency (diabetes). Often intense, ongoing abdominal pain after heavy/fatty meals or alcohol. Steatorrhea (fatty stools) may be present with significant pancreatic dysfunction and weight loss. May involve jaundice from common bile duct compression.
  - Dietary Management (Chronic): individualized approach. Low fat, high carbohydrate and protein diet (unless diabetic). Bland consistency foods, small, frequent meals. Avoid frying/breading.
Cystic Fibrosis (CF): Inherited (autosomal recessive) disease impacting ion transportation affecting mucous secretion.
- Effects: Abnormal inorganic ion concentrations in secretions (particularly increased sodium chloride in sweat), increased mucus viscosity (thick, dehydrated mucus affecting breathing and leading to infections). Increase susceptibility to chronic bronchial infections from specific bacteria. Chronic Diarrhea. Obstruction of pancreatic excretory ducts.
- Manifestations (CF):
Respiratory:* Frequent infections, thick airway secretions, causing cough, wheezing. Sinus issues, nasal polyps, and recurrent otitis.
Gastrointestinal:* Newborn: meconium ileus (obstruction in the distal ileum from thick meconium). Reduced pancreatic enzyme release, impacting digestion and nutrient absorption, ultimately resulting in chronic diarrhea & fatty/oil-like stool. Pancreatic endocrine implications. Often leads to malnutrition and growth retardation.
Other implications:* Salivary glands, sweat glands, cardiovascular issues, endocrinological and reproductive issues.
- Nutritional Management (CF): High-calorie, high-protein, and normal/high-fat diet, adjusted for age and gender. Increased fat intake is focused on unsaturated fatty acids. Increased Vitamin intake, especially fat-soluble vitamins, minerals, and salt (given sweat losses).

Liver and Biliary Tract

Acute Hepatitis (uncomplicated): Diffuse liver inflammation due to hepatocyte necrosis. Common causes: viral infection, medications, toxins, excessive alcohol, and metabolic disorders. Symptoms (variable): nausea, vomiting, fever, jaundice, abdominal pain, dark urine.
Types:*
Viral (e.g., Hepatitis A, B, C): Viral replication in hepatocytes leads to liver cell damage.. Hepatitis A (transmitted by contaminated food or water) typically resolves completely. Hepatitis B (transmitted through bodily fluids) can be chronic and lead to cirrhosis or liver cancer; vaccinated against. Hepatitis C (transmitted through blood) can be chronic, often asymptomatic. No vaccine currently available.
Toxic (alcoholic hepatitis): Toxic effects of ethanol on the liver.
- Dietary Recommendations: -Frequent, small meals. -Mildly increased protein intake. -No significant adjustment in fat intake (unless intolerance). -Hydration is essential.
Fulminant Hepatitis: Massive hepatocyte necrosis, leading to liver shutdown. Causes: viral, toxic, drug-induced hepatitis, acute fatty liver of pregnancy, and cancer. Symptoms: jaundice, bleeding, hypoglycemia, renal failure, cerebral edema, low blood pressure, electrolyte imbalance, and respiratory insufficiency. Treatment: maintaining blood sugar, minimizing protein breakdown, promoting liver function regeneration (through diet). Adjusting carbohydrate intake based on blood sugar control.
Cirrhosis: Chronic, diffuse liver disease with irreversible liver damage and hepatocyte/tissue damage causing diminished liver function. Causes: excessive alcohol use, viral infections, obesity. Symptoms: jaundice, altered steroid hormone synthesis (testicular atrophy, gynecomastia), anemia, ascites (fluid buildup in the abdomen), dark urine, pale stools (faulty bile secretion), menstrual irregularities.
- Complications:
  - Ascites
  - Hepatic encephalopathy: cognitive, neurological, and personality changes
Dietary Management (Cirrhosis): Focus on preventing malnutrition. Increased protein intake and overall energy needs. Enteral or parenteral nutrition in severe cases.
Biliary Tract (Gallbladder):
- Gallstones (Cholelithiasis): Formation of gallstones (without infection). Usually asymptomatic but serious complications are possible. Choledocholithiasis: stones in the common bile duct (causing obstruction, pain). Jaundice, abnormal stool coloration, fever, and liver damage are potential consequences.
  - Causes: Age, pregnancy, sex (women affected more), family history, diabetes, obesity, certain medications, biliary tract infection, alcoholism.
Composition Changes:* Changes affect concentrations of primary bile constituents (bile acids, phospholipids, cholesterol), altering cholesterol solubility and causing precipitation of gallstones. Dietary adjustments are essential to control factors leading to stone formation.
Motility Disorder:* Changes in gallbladder/duodenal sphincter (e.g., Oddi's sphincter), altering bile evacuation (poor tone and enzyme response leading to bile buildup and high cholesterol concentrations). Dietary adjustments. - Dietary management (prevention): High fiber, water intake, weight management, and regular exercise.
- Cholecystitis (Acute and Chronic): Inflammation of the gallbladder (potentially with infection). Acute: intense abdominal pain, nausea, vomiting, fever, jaundice. Nutritional management: Initially, avoid oral nutrition (parenteral nutrition). Gradual introduction of fluids and low-fat diet.
- Chronic Cholecystitis: Often associated with gallstones and mechanical irritation. Symptoms may develop long after onset of gallstones. Treatment focus: avoiding foods triggering acute episodes (fatty, high-spice meats or dishes). Supplementation of fat-soluble vitamins if malabsorption is suspected. Lower than 25% fat intake, focusing on olive oil. Small, frequent meals.
Obstructive Jaundice: Blockage of the common bile duct causes bile accumulation which results in jaundice(skin yellowing). If blockage is short-lived, minor dietary adjustments (reducing fat intake) might be sufficient. Otherwise, vitamin deficiencies (especially vitamin K causing osteomalacia) could occur. Supplementation may be necessary.

Bacterial Foodborne Illnesses: Pathogenic microorganisms in foods can cause foodborne illnesses or toxiinfections. Symptoms can be mild (diarrhea, nausea, or abdominal pain) or severe.
- Salmonellosis: Bacteria from the Salmonella genus. Contaminated food sources include meat, poultry, fish, eggs (undercooked), and certain fruits/vegetables from animal/human fecal contamination. Symptoms manifest in enteric, septicemia (focal or not), or typhoid fever forms. Antibiotic use can affect protective gut microbes promoting development of illness.
- Cholera: Caused by Vibrio cholerae bacteria from contaminated water or food. Symptoms: severe watery diarrhea, no fever, considerable dehydration.
- Botulism: Clostridium botulinum produces toxins consumed via contaminated food/beverages. Causes paralysis. -Symptoms: blurry vision, dry mouth, dysphagia, difficulty speaking and swallowing, urinary retention. Severe cases involve respiratory muscle and diaphragm paralysis, loss of consciousness.
- Brucellosis (Malta fever): Consumption of unpasteurized dairy or contaminated meat. Causes chronic infection. Onset 7-42 days. Symptoms: high fever, sweating, fatigue, anorexia, joint pain, weight loss.
- Listeriosis: Consumption of food infected with Listeria monocytogenes. Higher prevalence in elderly, immunocompromised, pregnant women and newborns. Symptoms: fever, balance problems, muscle pain, diarrhea. In pregnancy: premature labor, miscarriage, fetal death.
Mycotoxicoses: Fungal toxins or mycotoxins in food. Symptoms can appear from renal, hepatic, neurological, and circulatory disorders, among others. Crucial to identify the type of mycotoxin. Occurrence in grains, legumes, etc under favorable conditions. Mycotoxins are mutagenic and carcinogenic.
- Aflatoxicosis: Aspergillus flavus produces aflatoxins. Lipophilic, heat-resistant, can cause liver damage and cancer. Common in certain crops like nuts, corn, and peanuts. Increased risk in sensitive individuals.
- Trichothecene Toxicity: Fusarium Triticum produces Trichothecenes (toxins). Interferes to protein synthesis; possible fatal outcome if consumed heavily. Initial symptoms: irritability, vomiting. Possible progression to food-borne toxic leukopenia (low white blood cell count).
- Ergotism: Claviceps purpurea produces ergots. Can damage to nervous system via convulsions, neurological problems, and hallucinations. Ergotism gangrenous causes severe peripheral vasoconstriction and consequent tissue damage.
Natural Toxin Poisoning: Natural toxins found in foods. Often affect sensitive individuals.
- Lathyrism: Consumption of certain legumes (e.g., Lathyrus sativus). Major neurologic disturbance. Can be frequent in areas where staple foods are from these legumes and may result in extremity spasms, rectal paralysis, brain damage, and urinary bladder dysfunction. Cooking/roasting can remove toxins but loses nutrients.
- Favism: Consumption of fava beans (vicine and convicine compounds). Genetic deficiency in glucose-6-phosphate dehydrogenase (G6PD) can lead to severe hemolysis. Hemolysis, anemia, hematuria, fever, spleen/liver inflammation are common. More common in Mediterranean countries. Cooking doesn't always eliminate problems.

Drug-Nutrient Interactions

Drug-Nutrient Interactions (DNIs): Medications can modify nutrient absorption (blocking, enhancing/decreasing metabolism/urine excretion). Chronic medication use may damage segments of the gut (affecting swallowing, motility, and pH), impacting nutrient utilization.
Effects of Medications on Nutrients:
Vitamin B6 (Pyridoxine): Oral contraceptives can reduce absorption, influencing amino acid metabolism. Deficiency can cause severe neurologic issues. Supplementation may be needed.
Vitamin B12: Medications (like omeprazole) can disrupt absorption, potentially increasing needs if taken long-term or in risk groups.
Vitamin B1 (Thiamine): Diuretics can reduce absorption, causing potential cardiac issues.
Biotin (B8): Long-term anticonvulsants or antibiotics can increase biotin needs due to absorption/degradation issues.
Effects of Food on Medications (DNIs): Food can change drug pharmacokinetics, affecting drug levels, tissue impact, and overall therapeutic effect.
- Pharmacokinetic phases affected by foods: Absorption (altered speed/quantity), Distribution (displacement of drugs from protein binding, impacting free drug availability), Metabolism (altered rate/extent by certain foodstuffs (e.g., charbroiled foods)), and Excretion (altered urine pH affecting drug removal).
Additional Considerations for DNIs: Polypharmacy (using multiple drugs) increases risk of DNIs. Elderly, infants, pregnant women, and malnourished individuals are more vulnerable. Specific foods can affect efficiency, safety, or progression of certain treatment phases.

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Description

Este cuestionario explora la relación entre la salud bucodental y la elección de alimentos, así como los efectos de la cirugía gástrica en la dieta. Las preguntas abarcan temas como la caries dental, la gastritis, y el reflujo ácido. Ideal para profesionales del área de la salud y estudiantes interesados en nutrición y odontología.