Nutrition Therapy 1 (ND 7318) Unit 4 Past Paper PDF, University of Santo Tomas, 2024-2025

18/10/2024 NUTRITION THERAPY 1 (ND 7318) UNIT 4 DISEASES OF THE GIT University of Santo Tomas| 1st Sem AY 2024 -...

18/10/2024 NUTRITION THERAPY 1 (ND 7318) UNIT 4 DISEASES OF THE GIT University of Santo Tomas| 1st Sem AY 2024 -2025 1 Document History Developed by: ASST. PROF. DIANE MENDOZA-SARMIENTO, RND, MSc. AY 2020-2021 Updated by: MS. JOANNA L. LUSTERIO, RND, MSc. AY 2023-2024 AY 2024-2025 University of Santo Tomas | 2024 1  18/10/2024 2 OBJECTIVES 1 University of Santo Tomas | 2024 Discuss common diseases of liver, pancreas, gallbladder 2 Discuss the metabolic changes that occurs 3 Discuss the nutritional requirements Image from google FUNCTIONS: ▪ Motility – movement of food (propulsive contractions and mixing movements) ▪ Secretion- include water, electrolytes, mucus, enzymes and bile salts. ▪ Digestion- complex molecules are broken down in simplest form. ▪ Absorption- water, electrolytes, basic molecules, vitamins and minerals. UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS 2  18/10/2024 Anatomy and Physiology Teeth- mastication (break food, mix with saliva & stimulate taste buds). Tongue- assist foods in chewing Salivary glands- saliva ( moistening and lubricating food, initiating CHO digestion, antibacterial protection, enhancing taste, buffer, oral hygiene). UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS peristaltic - sweeps down bolus- small rounded mass of substance/ unang paglunok rounded mass esophagus - one way movement sphincter - reflux pag d mahigpit. Anatomy and Physiology Bolus- mixture of food and saliva. Esophagus- facilitate movement of bolus (motility). Lower esophageal sphincter- control release of bolus from esophagus to stomach. pulpy acidic fluid, partly digested food, semi fluid state - chyme two types of digestion; mechanical - sherring of food with gastric juices and chemical digestion - juices and enzymes UNIVERSITY OF SANTO TOMAS very little absorption DEPARTMENT OF NUTRITION AND DIETETICS 3  18/10/2024 Anatomy and Physiology Stomach- motility, secretion, digestion and absorption. Chyme- partially digested food in semifluid state. Mechanical digestion- shear food and mix with gastric juices Chemical digestion- pepsin: cleaves amino acids Pepsinogen (inactive) + HCl Pepsin (active) UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS Anatomy and Physiology 80-90% will be absorption Small intestines- provides maximum surface area and allow for complete digestion and absorption. Gastrin, secretin and CCK- pancreatic and gallbladder secretions. Large intestines- primary site for reabsorption of water, electrolytes and some vitamins and storage of feces. UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS 4  18/10/2024 some will be absopb in large intestines Diseases of the GIT Dental caries- decrease in decay of teeth pH nagiging that begins when acidic acid dissolves the enamel that covers the tooth. UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS 5  18/10/2024 Diseases of the GIT Stomatatis- inflammation of the membrane in the mouth Xerostomia- decreased saliva production and dry mouth Dysgeusia- impaired taste Ageusia- inability to taste UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS XEROSTOMIA: nutritional recommendation ▪ Encourage consumption of non-caffeinated, cold fluids to help relieve mouth dryness; ▪ Encourages foods with lubricating effects such as sauces, gravies and salad dressings; ▪ Mint or sugar-free gums may stimulate saliva; ▪ Sips on liquids and ice chips ▪ Avoid alcohol and caffeine UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS 6  18/10/2024 caregiver.dietitian to experiement on DYSGEUSIA: food kasi may deminishing of taste ▪ Determine taste or smell changes; ▪ Small, frequent, high energy, high protein meals; ▪ Adequate fluid intake; ▪ Experiment on foods; UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS HYPOGEUSIA: brain will trick us na masarap ang food watch out for healthy and needs to be balance ▪ Experiment with strong flavors to enhance food taste; ▪ Enhance food presentations; ▪ Liberal intake of “treat” or “comfort foods” ▪ Eat in a relaxed atmosphere; UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS 7  18/10/2024 Dysphagia difficulty in swallowing Nutrition Intervention: a.) Dysphagia diet 1 (Dysphagia Pureed)- includes food with pureed like consistency. b.) Dysphagia diet 2 (Dysphagia Mechanically Altered)- includes foods that moist and soft in texture. c.) Dysphagia diet 3 (Dysphagia Advanced)- includes most regular foods except very hard, sticky or crunchy items UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS GERD (Gastroesophageal Reflux Disease) sometimes because of food they consume, which relax the les, peppermints, high fat, coffee, chocolate, friedfood d nagiging tight ang les nila and pede magkaroon ng reflux occurs as a result of reflux of gastric contents into the esophagus. les is close it prevents reflux Nutrition Intervention: pag improper relaxation may reflux or heart burn Foods that Relax LES: peppermint/spearmint, chocolate, fried foods, high fat, alcohol, coffee Foods that may increase gastric acid secretion: coffee, pepper and alcohol. UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS 8  18/10/2024 Hiatal Hernia protusion/excess/ d sha nasa nromal alignment protrusion of part of the stomach through the diaphragm into the space normally occupied by the esophagus, heart and lungs. Nutrition Intervention: ✔Same with GERD UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS Achalasia weak movement bago bumaba un bolus a motility disorder in which there is an absence of peristalsis or weakened peristalsis within the esophagus. Nutrition Intervention: ✔ texture modification with increase calories and protein ✔Avoid foods in extreme temp and spicy ✔SFF UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS 9  18/10/2024 Gastritis- inflammation of the gastric mucosa. Peptic Ulcer disease (PUD)- involves the ulceration in the lining of the stomach, duodenum or esophagus. Helicobacter pylori- produce various proteins that damage mucosal cells, attracting lymphocytes and causing persistent inflammation. By products released by the organism result in damage to the epithelium and impair the mucous barrier within the stomach. Other causes: use of NSAIDs, alcohol, excessive glucocorticoid secretion medication, smoking, shock and stress. h pylori bacteria -cause UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS Symptoms: Acid regurgitation (retasting your food after eating) Difficulty or pain when swallowing Sudden excess of saliva Chronic sore throat Laryngitis or hoarseness Inflammation of the gums Cavities Bad breath Chest pain (seek immediate medical help) UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS 10  18/10/2024 Nutrition Intervention ✔ avoid: pepper, caffeine ✔ pH of food prior to its consumption has little effect after it is consumed ✔ Do not lie down after eating ✔ No large meal before bedtime ✔ Elevate the head of the bed 6-8 inches ✔ Lose weight ✔ Stop smoking ✔ Decrease alcohol intake ✔ Limit meal size and avoid heavy evening meals ✔ Do not lie down within two to three hours of eating ✔ Decrease caffeine intake UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS Gastric surgery babawasan stomach size then attach duodenum or s.i UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS 11  18/10/2024 NUTRITION INTERVENTION: ✔small frequent feedings of liquid foods are initiated, after which the patient can progress to solids as tolerated based on volume and consistency Diet progression: 1. Clear liquid diet 2. Full liquid diets 3. Pureed diet (discharge), 2-4 weeks 4. Solid and liquid foods, >4 weeks - Small frequent feedings, Low calorie (500 calories) 5. Solid foods and liquid foods, 2- 6 months - Small frequent feedings, 1000 calories, low fat, well cooked vegetables, meat Low sugar https://www.ucsfhealth.org/education/dietary-guidelines-after-bariatric-surgery UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS Dumping Syndrome- a group of symptoms that occurs with rapid passage of large amounts of food into the small intestine; ❑symptoms include dizziness, sweating, decreased blood pressure and diarrhea. rapid fluid shifts into the intestinal lumen and release of gastrointestinal hormones, resulting in gastrointestinal and vasomotor symptoms. UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS 12  18/10/2024 NUTRITION INTERVENTION: ✔Proteinsand fats are better tolerated than carbohydrates because they are hydrolyzed more slowly into osmotically active substances. ✔Liquids enter the jejunum rapidly: Delay fluid intake after meal (30 minutes) ✔Lyingdown immediately after meals may also decrease the severity of symptoms (at least 30 minutes) ✔Small feedings gerd ayaw nahihiga agad, pero dito rapid passage so higa agad after eating UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS sugar can help in transport of fluid in celluar cells Diarrhea- glucose stimulate sodium increase in frequency of bowel movements (>3 or 4 times a day) and/or increase in water content of stools that affects either the consistency or the volume of fecal output. - May be caused by infections (Viral, bacterial, parasitic), lactose intolerance, celiac disease, IBS, Diarrhea may cause dehydration and malabsorption Symptoms of dehydration: Symptoms of Malabsorption: ▪ thirst ▪ changes in appetite ▪ urinating less than usual, lack of energy ▪ bloating ▪ dry mouth ▪ gas ▪ no tears when crying ▪ loose, greasy, foul-smelling bowel ▪ decreased skin turgor movements ▪ sunken eyes, cheeks, or soft spot in the skull ▪ weight loss UNIVERSITY OF SANTO TOMAS https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea/ DEPARTMENT OF NUTRITION AND DIETETICS 13  18/10/2024 NUTRITION INTERVENTION: ✔Oral rehydration solutions ✔Homemade ORS: ▪ One teaspoon of salt and six teaspoons of sugar dissolved in one litre of safe water ✔Low residue diet ✔Broths, fruit juices or soft drinks: electrolytes UNIVERSITY OF SANTO TOMAS DEPARTMENT OF NUTRITION AND DIETETICS high fiber diet, increase water and movement Constipation- a decrease in frequency of bowel movements (