BLOCK 31 - GI and Surgery

Question 1

Rationale behind a gluten-free diet

Answer 1

essential for managing signs+symptoms of celiac disease and other medical conditions associated with gluten and reducing risk of complications

Question 2

Patients with coeliac disease/gluten associated medical conditions should avoid eating foods containing which type of grains?

Answer 2

Wheat
Barley
Rye
Triticale — a cross between wheat and rye
Oats (if cross contamination)

Question 3

Give examples of good patients with coeliac disease/gluten associated medical conditions should avoid:

Answer 3

Beer, ale, porter, stout (usually contain barley)
Breads
Bulgur wheat
Cakes and pies
Candies
Cereals
Communion wafers
Cookies and crackers
Croutons
French fries
Gravies
Imitation meat or seafood
Malt, malt flavoring and other malt products (barley)
Matzo
Pastas
Hot dogs and processed lunchmeats
Salad dressings
Sauces, including soy sauce (wheat)
Seasoned rice mixes
Seasoned snack foods e.g. potato and tortilla chips
Self-basting poultry
Soups, bouillon or soup mixes
Vegetables in sauce

Question 4

Which micronutrients may people on a gluten-free diet not be able to get due to the foods they have to avoid?

Answer 4

Iron
Calcium
Fibre
Thiamin
Riboflavin
Niacin
Folate

Question 5

List some practical implications of a gluten free diet

Answer 5

> DEFICIENCIES - People may become deficient in certain nutrients as they are not present in gluten-free foods e.g. iron, B vitamins

> EXPENSIVE - Gluten free foods more spenny

> RISK of OBESITY/becoming OVERWEIGHT - some gluten free foods have higher fat+sugar content

Question 6

List some examples of naturally gluten free foods

Answer 6

meat
fish
fruit and vegetables
rice
potatoes
lentils

Question 7

What sort of psychological difficulties does a change in physical appearance cause to a patient?

Answer 7

• reduced self-esteem
• patient may feel less attractive
• lack of confidence
• feeling insecure

Question 8

Define body image

Answer 8

• it is a psychological concept that entails perception, imagination, emotions and physical sensations of and about the body
• it is not static but sensitive to mood, environment and physical experiences but is influenced more by self-esteem

Question 9

What are some reasons for body image disturbances in individuals with a stoma?

Answer 9

• loss of control of bowel function
• associated stoma complications
• side effects of medication and surgery

Question 10

Acceptable elimination behaviour is acquired at an early age . How may a patient process a voluntary loss of excretory behaviour?

Answer 10

bodily waste is associated with disgust and seen as humiliating which is a major threat to a patient’s self-esteem

Question 11

What behaviours might an individual with a stoma exhibit?

Answer 11

• withdrawing from social interactions as they feel more vulnerable