C1 Digestive Disorders

Question 1

What are the 4 phases of swallowing?

Answer 1

Oral phase, oral propulsive phase, pharyngeal phase, esophageal phase

Question 2

What is dysphagia?

Answer 2

Anatomic or physiological swallowing problems that create a disturbance in the normal transfer of food from the oral cavity to the stomach.

Question 3

What are the energy and protein requirement for dysphagia?

Answer 3

Energy: 30 kcal/kg
Protein: 1.5g/kg

Question 4

What are some nutritional therapy for dysphagia?

Answer 4

• Take thick, soft, pureed food.
• Thickening food with honey, nectar, pudding or oat.
• NG tube feeding for severe cases of dysphagia
• Avoid alcohol, caffeine, spicy food and hot liquids.
• Place the food in the most sensitive area and use cold food.
• Moisten foods with small amounts of liquid to decrease saliva production.

Question 5

What are some nutritional therapy of constipation?

Answer 5

• GRADUALLY increase fiber intake to 20-25g/day
• Take adequate fluids: 1.5-2L per day
• Increase intake of prunes or prune juice
• Increase physical activity
• Restrict FODMAPS (fermentable oligosaccharides, disaccharides, monosaccharides and polyols)

Question 6

Describe nutritional therapy for diarrhea.

Answer 6

• High fiber, low fat, and lactose free diet.
• Increase fluid intake to replace fluid losses.

Question 7

What is a sign of fat malabsorption? Describe nutritional therapy for fat malabsorption.

Answer 7

• Steatorrhea, or the presence of fat in stools indicates fat malabsorption
• Take on a fat restricted diet
• Intake of medium chain triglycerides (MCT)

Question 8

Describe the effects of intestinal surgeries on nutrient absorption.

Answer 8

Duodenum/jejunum: Calcium and iron malabsorption if duodenum is resected/
Ileum: Fat, protein, fat-soluble vitamins and B12 malabsorption. Fluid loss, steatorrhea and diarrhea.
Colon: Diarrhea, fluid and electrolyte losses

Question 8

Compare the two major forms of inflammatory bowel disease.

Answer 8

Crohn’s disease:
- Inflammation occurs in discrete areas separated by normal tissue.
- can occur in the small intestines or colon
- deep fissures
- Fistulas
- Increased cancer risk

Ulcerative colitis:
- Continuous inflammation throughout the affected region.
- confined to the rectum and colon.
- Damage in the mucosa and submucosa
- Usually no fistula
- Greatly increased cancer risk

Question 9

If a patient with Crohn’s disease suffers from a severe bowel obstruction, what would be the proper approach to nutrition?

Answer 9

• Total Parenteral Nutrition (TPN)

Question 10

What is celiac disease?

Answer 10

An adverse, abnormal immune response to wheat gluten and related proteins that leads to severe damage to the intestinal mucosa. Nutrition therapy via gluten-free diet, dietary supplements and lactose avoidance if lactase deficiency occurs.

Question 11

Describe nutritional therapy for short bowel syndrome.

Answer 11

• IV supply of fluids and electrolytes after resection.
• Rehydration therapy within the first few weeks.
• Gradual transition from parenteral nutrition to tube feedings and oral feedings.
• Tailored dietary choices.

Question 12

Describe nutritional therapy for irritable bowel syndrome.

Answer 12

• Avoid fried or fatty foods, gas producing foods, and milk products
• Low FODMAP
• Small but frequent meals

Question 13

Describe the treatment for diverticulitis.

Answer 13

• Increased fiber intakes is recommended but does not prevent or reverse the disease
• Treatment with antibiotics
• IV fluids in severe cases.
• Surgical interventions for complications.

Question 14

Define probiotics and prebiotics.

Answer 14

• Probiotics are live microbial food supplements that support balance in the intestinal tract.
• Prebiotics are natural, non-digestible food ingredients that promotes the growth of helpful gut bacteria. Examples include inulin and galacto-oligosaccharides.