CA Of The Gastrointestinal Tract - Chapter 20 Flashcards
What are the protein needs of patients with gastric cancer
1.0-1.5g/kg
What are the calorie needs of those with gastric cancer
25-35kcal/kg
30-35 if weight gain needed
35 if hypermetabolic or stressed
The stomach is separated into two parts the upper and the lower section. Describe the upper section
The upper section is referred to as the PROXIMAL stomach. It contains the CARDIA, Which is closest to the esophagus, the fundus and the body.
Stomach is separated into two parts the upper and lower sections. Describe the lower section
The lower section is known as the DISTAL stomach. It contains the Antrim and the pylorus, which is the closest part of the stomach to the duodenum.
What is the liquid remaining after food is blenderized and liquefied in the stomach?
Chyme
The stomach in the duodenum trigger feedback mechanisms that do what?
Control appetite and affect the pace of stomach emptying into the small bowel
What is believed to be the leading cause of gastric
Helicobacter pylori , especially in the distal stomach
Gastric cancer stent in metastasized where?
Liver, lung, or bone
What are risk factors of upper gastric cancers are Cancers of the gastric esophageal Junction?
Being overweight or obese
Gastroesophageal reflux disease or GERD
What are risk factors of both upper and lower gastric cancers
Heavy alcohol intake
Smoking/tobacco product use
Lack of physical activity
What are risk factors of the lower gastric cancer or non cardia gastric cancer?
H-pylori
Gastritis
Autoimmune disorders with pernicious anemia
Stomach surgeries or gastric bypass
Childhood malnutrition
Salted or smoked Foods
High heme iron intake from meat
High intake of grilled and processed meat
Low intake of fruit and veggies particularly of foods with beta-carotene and vitamin C
What sex and race is gastric cancer most common in?
More common in men
Higher incidence in Hispanic, African and Asian Americans
What are the symptoms of gastric cancer?
Feeling full, bloated after eating Heartburn or indigestion Abdominal pain and discomfort Nausea, vomiting Anorexia and unintentional weight loss
What nutritional situations might having a gastrectomy put a person at risk of?
OSTEOPOROSIS
So do bone scan over 2 years
Monitor vitamin D levels
Encourage calcium citrate intake of 1500 mg per day
Separate calcium supplement from iron foods
NUTRITIONAL ANEMIAS
Due to possible malabsorption of iron, folate, and B12
Monitor and supplement if indicated
What are three types of partial gastrectomy?
Billroth 1 (gastroduodenostomy)
Bill Roth 2 (gastrojejunostomy)
Rouex-en-Y
Most surgeons prefer to avoid preoperative gastrectomy to beating placements in patients with favorable proptosis
When jujenal tube feedings are used for nutrition support what is the standard protocol for use?
Continuous feedings via pump are indicated
Fiber free, 1.0 standard formula, / 8 to 20 hours, advancing as tolerated
Begin with small volumes of full strength formula (about 20 to 30 cc’s per hour) and advance as tolerated
After gastrectomy either partial or total surgery what type of diet intervention should be followed?
More or less the diet for anti-dumping diet
Small frequent meals Limit concentrated sugars and lactose Avoid greasy fried foods Include protein sources at each meal Separate liquids from meal times
What is the main function of the colon or large bowel?
To maintain hydration and conserve electrolytes by reabsorbing fluid and salts
It also produces short-chain fatty acids that support colon health
Colorectal cancer is the_______most common cancer and more often is found in which sex?
It is the third most common cancer
, It is most often found in men
If colorectal cancer is going to metastasize where is it likely to metastasize?
To the liver
What are the risk factors for colorectal?
Being over the age of 50
Colon polyps
Inherited syndromes
Being African-American or Ashkenazi Jews
Having type 2 diabetes
Being overweight or obese, especially in the abdomen
Smoking
Heavy alcohol use
Physical inactivity
History of ulcerative colitis or Crohn’s disease
Grilling at high temperatures
Diets high in red meat and processed meat
Low serum vitamin D levels and low calcium intake
What is the most common symptom of colorectal cancer?
A change in the bowel habits particularly diarrhea constipation or narrowing of the stool
Others: Heme positive stools Unexplained anemia Abdominal pain or bloating Nausea and vomiting Blood in the stool Unintended weight loss and fatigue
If the terminal ileum has been resected what things will need to be considered
Monitor serum vitamin B12 levels
Monitor for diarrhea
Additional bile acid sequestrants may be needed
Because of losses, fat soluble vitamins a, d, e k and calcium zinc and magnesium supplements may be needed
What are the calorie needs for a patient with liver cancer
25 to 40 KCAL 4 kilogram if I acites
35 to 40 KCAL per kilogram if stable cirrhosis
25 to 35 KCAL without encephalopathy
35 KCAL per kilogram with a cute encephalopathy
30 to 40 KCAL if malnourished
What are the protein needs for liver cancer patients
1 to 1.5 grams kilogram for all except those with encephalopathy
.6 to .8 grams her kilogram for patients with acute encephalopathy
What are estimated fluid needs and liver patients with ascites
If mild ascites 3 to 5 kilograms
If moderate ascites 7 to 9 kilograms
If severe ascites 14 to 15 kilograms
