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MNT Prep > Celiac And Alt Therapies > Flashcards

Celiac And Alt Therapies Flashcards

1
Q

Define food intolerance.

A

Lacks enzyme to digest or more nutrients than enzyme. Not immune mediated
Lactose intolerance or FODMAPs

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2
Q

Define food sensitivity.

A

Variety of reactions when eating the food.
Usually not immune mediated response to nutrient.
No permanent damage.
Gluten sensitivity

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3
Q

Define food allergy.

A

Specific IgE mediated immune response rx to protein
Respond min-hrs after exposure
Usually 1st yr of life
Milk allergy wheat allergy

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4
Q

What does the body specifically react to from the cereals? What does it cause?

A

Prolamins-storage protein

Causes chronic inflammation, flat villi (Villous atrophy), malabsorption

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5
Q

What genes are specific to CD?

A

HLA-DQ2 and HLA-DQ8

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6
Q

Classic S/S of CD?

A

N/V, abd cramping, gas, bloating, chronic diarrhea to constipation, steatorrhea, dehydration, folate deficiency anemia, wt loss, dermatitis herpetiformis (lesions on GI tract and skin)

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7
Q

Specific cereal triggers and the proteins in them?

A

Wheat (gliadin)
Rye (secalin)
Barley (hordein)

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8
Q

What makes up the prolamin of wheat (storage protein)?

A

Gliadin and glutenin.

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9
Q

Steps of cellular and humoral response with gluten exposure?

A

High cellular TH1 makes INF gamma
Lymphocytes into epith makes humoral response then IgA, IgA, IgM
Gliadin upregulates zonulin to raise permeability
Proteins into circulation

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10
Q

What is zonulin? What does it regulate?

A

Intestinal permeability regulator. It is expressed after gliadin binds CXCR3 on outside of cell. Upregulation leads to leaky gut.

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11
Q

What 5 conditions being present mean to screen for CD?

A 
Infertility
Osteoporosis 
Lupus
DM1 
Thyroid diseases
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12
Q

Why is osteoporosis common with CD?

A

Less Ca and Vit D b/c think lactose intolerant
Thyroid probs- Ca comes out of bones
Prednisone- use to manage pain
No exercise or wt bearing activity -tired
Malabsorption fat so SOAP form with Ca Zn Mg

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13
Q

What is DH?

A

Dermatitis herpetiformis
85% people with this have CD. Only 10% people with CD have DH.
Watery itchy blisters. IgA deposited under top layer of skin.

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14
Q

How is CD usually Dx?

A

Detect serum IgA anti-tTG antibodies (sensitive to CD)

Gold standard: intestinal mucosal biopsy (need to be eating gluten still!)

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15
Q

Good names to know with CD?

A

A. Fasano (zonulin)

Michelle Pitzack

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16
Q

High risk groups for developing CD?

A 
Down's 
UC 
Asthma
Eczema 
Fibromyalgia 
Autoimmune (T1DM, thyroid, lupus, RA)
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17
Q

What is silent CD?

A

Not clinically harming until secondary effects (T1DM, Lupus, RA, osteoporosis, CA)
Just patchy small intestine involvement

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18
Q

MNT for CD.

A 
Possible wt gain (eat more and increase absorption) 
Monitor fiber intake 
Avoid BROW 
Allow CRAP (corn, rice, arrowroot, potatoes)
19
Q

What are other forms of wheat?

A

Triticale, spelt, couscous, durum, semolina, farina, Farro

20
Q

What does CELIAC stand for in MNT?

A

Consultation, education, lifelong GF diet, identify deficiencies, access advocacy group, continuous follow-up

21
Q

What is FDA GF definition? Gluten Intolerance Group definition?

A

GF label must have

22
Q

Avoid/monitor these foods on GF diet.

A

Malt anything, beer, miso (barely)
HVP, plastic bags, soy sauce (wheat berry), roux/cheese spreads, binder in meds, hygiene products
Distilled alcohol=ok!

23
Q

What is non-responsive CD?

A

S/s despite Dx and Tx
10% of pts
Usually from: gluten expose (more edu), IBS, di/mono deficiency

24
Q

What is NCGS?

A

Non-celiac Gluten sensitivity
No intestinal damage but s/s after gluten exposure
No Dx for sure (no CD for sure, no wheat allergy, maybe have bio markers)
50% of these people have HLA genes

25
Q

Define CD and avg Dx time.

A

Gluten-sensitive enteropathy or celiac sprue
Inherited, autoimmune, immune response to gluten (environmental)
Was 11 years but now 6 years for Dx.

26
Q

What are the 5 no’s of paleo? Risks with the diet?

A

No grains, sugars, dairy, processed foods, or beans (no PB)

Osteoperosis, ketosis,

27
Q

What is SCD?

A

Specific Carbohydrate Diet
Di and poly poorly absorbed= yeast overgrowth, thick mucus, and malabsorption
Can only eat monosaccharides, F/V but no pot/yam, no chick or soy, no milk, no grains, ok honey

28
Q

What are night shades?

A

2000 plant species
Solanaceae plant family
Believed to cause inflammation in joints
Bell peppers, tomatoes, eggplant, potato, paprika, Goji berries)

29
Q

What is diverticulitis? What are 2 types of conditions?

A

Inflammation in the colon

Diverticulosis and diverticulitis

30
Q

Define diverticulosis

A

Out pockets and pouches on SI or colon.
Asymtomatic, unknown cause, maybe LT constipation, obesity or low PA
Increases with age.
Possible: mild bleeding or different BM habits

31
Q

Define diverticulitis.

A

Acute inflammation of the diverticula that leads to infection
Caused by: lodged stool in pocket, tear pocket, lodged food, rupture diverticululum then colon contents infect body!
33% end up in hospital

32
Q

S/S with diverticulitis.

A

Not a lot of specific one
All common GI problem s/s
Most specific: pain in one specific quadrant

33
Q

3 main complications with diverticulitis.

A

Obstruction
Sepsis
Fistula

34
Q

MNT for diverticulosis.

A

High fiber diet ( insoluble- bulking)
Exercise
Fluids, avoid constipation from meds, no greasy food or popcorn.

35
Q

MNT for diverticulitis.

A

If burst- antibiotic therapy.

NPO, maybe TPN, clear liquid, low fiber, BRAT diet, low fat diet

36
Q

What is IBS? 3 types?

A

Irritable Bowel Syndrome; Abd pain associated with altered BM for 3 months. Biopsy finds nothing. No obstructions.
IBS-D, IBS-C, IBS-M

37
Q

What is SIBO?

A

Small intestinal bacterial overgrowth.
Thinks its main cause of IBS.
Focus on Candida albicans (white flour, sugar, yeast, cheese) may improve with FODMAP diet

38
Q

MNT for IBS?

A

Eliminate triggers, get reg eat pattern

Smaller meals, less lactose, fat, polyols, fructose, sucrose, gas producing foods (beans, peas, broccoli, cabbage, bran)

39
Q

Sources of fructose?

A

Honey, agave, HFCS

Dates, watermelon, pear, oranges, apples, melon, cherries

40
Q

What is lactose maldigestion and how Dx?

A

Can co exist with IBS.

Hydrogen breath test or monitored diet hx or eliminate lactose for 1-2 weeks and see

41
Q

What does FODMAP diet avoid? Why?

A

To avoid fermentation/osmotic effect of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
Started in 2001

42
Q

What ingredient should you look for in bars if stomach hurts?

A

Inulin anything

43
Q

3 main skills to teach pts with GI problems.

A

Label reading
Meal planning
Recipe modification

44
Q

What is FPIES?

A

Food protein induced enterocolitis syndrome

Severe food allergy

MNT Prep (27 decks)

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