Chapter 1- Nutrient Intake, Digestion, Absorption And Excretion Flashcards
This hormone is released from the gastric mucosa and white adipose tissue. It is stimulated by food deprivation. Low levels of this hormone increase energy intake and decrease energy expenditure
Leptin
This hormone is released into the stomach in response to fasting. It stimulates increase growth hormone secretion and increases food intake.
Ghrelin
What meal pattern and macronutrient composition is most likely to succeed in pts with prolonged history of wt loss due to poor intake, nausea and depressed appetite?
6 small, low fat meals daily
Aging is associated with decreased appetite and food intake. Why is it more ideal to use liquid ONS vs. solid ONS?
Liquids have been shown to lessen postprandial decline in hunger more than solids resulting in higher caloric intakes
What are the half emptying rates for liquids and solids from the stomach?
The half emptying time of liquids from the stomach is ~12min and ~2hours for solids. The swallowing reflex plays a role in gastric tone. If swallowing is bypassed by NG tube or PEG the emptying rate of liquids increase.
What foods should you avoid when feeding a cancer pt experiencing frequent nausea?
High fat, high fiber
Why is bolus feeding inappropriate for pts with J-PEG?
J-PEG bypasses the duodenum. The duodenum possesses sensory receptors that are associated with neurohumoral reflexes that influence gastric emptying time. As a result, feedings
On average, after abdominal surgery how long does it take the stomach, small intestine and colon respectively to regain peristalsis?
Stomach -48 hours
Small intestine-24hours
Colon-3 to 5 days
What are the A.S.P.E.N guidelines for use of fiber for pts with diarrhea?
Diarrhea unrelated to C. diff or hyperosmolar agents- use soluble fiber 👍
Critically ill pt- soluble fiber👍, insoluble fiber NO!👎
Pts at risk of bowel ischemia- NO FIBER👎👎👎
How does fermentable vs nonfermentable fiber control diarrhea?
Fermentable fiber slows gastric emptying and binds bile acids
Nonfermentable fiber exerts osmotic force that absorbs water from the contents of the colon
What diet would you prescribe for a pt with C. Diff after being NPO?
Caffeine free liquids followed by low fat, low fiber, low lactose diet
While lactobacillus or yogurt with live cultures may be supplemented as probiotics evidence base for this practice is weak
What is the MNT for gastroparesis?
Small frequent meals, drinking fluids with meals, limit dietary fat and possibly fiber, maintain good glucose control
MNT for dumping syndrome
Slow introduction of solid foods, elimination of simple sugars, frequent small meals, no liquids with meals
Lying down after meals and introduction of functional fiber may delay gastric emptying
In pts with gastric resection liquid MVI with minerals and Vit B12 injections may be necessary
Where are fat soluble vitamins absorbed?
Terminal ileum
Why are medium-chain triglycerides ideal for pt who normally maldigest or malabsorb fats?
They are hydrolysis and pass through enterocytes directly into the portal circulation. May be used as a calorie supplement
No micelles required!
