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nutrition > chapter 18 > Flashcards

chapter 18 Flashcards

1
Q

dyspepsia

A

indigestion

discomfort in digest tract (physical or psych in origin)

heartburn, bloating, pain, sometimes regurgitiation

phycial cause: overeating or spicy foods or symptom of another problwem like appendicitis or a kidney, gallbladder or colon disease ,or possibly cancer (if organic problem then tratment of underlyic cause)

psychological: find relief from underlying stress, allow sufficient time to relax and enjoy meals, learn to improve eating habits

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2
Q

esophagitis

A

irritating effect of acid reflux on the mucosa of the esophagus

heartburn, regurigtaiton, and dysphagia

acute could be irritating agent or GERD or hiatal hernia, reduced lower esophageal sphincter (LES) pressure, abd pressure, recurrent vomiting, alc use, overweight, or smoking

cancer of esophagus and silent aspiration may be life threatening for those w GERD

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3
Q

hiatal hernia

A
  • condition in which a part of stomach protureds through the diaphragm into the thoarci cavity

hernia prevents food from movigng normally along diestive tract although food does somewhat mix w gastric juices

food might move back into esophagus, creating heartburm or regureigiation into mouth

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4
Q

medical nutrition therapy for dyspepsia, esophagitis and hiatal hernia

A
  • small, frequent meals so amount of food in stomach is never large
  • avoid irritatns to esophagus like carbonated becerages, chocolate, citurs fruits and uices, tomato products, spicy foods, coffee, pepper, and some herbs

some food can cause lower esophageal sphincter to relax like fatty and fried foods, spicy foods, cirtrus foods, tomato products, onions, chocolate, mint candy, caffeinated beverages, and alc so they should be avoided

if obese, wt loss

avoid late-night dinners and lyign down for 2-3 hours after eating (sleep w heads and upper toros somewhat elevated and wearning loose-fitting clothing)

may need sugery

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5
Q

peptic ulcers

A

erosion of mucous membranes

gastric ulcer in stomach or duodenal ulcer in duodenum

cause is unclear but could be genetic predisposition, abn high secretion of HCL in stomach, stress, excessive use of aspirin or ib uprofen, cig smoking, bacterium H. pylori

symptom is gastric pain and maybe hemorrhage

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6
Q

treatment for ulcers

A

treat gastric pain w food or antacids
hemorrhage traeated w surgery

ulcers treated w drugs such as antibiotics and cimetidine

antibiotics kill bacteria and cimetidine inhibits acidsecretion in stomach and thus helps ulcer hal

antacids contain calcium carbonate which neutraizes any excess acid

stress managemtnt

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7
Q

diet for ulcers

A

sufficient low-fat sources of protein but not in excess as it stimulates gastric acid secretion

(no more than 9,8g protein per kg body wt; if blood loss inc to 1-1.5 g per kg)

vitamin and mineral suppplements (esp uron if hemorrhage)

increased intake of fat as fat delayed emptying stomach in moderation as ppl w peptic ulcers are more prone to atherscleroris

spicy foods as tolerated; avoid coffee, tea, or caffeine, alc, aspirin as irritate mucous membrane; cig smokng decrease secretion of pancrease that buffers gastric acid in duodenum

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8
Q

diverticulosis/ diverticulitis

A

diverticulosis - intenstinal disorder charcteriszed by little pickets n side of large intenstine

diverticulitis - fecal matter collect in pockets, breeding bacteria, and infalammation and pain may reulst

deverticulum rupture = surgery

thought to be caused by diet lacking in fiber so high-fiber diet recommendnet

treatment for diverticulitis is antibotics, clear-liquid diet, low-residue diet to allow bowel to rest and heal, then high fiber diet to increase stool volume, reduce pressure in colon, and shorten time food is in intestine

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9
Q

irritable bowel syndrome

A

function gi disorder

gi tract not functioning properly

previously known as spastic colon or colitis

abn pain or discomfort for the last 3 months, at least 3x during those months

some indv may exp diarrhea, constipiation, mixutre of both, cramping, bloatin g

cause not welknown but may be genetics, food sensitivity, bacterial inection or overgrowht, motility issues, altered neurotransmitters, GI hormones, psych issues

treated by changes in diet, med, probiotics, therpaies for mental health

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10
Q

avoid food for IBS

A
  • foods high in fat
  • milk products
  • alc or caffeine drinks
  • drinks w large amoutns of artifical sweenters
  • beans, cabbage, other gas-producing foods
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11
Q

FODMAP Diet

A

(feremtnable oligo-, di-, mono-saccharides and polyols)

  • restirct fodos w constituents such as honey, high fructose corn syrup, fruits w pits or seeds, milk, wheat, onions, and garlic, starchy beans, and sugar alc
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12
Q

inflammatory bowel disease

A

chronic conditions causing inflammation in GI tract
- cause malabsorption that often leads to malnurition
- acute phase is irregular and are followed by symptom free preiod
- ex are ulcerative colitis and Crohns Disease

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13
Q

ulcertive colitis

A

inflammation and ulceration of the colon, rectum, and smoetmies entire large intstine

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14
Q

crohns disease

A

autoimmune disease

chronic progressive disorder that can affect both small and large intestine

ulcers can penetrate entire intestinal wall
chronic inflammation can thicken the intestinal wall causing obstruction

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15
Q

IBD symptoms

A

bloody diarrhea
cramps
fatigue
nausea
anorexia
malnutrition
wt loss

electroylte, fluids, vitamins, anod other minerals are lost in diarrhea, and bleeding can cuase loss of iron and protein

clients w crohsn are often thin and may be malnoursihed due to malabsorption of nutrients

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16
Q

treatments for IBD

A

anti-inflammatory drugs + med nutrition therapy

low-resideu diet to avoid irritating inflamed area and avoid danger of obstruction

when tolerated include abt 100g protein, addition cal, vitamins, and minerals

in severe cases total parenteral nutrition

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17
Q

ileostomy or colostomy

A

severe IBD may need stoma for defectation (size of nickel)

ileostomy if entire colon, rectum and anus msy be removed

colostomy - enterance to colon if rectum and anus are removed (temp or permanent)

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18
Q

short bowel syndrome

A

after surgical removal of small intstine (at least half) and/or dysfunction or removal of colon

patient lacks sufficient bowel length or function to support nutrient neesd

reduced intestinal lenght and decreased transit results in nutrient malabsorption and fluid losses

may need parenteral or specialized enteral formula after surgery, need food asap as nuteints from food are the most potent stimuli to foster bowel adaptation

successful adaption more liekely in pt whose colons reamin

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19
Q

treatment for short bowel syndrome

A

anti-diarrheal and anti-secretory medication + pancreatic enzumes, oral rehydration solutions and soluble fibers

larger instutuets have intesitnal rehab programs devoted to weaning idn off parenteral nutritio nand IV fluids

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20
Q

diet for short bowel syndrome

A

diet focus on six small meals per day and low fat, no concetrated swee emphasis

w ilesotaomtes hve greater need for salt and water

vitamin C and B12 supplement as well as fat-soluble vitamins

liquid or cheweable multivitmain

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21
Q

celiac disease

A

gluten-sensitive enteropathy or sprue

chronic autoimmune disorder caused by interolanerce to gluten (protein wheat, barley and rye)

produce antibodies that attack intestine when they ingest gluten

1/3 ppl have genes for celiac but unknown environemntal factors determine who get celiac dsease or glyen sensitivity

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22
Q

celiac disease symptoms

A

diarrhea
constpiation
wt loss or gain
abd cramping and bloating
malnutrition
joint pain
anemia
fatigue

growht compromised in children with untreated celiac

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23
Q

1 in ___ americans have celiac

A

133

24
Q

celiac is _____ as common as crohns, ulcerticatives colitis, and CF. ombined and -__$ celiac indv remain undaginosed or misdaginsed

A

twice

83

25
Q

_____ year lapse before celiac diagnosis

A

6 to 10 year

26
Q

celiac diagnosis and treatment

A

celiac panel - blood tests that measure immune response to gluten which nust be done prior to start of glutenfree diet

biopsy of intestine

strict-gluten free diet

27
Q

—% of pop are neg for celiac but have gluten sensitivty

A

6%

28
Q

how to assess non celiac gluten intolerance

A

trial of 2 to 3 weeks of gluten free diet (elimination) and challenge of returningback to gluten

then monitor synmptoms

non-celiac gluten sensitivity dont have damange to intestinal villi compared to someone w celiac disease

29
Q

gluten-containing grains to avoid

A

barley (malt extract, beer, and ale), rye, wheat (all wheat flours and products made w wheat, bran, germ, starch), spelt, triticale, and farro

30
Q

gluten free grains and starches

A

rice
wild rice
millet
amaranth
arrowroot
corn
flax
buckwheat
soy
teff
flours made from ntus, beans, seeds, potato, tapioca, and sorghum

31
Q

most nutritious high giber gluten-free grains

A

brown rice
wild rice
quinoa
amaranth
buckwheat
gluten-free steel cut oats
rice bran

32
Q

liver function

A

all nutrients expect for a few fatty acids are absorbed in intestines and transported to liver

liver then dismantles some of nutrients, stores others, anuses some to synthesize other substances

liver determine where amino acids are needed, synthesizes some proteins, enzymes, and uera

changes simple sugars to glycogen, provides glucse to body cells, sythesizes glucose from anio acids if needed

converts fats to lipoproteins and syhtesizes cholesterol

stores iron, copper, zinc, mangeiusm, fati-soluble vitmains, and b viitamin

synehzies bile

detoxifies many substances such as barbiturates and morphine

33
Q

cirrhosis

A

general term for all liver disease characteriszed by cell loss

alc abuse is most common cause but could also be congential defects, infections, or other otxic chemicals

replacement does not match loss of cells in cirrhosis

also has fatty infilatration and fibrosis

blood flow thorugh liver is upset, form of phyertension, anemia, and hemorrhage

34
Q

dietary treatment of cirrhosis

A

25-35 cal or more + 0.8-1g of protein per kg

if hepatic coma is imminent then lower amt

supplements of vitmains and minerals

advanced chirrhosis: 50-60% of call from carb

in some cirrhosis fat is not tolerated well so restricted

if protein not toelrated well its restricted to 35-40g a day

cirrhosis can cuase ascites

sodium and fluids may be restricted

fluid may be restircted if bleeding in esophagus

smaller feedings

no alc

35
Q

hepatitis

A

inflammation of the liver

caused viruses or toxic agents sucha sdrugs and alc

necrosis

in mild cases cells can be replaced, in severe cases damage is extensive and then lver failure and dath and bile stasis, decreased blood albumin level,s nausea, heachae, fever, fatigue, tender and enerlaged liver, anorexia, and handice, wt loss

36
Q

types of hepatitis

A

hep A: contaminatd drinking water, food, and sweage vita fecal-oral route

hep B and hep C: blood, blood products, semen and salivia (Hep b and C can lead to chronic active hep (CAH))

CAH can lead to liver failure and end stage liver disease

37
Q

treatment for hepatitsi

A

bed rest
plenty of fluids
med nutriton therapy
35-40 g cal per kg
most of cal from carb, mod fat, and 70-80g protein if necrosis no severe

limit protein if necrosis is not severe

smal lfrequent meals

clients w liver disease requre a great deal of encouargement bc anorexia and conseuqnet feelings of general malaise can be severe

recovery take patience rest and time

38
Q

cholecystitis and cholelithiasis

A

may inhibits flow of bile and cause pain

cholecystitis can cuase changes in gallbladder tissue which in turns affect cholesterol, causing it to harden and form stones

thought chronic overindulgence in fats may contribute to gallstones bc fat stmiaultes liver to prodcue more cholesterol for bile which is necessary for digestion of fat

39
Q

etiology of gallbladder disease

A

heredity factors

women develop gallbladder disease more oftne than men

boesity, TPN, very-low-cal diet for rapid wt loss, use of estrogen, various small intestien disease

40
Q

function of gallbalder

A

dual function of gallbladder is concentration and storage of bile

gallbaldder contecntates ble formed in liver

fat in duodenum triggers gallbladder to cntract and release bile in common duct

41
Q

symptoms and treatment for gallbladder inflammation and sotnes

A

symtpoms: pain, indgiestion, vomiting (particularly after ingestion of fatty foods)

treatment - mediciatio nto dissolve stones, diet therapy, cholescystectomy

42
Q

med nutritoin therapy for gallbladder stones

A

clear-liquid diet

rgular but fat-restircted diet (40-45g fat daily)

chronic cases: fat restricted on permanent basis

wt loss if obsese

water-misicle forms of fat-soluble vitmaisnp

43
Q

pancreas function

A

prodcues insulin and other hormones and enzymes essnetial to digetion of protein, fats, and carbs

44
Q

pancreatitis

A

inflammation of pancrease

caused by infection, surgery, alcholism, biliary tract disease pr certain drugs

45
Q

symptoms of pancreatitis

A

abd pain, nausea, steatorrhea

malabsopriton of fat-solube vitmains

wt loss

if islet of Langerhans are destroyed, diabetes mellitus

46
Q

diet therapy for pancreatitis

A

protein and HCL stimualte pancrease thus during acute pancreatitis client is noursihed stricly parenterally

later liquid diet of mainly carb

then small ,fdreuqnt feedings of carbs and proteins w little fat or fiber bc deficiency of pancreatic lipase

vitamin supplements

47
Q

residue controlled diets

A

dietary fib er is mostly found in plant foods

resude is solid part of feces

reside made up of all undigested and unabsorbed parts of food, connective tissue in animal foods, dead cells, and inestinal bacteria and prodcts (mostly fiber)

diets can be adjusted to increae or decrease fiber and residue

48
Q

high fiber diet

A

30g or more

bleieved to help prevent diverticulosis, constipation, hemorrhoids, and colon cancer

helpful in treatment of diabetes mellitus and athersclerosis

normal diet in US contains about 15g of dietary fiber, rec is for 38g men and 25g women byt not to exceed 50g

intrudce gradually

8 8-oz glasses of water must also be consumed

49
Q

recommendent foods for high fiber diet

A

coarse and hwole grain breads and cerea;s

bran

all fruits and veg (esp raw) and legumes

50
Q

low residue diet

A

5-10 g ietary fiber to reduce normal work of interstines by reduced amt of dietary fiber and thus residue

may be used in cases of severe diarrhea, diverticultisi, ulcerative colitis, and intestinal blockage and in prep for and immeiatley after instential surgery

no more than 3g of fiber in some facitlirs

51
Q

diarrhea

A

frequent expulsion of watery feces

causes food to move through the digestive system too quickly for nutrients to be fully absorbed + loss of liquid

may be caused by Food sensitivity, harmful bacteria, and stress

52
Q

constipation

A
  • chyme moves v slow hrough large intestine so too much water is absorbed
  • feces become hard,bowel movement becomes painful
  • excess straining can lead to hemorrhoids
  • caused by erratic eating habits, low fiber, lack of physical activity, too little water, ignoring bowel movements
53
Q

indigestion

A
  • abd discomfort after eating and relates to difficulty digesting food
  • caused by stress, eating too fast or much, particular foods
  • symptoms include gas, stomach cramps, nausea
54
Q

heartburn

A

burning sensation in middle of chest

caused by stomach acid into esophagus; aka reflux

prevent by avoiding certain foods or drinks, decrease fatty and spicy food intake, small frequent meals > large meals, no eating several hours before bed

55
Q
A

nutrition (21 decks)

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