Chapter 27: Medical Nutrition Therapy for Lower Gastrointestinal Tract Disorders Flashcards
aerophagia
Swallowed air
eructation
Belching
flatus
Gas in or from the stomach or intestines, produced by swallowing air or by bacterial fermentation
flatulence
Excessive gas
constipation
Difficulty with defecation characterized by infrequent bowel movements or painful, hard, or incomplete evacuations
primary constipation
Caused by physical or functional problems when no underlying disorder can be identified. Also known as idiopathic or functional constipation
stool softeners
Anionic surfactants with an emulsifying detergent-like property that increases the water content in stool to make bowel movements easier to pass
osmotic agents
Magnesium hydroxide, sorbitol, lactulose, and polyethylene glycol contain poorly absorbed or nonabsorbable sugars and work by pulling fluid into the intestinal lumen
stimulant laxatives
Increase peristaltic contraction and bowel motility and act to prevent water absorption
neurogenic bowel
A type of bowel dysfunction caused by nerve malfunction after spinal cord injury or nerve diseases including but not limited to multiple sclerosis (MS), or amyotrophic lateral sclerosis (ALS) that damage nerves associated with controlling the lower colon
dietary fiber
Edible plant material not digested by the enzymes in the GI tract and is categorized as soluble or insoluble
soluble fiber
Forms a gel, acting to slow digestion and does not generally have a laxative effect
insoluble fiber
Absorbs water to add bulk to stool and accelerate fecal transit through the intestines
high-fiber diet
A high-fiber therapeutic diet may have to exceed 25 to 38 g/day
diarrhea
As the passage of three or more loose or liquid stools per day. Diarrhea occurs when there is accelerated transit of intestinal contents through the small intestine, decreased enzymatic digestion of foodstuffs, decreased absorption of fluid and nutrients, increased secretion of fluids into the GI tract, or exudative losses
steatorrhea
Excess fat in the stool
microbiota
The human intestinal tract is home for trillions of bacteria microbiota
antibiotic-associated diarrhea (AAD)
Refers to passing loose, watery stools three or more times a day after taking medications used to treat bacterial infections (antibiotics)
Clostridium Difficile (C. Difficile) infection (CDI)
C. difficile is a spore-forming organism, and the spores are resistant to common disinfectant agents. The spore-forming C. difficile allows the organism to spread inadvertently to other patients by health care providers if strict infection control procedures are not followed
fecal microbiota transplant (FMT)
The gut microbiota of the person with C. difficile is replaced with healthy donor stool, typically from a family member with similar dietary and living habits
syntiotics
Products that combine probiotic microorganisms and a prebiotic fiber source
probiotic
A live nonpathogenic organism (bacteria or yeast) which when administered in adequate amounts confer a health benefit on the host
prebiotic
A selectively fermented ingredient that allows specific changes, both in the composition and activity in the gut microbiota, that confer benefits upon host well-being and health
short-chain fatty acids (SCFAs)
In physiologic quantities serve as a substrate for colonocytes, facilitate the absorption or fluid and salts, and may help to regulate GI motility
oral rehydration solution (ORS)
The standard WHO-recommended ORS historically had an osmolarity of 311 mOsm/L and contained specific concentrations of sodium (90 mEq), potassium (20 mEq/L), chloride (80 mEq/L), and glucose (20 g/L)
celiac disease (CD)
A disease in which the small intestine is hypersensitive to gluten, leading to difficulty in digesting food
dermatitis herpetiformis
Another manifestation of CD, presents as an itchy skin rash; its presence is diagnostic of CD
gluten-sensitive enteropathy
Another name of Celiac Disease. Characterized by a combination of four factors: 1. genetic susceptibility, 2. exposure to gluten, 3. an environmental “trigger”, and 4. an autoimmune response
gluten
Refers to a specific peptide fractions of proteins (prolamins) found in wheat (glutenin and gliadin), rye (secalin), and barley (hordein)
gluten sensitivity
Used commonly to describe persons with nonspecific symptoms, without the immune response characteristic of CD or the consequential intestinal damage
gluten intolerance
Also called nonceliac gluten sensitivity, describes individuals who have symptoms after ingesting gluten-containing foods. Symptoms may be isolated in the gastrointestinal tract such as nausea, abdominal cramps, or diarrhea; or may be extraintestinal in nature such as brain fog or generalized pain
refractory celiac disease
When patients do not respond or respond only temporarily to a gluten-free diet, and all external causes have been ruled out, including inadvertent gluten ingestion
tropical sprue
An acquired diarrheal syndrome with malabsorption that occurs in many tropical areas. In addition to diarrhea and malabsorption, anorexia, abdominal distention, and nutritional deficiency as evidenced by night blindness, glossitis, stomatitis, cheilosis, pallor, and edema can occur
lactose intolerance
The syndrome of diarrhea, abdominal pain, flatulence, or bloating occurring after lactose consumption
hypolactasia
The decline of lactase
fructose malabsorption
The malabsorption of fructose. Although it is common in healthy people, its appearance depends on the amount of fructose ingested
inflammatory bowel disease (IBD)
A chronic and relapsing disorder of the gastrointestinal tract. It is characterized by chronic intestinal inflammation and is categorized into two major forms as either Crohn’s disease or ulcerative colitis (UC)
Crohn’s disease
A form of inflammatory bowel disease (IBD). Crohn’s disease is characterized by abscesses, fistulas, fibrosis, submucosal thickening, localized strictures, narrowed segments of bowel, and partial or complete obstruction of the intestinal lumen
ulcerative colitis
A form of inflammatory bowel disease (IBD). Causes inflammation and ulcers (sores) in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine (colon) and rectum. Symptoms usually develop over time, rather than suddenly.
microscopic colitis
Characterized by inflammation that is not visible by inspection of the colon during colonoscopy and is apparent only when the colon’s lining is biopsied and then examined under a microscope
lymphocytic colitis
An accumulation of lymphocytes within the lining of the colon
collagenous colitis
A layer of collagen (scar tissue) just below the lining of the colon
irritable bowel syndrome (IBS)
A functional gastrointestinal disorder defined as “abdominal discomfort associated with altered bowel habits”
Rome IV criteria
Used to define the diagnosis of IBS based on the presence of GI symptoms
FODMAPs
Fermentable oligo, di, & monosaccharides and polyols
diverticulosis
Characterized by the formation of sac-like outpouchings or pockets (diverticula) within the colon that form when colonic mucosa and submucosa herniate through weakened areas in the muscle
diverticulitis
A complication of diverticulosis that indicates inflammation of one or more of the diverticulum. It often represents a flare-up of diverticulosis, and after it subsides into a period of remission, it reverts to the state of diverticulosis
short-bowel syndrome (SBS)
Defined as an inadequate absorptive capacity resulting from reduced length or decreased functional bowel after resection. A loss of 70% to 75% of small bowel usually results in SBS, defined as 100 to 120 cm of small bowel without a colon, or 50 cm of small bowel with the colon remaining
small intestinal bacterial overgrowth (SIBO)
A syndrome characterized by overproliferation of bacteria normally found in the large intestine within the small intestine
fistula
An abnormal passage of an organ to another organ, skin, or wound
enterocutaneous fistula (ECF)
An abnormal passage from a portion of the intestinal tract to the skin or to a wound
ostomy
Refers to a mouth or opening
intestinal ostomy
A surgically created opening between the intestinal tract and the skin and is specifically named according to the site of origin along the intestinal tract
loop ostomy
Formed when a loop of bowel is brought up to the skin, and an incision is made on one side. The distal end is sutured to the skin, whereas the proximal side of the loop is everted back on itself. The result is a stoma with two openings; the proximal (functional) limb from which the effluent or stool is discharged, and the distal limb, which may connect to the anus and secrete mucus
end ostomy
Created when the bowel is cut and the end is brought through the skin to create the stoma
colostomy
A surgically created opening from the colon to the skin when a portion of the large intestine is removed or bypassed
ileostomy
A surgically created opening from the distal small bowel to the skin when the entire colon, rectum, and anus are removed or bypassed
high-output stoma (HOS)
Output that exceeds 2000 mL/day over 3 consecutive days, at which point water, sodium, and magnesium depletion are expected
proctolocolectomy
A surgery to remove all of the colon (large intestine) and rectum
ileal pouch anal anastomosis (IPAA)
Creation of a reservoir using a portion of the distal ileum. This pouch is then reconnected to the preserved anal canal in which the diseased mucosa has been removed, thus maintaining continence and voluntary function
ileal J-pouch
Uses two limbs of bowel to create a J-shaped reservoir out of the patient’s own small intestine. It is the preferred pouch because of the efficiency of construction and optimal functional results by allowing a more normal route of defecation
S-pouch
Three limbed pouch. An alternative to the J-pouch. Rarely performed due to the complexity of construction
W-pouch
Four limbed pouch. An alternative to the J-pouch. Rarely performed due to the complexity of construction
Koh pouch
A type of appliance-less ileostomy that uses an internal reservoir with a one-way valve, constructed from a loop of intestine that is attached to the abdominal wall with a skin-level stoma
pouchitis
A nonspecific inflammation of the mucosal tissue forming the ileal pouch and is the most frequent long-term complication of IPAA in patients with UC
