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nutrition > Diet and GI disorders > Flashcards

Diet and GI disorders Flashcards

1
Q

chronic allergic inflammatory condition, with eosinophilic infiltration of the lining of the esophagus

A

Eosinophilic Esophagitis (EoE)

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2
Q

what condition Can result in long-term damage including scarring and strictures

A

Eosinophilic Esophagitis (EoE)

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3
Q

Eosinophilic Esophagitis (EoE) is characterized by what that may result in food impaction, inability to eat, reflux

A

odynophagia or dysphagia

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4
Q

dietary modifications for EoE

A
  1. Removing allergy-causing foods
  2. SFED - Six-Food Elimination Diet
  3. Elemental Diet - Nutrient-rich amino
    acid formulas
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5
Q

what is the Six-Food Elimination Diet (SFED)

A

Diet based on removing the six most common allergy-causing foods:
Milk, wheat, eggs, soy, peanuts/tree nuts, fish/shellfish

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6
Q

what is the less aggressive approach of the SFED

A

(4 foods, 2 foods)
Eliminating cow’s milk alone has slightly lower
success rates but better quality of life and adherence

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7
Q

Diet based on nutrient-enriched amino acid formulas

A

Elemental Diet

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8
Q

Amino acids mixed with what/

A

sugars, fats, minerals and vitamins

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9
Q

amino acids are meant to do what and meet nutritional needs?

A

replace table food

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10
Q

the elemental diet is implemented more in who with EoE

A

children > adults

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11
Q

how can SFED improve disease process in pts

A

Histologic response in 69% of patients
Symptom response in 87% of patients

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12
Q

how can the elemental diet improve the disease process in pts?

A
  1. Histologic response in 95% of patients
    - Complete histologic response in 71%
  2. Symptom response in 100% of patients
    - Asymptomatic status in 88%
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13
Q

disorder characterized by recurrent retrograde
acid reflux into the esophagus

A

Gastroesophageal Reflux Disease (GERD)

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14
Q

GERD is often accompanied by what symptoms

A

Burning pain, often shortly after eating
Difficulty swallowing
Regurgitation of food

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15
Q

GERD can result in long-term damage to what?

A

esophagus

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16
Q

EoE can be treated with what interventions

A
  1. meds
  2. diet
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17
Q

GERD can be treated with what interventions

A
  1. lifestyle changes
  2. meds
  3. diet changes
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18
Q

chronic, recurring upper abdominal discomfort

A

Dyspepsia

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19
Q

Symptom, rather than diagnosis, but patients can be diagnosed with ____ if no other cause of symptoms found

A

functional dyspepsia

20
Q

dyspepsia can manifest as what other symptoms

A

burning pain, bloating, early satiety, gassiness, nausea

21
Q

characterized by open sores (ulcers) that form on the mucosal membrane of the stomach or duodenum

A

Peptic Ulcer Disease

22
Q

3 causes that can contribute to peptic ulcer disease

A

NSAID use
H. pylori
gastrinomas

23
Q

peptic ulcer disease may be treated with:

A

Medication
Surgery
Diet changes

24
Q

marco recommendations for GERD, dyspepsia, and PUD

A
  1. Carbs - avoidance of simple carbs and increase of fiber
    - Diets like the Mediterranean Diet have been associated with GI symptom improvement
  2. Protein - no major literature for or against certain types
  3. Fats - High-fat and fried foods may trigger symptoms
25
Q

what foods to avoid for GERD, dyspepsia, amd PUD

A
  1. Vary from patient to patient
  2. Acidic Foods - Tomato-based foods, citrus foods, carbonated beverages
  3. Spicy Foods - capsaicin-related
  4. Gastric Irritants - coffee, tea, tobacco, alcohol, peppermint
  5. Others - fried or fatty foods, large meals, chocolate
  6. Alcohol - may increase likelihood of peptic ulcer formation
    - Greatest risk of ulcer formation in patients who have heavy consumption
    - May also irritate stomach, increasing symptoms in GERD/Dyspepsia/PUD
  7. Dairy - Fermented dairy products associated with lower PUD risk
    - Thought to be secondary to Lactobacillus or Bifidobacterium cultures often found in fermented dairy products
  8. CAM/Herbals - mixed evidence for curcumin, ginger, and peppermint oil/caraway oil to relieve GI symptoms
26
Q

Lifestyle modifications for GERD

A

Small, frequent meals
Avoiding laying down flat after eating
Elevating the head of the bed
Quitting use of tobacco, alcohol, caffeine
Avoiding tight clothing
Weight loss of 10% or more

27
Q

foods high in non-digestible fiber that promote the growth of beneficial gut bacteria

A

Prebiotics

28
Q

food containing live commensal organisms (bacteria or yeast) associated with health benefits

A

Probiotics

29
Q

what are the 4 common strains of Probiotics

A
  1. Lactobacillus
  2. Bifidobacterium
  3. Saccharomyces
  4. non-pathogenic strains of E. coli
30
Q

which probiotic strain is often seen in fermented dairy products

A

lactobacilli

31
Q

which probiotic strain growth is encouraged by fructo-oligosaccharide, which are found in prebiotic foods

A

bifidobacterium

32
Q

8 common prebiotics

A

1.onion
2. soy bean
3. asparagus
4. bananas
5. leek
6. bread
7. artichoke
8. garlic

33
Q

8 common probiotics

A
  1. aged cheese
  2. bitter chocoalte
  3. kefir
  4. sour cream
  5. miso soup
  6. pickles
  7. probiotic milk
  8. yogurt
34
Q

Constipation is a symptom-based disorder characterized by one or more of the following:

A

Infrequent stools
Hard stools
Difficult stool passage

35
Q

constipation may be associated with other complications, including

A

hemorrhoids, diverticulosis, or anal fissures

36
Q

nutritional management of constipation

A
  1. Increasing fiber intake
    - Goal of 30 g/day or more
    - Emphasis on fruit and vegetable fiber
    - Dried fruits are considered an excellent source of fiber
    - Can also choose things like bran cereals, whole grain products
    - Fiber additives
    - adequate hydration status
    - Physical activity - may help promote GI peristalsis
    - Probiotics - not strongly backed by evidence
37
Q

what fruit contains the compound sorbitol
May be associated with increased gas and bloating

A

prunes

38
Q

what are the 4 fiber additives

A

dextrin, methylcellulose, psyllium, calcium polycarbophil
1. Variable response, can be costly
2. Less additional benefits than fruits/vegetables

39
Q

SE of fiber additives

A

gas, bloating, flatulence, abdominal pain

40
Q

Even with adequate fiber intake (30+ g/day) but poor hydration status, what can happen?

A

constipation symptoms
Fiber increases stool bulk by absorbing water

41
Q

what is the goal fluid intake

A

1.5-2L/day

42
Q

what is diarrhea

A

3 or more loose, watery stools per day
- Numerous causes - infection, inflammation, altered neurohormonal signals, altered GI secretions
- Chronic - if greater than 4 weeks

43
Q

acute diarrhea is usually __

A

infectious

44
Q

nutritional management for acute diarrhea

A
  1. Maintaining hydration with electrolyte-rich fluids
  2. BRAT(Y) Diet - easy-to-digest, less acidic foods that result in fewer bowel movements
    - Bananas, Rice, Applesauce, Toast
    - +/- Yogurt
    - If yogurt used–should have active cultures, no added sugars or artificial sweeteners
    - Not for long-term - nutritionally incomplete
  3. Probiotics may help
    - Often recommended prophylactically with abx
45
Q

nutritional management for chronic diarrhea

A
  1. Recommended to trial a low-FODMAP diet
    - Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols
    — causes gas, bloating, and abdominal pain
    — Includes sugar alcohols, wheat, milk, several fruits and veggies
    - Temporary remove foods and gradually re-introduced to see which foods are tolerated
    — avoid artificial sweeteners long-term
  2. Probiotics - weak/limited evidence
46
Q

causes of chronic diarrhea

A

infectious, medication-related, inflammatory, food intolerance, pancreatic disorders

nutrition (12 decks)

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