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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
what foods to avoid for GERD, dyspepsia, amd PUD
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
Lifestyle modifications for GERD
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
foods high in non-digestible fiber that promote the growth of beneficial gut bacteria
Prebiotics
28
food containing live commensal organisms (bacteria or yeast) associated with health benefits
Probiotics
29
what are the 4 common strains of Probiotics
1. Lactobacillus 2. Bifidobacterium 3. Saccharomyces 4. non-pathogenic strains of E. coli
30
which probiotic strain is often seen in fermented dairy products
lactobacilli
31
which probiotic strain growth is encouraged by fructo-oligosaccharide, which are found in prebiotic foods
bifidobacterium
32
8 common prebiotics
1.onion 2. soy bean 3. asparagus 4. bananas 5. leek 6. bread 7. artichoke 8. garlic
33
8 common probiotics
1. aged cheese 2. bitter chocoalte 3. kefir 4. sour cream 5. miso soup 6. pickles 7. probiotic milk 8. yogurt
34
Constipation is a symptom-based disorder characterized by one or more of the following:
Infrequent stools Hard stools Difficult stool passage
35
constipation may be associated with other complications, including
hemorrhoids, diverticulosis, or anal fissures
36
nutritional management of constipation
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
what fruit contains the compound sorbitol May be associated with increased gas and bloating
prunes
38
what are the 4 fiber additives
dextrin, methylcellulose, psyllium, calcium polycarbophil 1. Variable response, can be costly 2. Less additional benefits than fruits/vegetables
39
SE of fiber additives
gas, bloating, flatulence, abdominal pain
40
Even with adequate fiber intake (30+ g/day) but poor hydration status, what can happen?
constipation symptoms Fiber increases stool bulk by absorbing water
41
what is the goal fluid intake
1.5-2L/day
42
what is diarrhea
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
acute diarrhea is usually __
infectious
44
nutritional management for acute diarrhea
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 2. Probiotics may help - Often recommended prophylactically with abx
45
nutritional management for chronic diarrhea
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
causes of chronic diarrhea
infectious, medication-related, inflammatory, food intolerance, pancreatic disorders

nutrition (12 decks)

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