Disorders of the Lower GI Tract Flashcards
Diarrhea
passage of frequent, watery stool
Secretory Diarrhea
secretion of fluid exceeds the amount that can be re-absorbed
causes: bacterial food poisoning
bacteria affects the re-absorption of water
Osmotic Diarrhea
unabsorbed material attracts water to the colon
Causes: Lactose deficiency, ingestion of laxatives
Intractable Diarrhea
chronic, does not respond to treatment
What is the treatment for Diarrhea?
1st: fluid and electrolyte replacement
low fiber
lactose free
Fat Malabsorption
Cause:
-interference with the production of either bile or pancreatic lipase
unabsorbed fatty acids binds with minerals to form “soap”
causes Steatorrhea
What is Soap?
the chemical component formed when unabsorbed fatty acids bind with minerals
What is Steatorrhea?
excessive fat in stool (Stool floats)
What are the S/S of Fat Malabsorption?
loss of energy, fatty acids, fat-soluble vitamins, minerals, bone disease, kidney stones (high oxalate absorption)
*Fat is nutrient dense so they wont be getting a lot of nutrients
What dietary adjustments need to be made for Fat Malabsorption patients?
high calorie (protein)
MCT (medium-chain triglycerides : these are short chain fatty acids, b/c long chain triglycerides are the ones that require bile to be digested)
What does bile do?
emulsifies fat so digestive enzymes can do their job and nutrients can be absorbed
How does Fat Malabsorption contribute to kidney stone production?
in a normal healthy condition:
oxalate binds with calcium —> calcium oxalate (excreted with stools)
with fat Malabsorption:
fatty acids bind with calcium… oxalate cannot bind with calcium and is reabsorbed into the blood and filtered in the kidney…which attributes to kidney stone formation
What is pancreatitis?
inflammation of the pancreas
damage to the pancreatic tissue will release pancreatic enzymes causing the pancreas to self digest itself
may last few days, weeks or months
may be acute or chronic
What are the S/S of pancreatitis?
pain, vomiting, Steatorrhea (pancreatitis leads to fat Malabsorption), weight loss
What are the causes of pancreatitis?
gallstones, excessive alcohol consumption, exposure to toxin, cancer
What are the nutritional recommendations for patients with pancreatitis?
replacement of fluid and electrolytes
progressive diet: low fat, high protein, small meal, pancreatic enzyme replacement (chronic cases)
What is Cystic Fibrosis?
GENETIC disorder: the most common life-threatening disorder among Caucasians (1 in 2000 to 1 in 3000)
production of THICK MUCUS clogs lungs and pancreas
What will Cystic Fibrosis eventually lead to?
LUNG DISEASE: obstructions in small airways, labored breathing, chronic coughing, respiratory infections
PANCREATIC DISEASE: accumulation of digestive enzyme in the pancreas, Malabsorption, pancreatitis, hyperglycemia, diabetes
-pancreatic duct is clogged with mucus
What are the diet requirements for Cystic Fibrosis patients?
high calorie/high protein diet, frequent meals, extra vitamins, minerals (Ca and Na), pancreatic enzyme replacement
What is Celiac Disease?
abnormal immune response to a protein fraction in wheat gluten
shrinking of the intestinal cells (surface area isn’t as large and nutrient absorption is effected)
Malabsorption of macronutrients, fat-soluble vitamins, electrolytes, calcium, magnesium, zinc, iron, folate, and vitamin B12
What are the S/S of Celiac Disease?
diarrhea, Steatorrhea, flatulence, lactase deficiency, stunted growth, underweight
What considerations do those with Celiac Disease have to take?
removal of wheat, oats, rye and barley from diet
READ LABELS CAREFULLY b/c gluten may not be listed but other components/ingredients may contain gluten
What are the two types of inflammatory bowel disease?
Crohn’s and Ulcerative Colitis
Crohn’s Disease
inflammation along the GI tract: mostly ileum and colon but can be anywhere in the GI tract
What are the S/S of Crohn’s Disease?
diarrhea, abdominal pain, weight loss
What are the complications of Crohn’s disease?
MALNUTRITION: Malabsorption of fat, fat-soluble vitamins, Ca, Mg, Zn, vitamin B12
Anemia
Anorexia
Increased risk of cancer in small intestine
What are the dietary recommendations for Crohn’s Disease?
high calorie, high protein, low fat (fat is mostly absorbed in the intestines, inflammation effects absorption), low fiber, low lactose, small and frequent meals
What is Ulcerative Colitis?
inflammation starts in the rectum and expands to the colon, usually ulcer development occurs
serious when accompanies with rectal bleeding
What are the S/S of Ulcerative Colitis?
diarrhea, rectal bleeding, abdominal pain
What are the complications of Ulcerative Colitis?
weight loss, fever, weakness, anemia, dehydration, fluid and electrolyte imbalances, protein losses, high risk of developing colon cancer
What are the dietary recommendations for Ulcerative Colitis?
fluid and electrolyte replacement
high protein, low fat, low fiber diet
correction of deficiencies due to protein and blood losses
What is Short Bowel Syndrome?
a group of problems related to poor absorption of nutrients that typically occurs in people who have had half or more of their small intestines removed
When part of the small intestines has been resected (removed), the remaining will lengthen and thicken. Malabsorption occurs when absorptive capacity of the remaining intestine is insufficient for meeting nutritional needs.
What is Intestinal Adaptation?
the remaining intestines lengthens and thickens
-having part of the small intestines resected doesn’t always lead to Malabsorption because of this
Does the ileum of jejunum have a greater capacity for adaptation?
ileum
What are the S/S of Short Bowel Syndrome?
diarrhea, Steatorrhea, dehydration, weight loss, hypocalcemia (low blood Ca), hypomagnesemia (low blood Mg), anemia
What is a Colectomy?
removal of large intestine
will have a reduction in fluid and electrolyte absorption
What is the suggested diet changes for Short Bowel Syndrome?
high calorie, high calorie, high complex carbohydrate, extra vitamin and minerals, low fat, low oxalate
What is Irritable Bowel Syndrome?
MOTILITY disorder of small and large intestine
chronic recurring intestinal symptoms :
-indigestion, nausea, cramps, gas, diarrhea, constipation, flatulence
worsened by:
-stress, anxiety, possible infection
May be worsened by or onset by:
-antidepressants, antidiarrheal agents, laxatives
How to manage IBS…
small frequent meals, high fiber low fat diet, adequate fluid intake, avoid alcohol and caffeine, eat slowly
Why do you want to avoid alcohol and caffeine with IBS?
because an increase or decrease in blood pressure may worsen IBS
Ileostomy
stoma in the ileum, removal of entire colon, rectum and anus
stools: liquid - water not being absorbed (food does not go through any large intestines which is where water is absorbed)
Colostomy
stoma in the colon, removal of part of large intestine, rectum and anus
stools: depends on where/ semi-solid to solid. some absorption b/c some of large intestine is being used
Ostomy
surgical opening (stoma) in the abdominal wall
purpose:
removal of dietary waste (stool)
2 types : ileostomy and colostomy
Stool consistency vary depending on location of ostomy
