exam 3: GI tract disorders Flashcards
clear liquids are
broth and tea
____ can cause diarrhea after a GI infection
lactose
mechanical soft diet can be used for a pt with ________ ________
missing teeth
mechanical soft diet
foods are liquid, chopped, tender or cooked
______ foods better tolerated with mouth ulcer
cool
cool foods examples (2)
yogurt
ice cream
_______ and _______ can cause reduced saliva
- radiation
- Sjogrens syndrome
pts with reduced saliva are at greater risk for ______ and ________
- dental decay
- periodontal disease
pudding thick liquid
- thickest
- holds its own shape
honey thick
drizzles from cup or bowl
nectar thick
- thinnest
- easily pourable
stage 1 solids
- pureed
- for pts with greatest difficulty swallowing
stage 2 solids
- ground, moist, soft textured
- easily chewed
stage 3 solids
-moist, bite sized
stage 4 solids
regular diet
foods that are difficult to swallow (2)
- peas
- peanut butter
fiber DRI for women
about 25 grams a day
fiber DRI for men
about 38 grams a day
foods that promote gas production
- carbonated beverages
- cruciferous veggies (broccoli, cauliflower)
- onions, garlic
- beer
- apples
- excess of fruit juice
foods that reduce colostomy odor(4)
- yogurt
- buttermilk
- parsley
- cranberry juice
endoscopy or biopsy of intestines looks at the ______ _______ to determine if someone is malnourished
-absorptive surface
test for lactose intolerance
hydrogen breath test
test for fat malabsorption
-fecal fat measurement
test for vitamin b12 malabsorption
-schilling test
gastric bypass can cause ______ _____
dumping syndrome
results of gastric bypass:
reduced _____ ____ and reduced absorption of ______
- stomach volume
- some nutrients
what is gastric banding?
- adjustable band around top of stomach, creating a small pouch
is there more weight loss with gastric banding or gastric bypass?
gastric bypass
in lactose intolerance, pts lack ______ in intestines, so they are unable to break down _____
- lactase
- lactose
what cultures is lactose intolerance most common?
- asians
- african americans
- native americans
- latinos
- Ashwakanazi Jews
most _____ _____ and ______ is fairly well tolerated in people with lactose intolerance
- aged cheese
- yogurt with active cultures
dysphagia causes
- aging
- nervous system diseases
- developemental disabilities
- stroke
how is dysphasia diagnosed?
- xray
- fluoroscopy
- measurement of sphincter pressure and peristalsis
______ placement is preferred to ______ placement when using tube feeds with a pt with dysphagia
- intestinal
- gastric
intestinal placement is preferred to gastric placement in pts with dysphagia to prevent ______ _______
aspiration pneumonia
another word for indigestion
dypepsia
GERD causes
- frequent heartburn
- ascites
- pregnancy
- asthma
- peptic ulcers
- IBS
esophagus becomes ______ and ______ with GERD
- narrowed
- scarred
GERD often caused by _____ ______bc the sphincter protrudes up through the diaphragm
-hiatal hernia
antacids for gerd
- proton pump inhibitor- prilosec
- histamine 2 receptor blocker –pepcid
what do antisecretory meds do?
-suppress gastric secretions
what do cholingeric meds do?
strengthen cardiac sphincter pressure
acute gastritis causes
- overuse of aspirin
- alcohol abuse
- food poisining
- radiation
- bacterial infection
- metabolic stress
chronic gastritis common in _____
seniors
chronic gastritis causes
- gastric surgery
- diseases of stomach or liver
- h pylori
- aging
what 2 deficiencies can develop with chronic gastritis?
- vitamin b12
- iron
_____ _____ is erosion of top layer of cells
peptic ulcer
peptic ulcer is _____ of top layer of _____
- erosion
- cells
ulcers:
underlying cells exposed to ______ _____
gastric juices
causes of ulcers
- h pylori
- anti inflammatory meds
- disorders that increase gastric secretions
disorder that increases gastric acid secretion
Zollinger Ellison syndrome (pancreatic tumor)
______ ______ worsens ulcers
cigarette smoking
diets rich in _____ from _____ and ____ seems to help prevent duodenal ulcers
- fiber
- fruits and veggies
insoluble fiber:
adds ____ to stool
bulk
insoluble fiber:
increases _____ ______
GI transit
insoluble fiber:
_____ bowels
stimulates
insoluble fiber helps with ______
constipation
soluble fiber delays ____ ______
GI transit
soluble fiber is good for pts with ______
diarrhea
high fiber diets used in pts with
- diabetes
- cardiovascular disease
- diverticulosis
- irritable bowel
- chrons in remission
which sugar alcohols cause gas?
- sorbitol
- manitol
_____ can cause gas and bloating
fructose
low fiber diets used for
- diverticulitis
- active chrons
high soluble fiber, low insoluble diet used for
- diarrhea
- IBS
diet for delayed gastric emptying
low fiber, low fat
_____ _____ can cause delayed gastric emptying
-diabetic neuropathy
______ is a gut stimulant
caffeine
eat foods with _____ when experiencing diarrhea to replenish bacteria in gut
probiotics
IBS aggravated by ______
stress
foods to avoid with IBS
- lactose
- fatty foods
- gas forming foods
- caffeine
- alcohol
- fructose
- sorbitol
what is the FODMAPS diet
has pts eliminate all of these foods and gradually add them back one by one to see how they are tolerated
______ disease has no known cure
chrons
chrons disease:
_____ and ______ of GI
-inflammation and ulceration
chrons:
____ tissue can form in intestines
fibrous
fibrous tissue reduces absorption of ______
nutrients
what is a fistula?
an abnormal connection between 2 organs
fistulas can cause _____ loss
fluid
if fistula forms, ______ from ____ may enter parts of GI
- bacteria
- colon
chrons can cause:
deficiency in ______
-calcium
chrons can cause
deficiency in _______
magnesium
chrons can cause
deficiency in _______
zinc
chrons can cause
deficiency in _______
iron
chrons can cause
deficiency in vitamin _______
b12
chrons can cause
deficiency in _______
folate
chrons can cause
deficiency in vitamin _______
c
____ formulas preferred with chrons pts
hydrolyzed
chrons diet:
high in ____ and _____
calories and protein
chrons diet:
low in ___, _____, and ____
- fat
- fiber
- lactose
ulcerative colitis is inflammation of _____ ______
large intestine
can ulcerative colitis be cured?
if the part of the colon that is ulcerated is removed, it can be cured
_____ used if surgery is anticipated for pt with ulcerative colitis
TPN
diverticula cause:
______ in intestinal lumen and _____ of supporting muscles
- pressure
- weakness
diverticula form due to _____ and lack of _____
- aging
- fiber
diet for diverticulitis in active phase
low fiber
diet to manage diverticulitis
high fiber
resections of ____ intestine are less likely to cause nutritional problems than resection of ______ intestine
- large
- small
colostomy:
____ and ____ removed
- rectum
- anus
ileostomy:
_____, _____, and _____ removed
- colon
- rectum
- anus
ileostomies cause _____ stool
watery
foods to avoid after large bowel resection
- stringy foods
- tough skins (dried fruit, corn)
- seeds
- nuts
- mushrooms
foods that thicken stool (5)
- applesauce
- peanut butter
- bananas
- starchy foods
- cheese
limit _____ ____ postgastrectomy to prevent dumping syndrome
simple sugars
limit simple sugars postgastrectomy to prevent ______ _______
dumping syndrome
simple sugars cause _______ reaction in the intestine
hyper osmotic
postgastrectomy:
avoid ____ with meals
- liquids
- creates more volume in the stomach
postgastrectomy:
____ _____ after eating can prevent dumping syndrome
laying down
postgastrectomy diet:
emphasized _____ and moderate ____ in meals
- protein
- fat
postgastrectomy:
protein and fat in meals can help slow down _____ and prevent ___ _____
- absorption
- dumping syndrome
add ___ or _____ gum to food to slow down absorption
- pectin
- guar
what is steatorrhea?
fatty, frothy stool
postgastrectomy:
_____ and ______ malabsorption causes bone disease
- calcium
- vitamin D
what is dumping syndrome?
when the pyloric sphincter is removed and material dumps from the stomach into the intestines rapidly
dumping syndrome:
______ volume decreases
blood
how does dumping syndrome cause hypoglycemia?
bc the material was dumped so rapidly and absorbed so rapidly that there is a surge in insulin production
gastric partitioning:
vitamin ____ and vitamin____ deficiencies common
-D and B12
gastric partitioning:
______, ______, and ______ deficiencies common
- folate
- iron
- calcium
emphasize ______ first in meals after gastric partitioning
protein
celiac disease affects _____ in ____ people
1 in 100
what has gluten in it? (4)
- wheat
- oats
- rye
- barley
celiac disease:
malabsorption of fats, proteins, carbs, fat soluble vitamins, iron, calcium, magnesium, and zinc happens bc of
atrophy of the villi
celiac disease:
malabsorption of ____, ______, and_____
- fats
- proteins
- carbs
celiac disease:
malabsorption of _____ _____ vitamins
fat soluble
celiac disease:
malabsorption of _____, ______,_______, and _____
- iron
- calcium
- magnesium
- zinc
celiac disease:
edema caused by ______ _____ ___________
protein energy malnutrition
______ _______ often permanent with celiac disease
lactose intolerance
what skin condition can develop with celiac disease?
dermatitis herpetiformis
celiac disease s/s
- steatorrhea
- anemia
- edema
- vitamin k deficiency
- fertility problems
what happens to calcium and magnesium during fat malabsorption?
they bind with unabsorbed bile and form soaps. since they are bonded in a new compound they cannot be absorbed and are then passed through the stool
_______ and _______ bind with unabsorbed bile and form soaps during fat malabsorption
calcium and magnesium
____ used for energy during fat malabsorption since fat is not being stored
protein
fat malabsorption:
loss of vitamin _____ reduces ____ absorption
- vitamin D
- calcium
fat malabsorption:
less calcium to bind to ______
oxalates
fat malabsorption:
less calcium leads to increased _____ ______ levels
blood oxalate
fat malabsorption:
increased absorption of oxalate increases risk for ____ ______
kidney stones
treatment for fat malabsorption:
less than _____ grams of fat in diet
50
medium chain triglycerides are easier to ____ and _____
digest and absorb
foods with oxalate to restrict with fat malabsorption
- leafy green veggies
- beets
- nuts
- chocolate
- tea
what is enzyme replacement therapy?
pancreatic enzymes are used to digest fat
bacterial overgrowth can cause ______ ________
fat malabsorption
what 2 things usually prevent bacterial overgrowth?
- gastric acid
- peristalsis
chronic gastritis:
cells of stomach _____ and less _____ _____ is produced
- atrophy
- hydrochloric acid
bacteria overgrowth:
bacteria dismantle ____ causing ______ ______
- bile
- fat malabsorption
bacterial overgrowth causes (5)
- chronic gastritis
- antiulcer meds
- HIV
- small bowel obstruction
- neuropathy in diabetes
______ ____ _______ from gastric surgery can cause bacterial overgrowth
blind loop syndrome
what is blind loop syndrome?
occurs when digested food slows or stops moving through part of the intestine
bacterial overgrowth:
can see ____ and vitamin ______ deficiencies
- folate
- vitamin b12
bacterial overgrowth:
_____ anemia can happen due to vitamin b12 and folate deficiencies
macrocytic
short bowel syndrome causes (5)
- cancer surgery
- chrons
- significant diverticulitis
- obstructions
- fistulas
short bowel syndrome can lead to (4)
- diarrhea
- weight loss
- muscle wasting
- bone disease
short bowel syndrome:
up to ____% of small intestines can be removed
50%
if _____ _____, ______ valve, and _____ are left the pt will have less nutritional problems
- terminal ileum
- ileocecal valve
- colon
short bowel syndrome:
loss of ______ and _____
calcium and magnesium
short bowel syndrome:
_______ and _____ malabsorption
protein and fat
short bowel syndrome:
______ can salvage carbs
colon
_____ _____ is reduced in short bowel syndrome
absorptive surface
remarkable adaptation:
the villi can change, become healthier, ____, and increase the ____ _______
- taller
- absorptive surface
what is remarkable adaptation?
certain parts of the intestine that weren’t responsible for absorbing nutrients before surgery can adapt and develop the ability
short bowel syndrome diet
high in _____, low in ____ and _____
- carbs
- fat and oxalates
short bowel syndrome:
take vitamin _____ supplements
b12
