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Nutrition Semester 3 > Gastroinstestinal > Flashcards

Gastroinstestinal Flashcards

1
Q

What is hypochlorhydia?

A

Low stomach acid
Fasting gastric PH above 3.0
1.5-3.0 is normal

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2
Q

Hypocholrhydria signs and symptoms

A

Gas and bloating often less than 30 mins after eating
Heartburn
Full sensation after meals
Foul smelling stools
Diarrhoea
Food allergies
Brittle nails
Nutrient deficiencies (Iron, zinc, folate, B12)

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3
Q

Hypochlorhydria implications

A

Reduced mineral absorption
H. pylori and SIBO
Poor pancreatic juice and bile flow

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4
Q

Natural help for hypochlorhydria

A

Chew, don’t overeat or drink with meals
Apple cider vinegar (1-2tsp in water before meals)
Zinc and B6
Bitter greens - rocket, chicory, watercress
Herbs - Dandelion, cardamon, fennel

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5
Q

What is exocrine pancreatic insufficiency?

A

A deficiency of the pancreatic enzymes needed for normal digestion, resulting in nutrient malabsorption (esp fat)

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6
Q

EPI symptoms

A

Bloating, belching, flatulence 1-2 hours after eating
Greasy, floating stools
Drowsiness after meals
Food intolerances

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7
Q

Causes of pancreatic insufficiency

A

Chronic stress
Hypochlorhydria
SIBO
Dysbiosis

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8
Q

Natural help for pancreatic insufficiency

A

Avoid snacking between meals
Correct stomach acid levels
Diaphragmatic breathing before meals
Use bitters

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9
Q

What is bile insufficiency?

A

A condition where bile synthesis and or bile flow is compromised affecting one’s ability to digest, absorb and use fatty acids

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10
Q

Signs and symptoms of bile insufficiency

A

Constipation or diarrhoea
Intolerance to fatty foods
Bloating, excess flatulence and cramping

Stool test shows:
Low/absent bile acids
High faecal fats

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11
Q

Bile insufficiency causes

A

Low Hcl
Obesity
Oestrogen dominance
Impaired liver function

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12
Q

Long term bile insufficiency implications

A

Deficiency of fat soluble vits
Hormone imbalances
Hypercholsterolemia
SIBO

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13
Q

Natural help for bile insuffiency

A

Adequate hydration
Avoid processed food
Diaphragmatic breathing
Taurine and choline rich foods

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14
Q

What is the mucosal barrier?

A

Mucus covering the entire GIT provides a thick barrier between the immune stimulating contents of the outer world and the multitude of immune cells in the gut wall

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15
Q

How to support the mucosal barrier

A

Dietary fibre
Polyphenols (green tea, cranberry, blackcurrant, pomegranate)
Slippery elm, marshmallow, liquorice
Seaweed and algae

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16
Q

Intestinal junction support

A

Glutamine
Zinc, vit A and glucosamine
Bone broth (glycine)

Zonulin in stool test

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17
Q

What is secretory IGA

A

It resides in the mucosal lining and protects the intestinal epithelium from toxins and pathogenic microbes

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18
Q

Why is low SIgA a problem?

A

It increases the risk of infections including SIBO

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19
Q

How is low SIgA caused?

A

Emotional/physical stress
NSAID use
Antibiotics

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20
Q

Increase SIgA by

A

Vits and D
Saacharomyces Boulardii
Pre and probiotics
Echinacea
Polyphenols

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21
Q

Elimination diet stage 1

A

Detox

Days 1-2
Increase fruits, veg, healthy fats, water, herbal teas

Remove processed food, chocolate, caffeine

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22
Q

Elimination diet stage 2

A

Days 3-14

Detox as in stage 1 and also
remove all suspected foods for 2 weeks e.g gluten, dairy, corn, soy, eggs, nuts, beef, pork, yeast, citrus, chocolate, nightshades, chocolate and coffee

23
Q

Stage 3 elimination diet

A

Reintroduction (day 15 onwards)

Eat the challenge food 2-3 times a day for 1-3 days
If you get symptoms remove the food and wait for symptoms to disappear before trying the next food
Keep a reaction food out of the diet for 3 months before trying again.

24
Q

The 5R protocol

A

Remove - foods, toxins, unnecessary drugs, use microbials if needed
Replace - e.g support bile, pancreatic or stomach acid
Reinoculate - pre and probiotics
Repair - junctions, mucosa and SIgA
Rebalance - address stress, sleep and exercise

25
Q

What is dysbiosis?

A

An imbalance in the colonies of the bowel flora leading to a potential disruption in both local and systemic health

26
Q

Aetiology of dysbiosis

A

Poor diet
Infections
Medication use - antibiotics and OCP
Stress
Low digestive secretions
C-section and bottle fed

27
Q

Dysbiosis and diseases

A

Atopic disease - lower abundance of bifidobacteria and lactobacilli
Metabolic syndrome - less bifido and akkermansia
Colorectal cancer - pathogens
Neurodegenerative - pathogens

28
Q

What is SIBO?

A

An overgrowth of non-pathogenic bacteria in the small intestine. It is the most common cause of IBS (60-70%)

29
Q

SIBO symptoms

A

Bloating, abdominal pain or discomfort, constipation, diarrhoea, flatulence

30
Q

Key clinical indicators of SIBO:

A

Probiotics and fibre worsen symptoms
Chronic low ferritin
Post infection IBS
A coeliac patient does not improve on a strict gluten free diet

31
Q

SIBO aetiology

A

Hypothyroidism
Stress
Poor oral health
Low SIGa
Histamine or Lactose intolerance

32
Q

SIBO diet support

A

Low FODMAP
Specific carbohydrate diet

33
Q

Anti microbials for SIBO

A

Berberine, oregano, cinnamon

34
Q

Other therapeutics for SIBO

A

Digestive bitters
Fasting and meal spacing
Lion’s mane

35
Q

What is IBD?

A

A group of autoimmune conditions of the colon and small intestine. Crohn’s disease and ulcerative colitis are the most common.

36
Q

IBD symptoms & complications

A

Symptoms peak between ages 15-35
Abdominal pain and diarrhoea
Urgency to pass stools
Rectal bleeding
Weight loss
Fatigue

Colorectal cancer, osteoporosis and anaemia

37
Q

Crohn’s overview
Region, distribution, layers, symptoms, complications

A

Region: Mostly terminal ileum
Distribution: skip lesions
Layers: All
Symptoms: Crampy abdominal pain (right) & loose semi solid stools
Complications: Malabsorption, obstruction, abscess

38
Q

Ulcerative colitis
Region, distribution, layers, symptoms, complications

A

Region: Colon and rectum
Distribution: Proximally continuous
Layers: mucosa only (ulcers)
Symptoms: Abdominal pain (left) and bloody diarrhoea
Complications: Haemorrhage - anaemia

39
Q

IBD triggers

A

Medication
Smoking
Stress
Infections
Poor diet

40
Q

IBD diet

A

Remove inflammatory food
Consider low FODMAP or SCD
Soups, stews and broths
Elimination diet
Omega 3 to 6 ratio
Green juices for chlorophyll and anti-inflmmatory

41
Q

IBD natural help

A

Vit D -tight junctions, support bacteria, regulate mucosal inflammation
Fish oils - 4.5g/day for inflammation
Herbs - marshmallow root, slippery elm
Green tea for muscosal barrier
Vit A, zinc, l-glutamine, glucosamine

42
Q

What is candidiasis albicans?

A

The most common commensal yeast that asymptomatically inhabits mucosal surfaces

43
Q

Candida signs and symptoms?

A

Frequent UTIs
Brain fog
Anxiety and depression
Joint pain
Skin and nail fungal infections

44
Q

Candidaiasis pathophysiology

A

Disruption of the host bacterial environment or immune dysfunction can allow candida to proliferate

45
Q

Candidiasis risk factors

A

Dysbiosis
High sugar intake
Antibiotic use
High stress
Low SiGA

46
Q

Candidaiasis testing

A

Stool: mycology culture
Organic acids test: elevated arabinose
Saliva test: candida antibodies
Blood test: circulating candida antigens
Spit test: saliva sinks or has legs

47
Q

Naturopathic approach to candidaiasis

A
  1. Elimination and detox: soluble fibre and liver support
  2. Diet: go gluten/dairy free, lots of non starchy veg
  3. Antifungals and biofilm disruptors: berberine, oregano oil, thyme
  4. Predisposing factors: stress, smoking, sleep
  5. Nutrient deficiencies: With testing or a multivitamin
  6. Microbiome: pre and probiotics
48
Q

What are gallstones?

A

Crystalline calculi formed in the gallbladder from a build up of bile components. 80% of gallstones contain cholesterol.

49
Q

Key risk factors for gallstones

A

Sedentary
Weatern Diet
OCP
Obesity
Alcohol

50
Q

Natural approach to gallstones

A

Fibre
PUFA
Peppermint
Vit C

51
Q

What is gastro-oesophagul reflux disease? GORD

A

The reflux of gastric juices back into the oesophagus

52
Q

GORD risk factors

A

Pregnancy
Obesity
Fatty foods
Medications e.g NSAIDs

53
Q

Natural approach to GORD

A

Keep upright after meals or when sleeping
Chew well
Eat a mediterranean diet
Increase stomach acid

Nutrition Semester 3 (3 decks)

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