GI Disease - Exam 2

Question 1

What is Eosinophilic Esophagitis? What is the result? What does it present like?

Answer 1

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

scarring and strictures

odynophagia or dysphagia
May result in food impaction, inability to eat, reflux

Question 2

What is the dietary approach to Eosinophilic Esophagitis?

Answer 2

remove the food causing the allergy

SFED - Six-Food Elimination Diet
Elemental Diet - Nutrient-rich amino
acid formulas

Question 3

What are the 6 components of the 6 food eliminating diet? What is the less aggressive approach?

Answer 3

Milk, wheat, eggs, soy, peanuts/tree nuts, fish/shellfish

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

Question 4

What is the elemental diet? How long is it recommended to try?

Answer 4

Diet based on nutrient-enriched amino acid formulas
Amino acids mixed with sugars, fats, minerals and vitamins
Meant to totally replace table food and meet nutritional needs

Usually done for a short period (2-6 weeks)

Question 5

_____ disorder characterized by recurrent retrograde acid reflux into the esophagus. What is the result?

Answer 5

Gastroesophageal Reflux Disease (GERD)

long-term damage to esophagus

Question 6

____ is chronic, recurring upper abdominal discomfort. What are some s/s? Is it normally a dx by itself?

Answer 6

Dyspepsia

burning pain, bloating, early satiety, gassiness, nausea

NOT usually a dx by itself, usually a symptoms but if no other s/s are present. FUNCTIONAL dyspepsia is the dx

Question 7

______ characterized by open sores (ulcers) that form on the mucosal membrane of the stomach or duodenum. What are some causes?

Answer 7

Peptic Ulcer Disease

NSAID use, H. pylori infection, gastrinomas

Question 8

What types of carbs trigger GI related illnesses? What type of fats? What diet should be encouraged?

Answer 8

avoidance of simple carbs and increase of fiber

High-fat and fried foods may trigger symptoms

Mediterranean Diet

Question 9

Give some examples of food that pts should avoid with GI illnesses?

Answer 9

Tomato-based foods, citrus foods, carbonated beverages, spicy foods, coffee, tea, tobacco, alcohol, peppermint, fried or fatty foods, large meals, chocolate

Question 10

What is the effect of alcohol and GI illness?

Answer 10

Greatest risk of ulcer formation in patients who have heavy consumption
>15 drinks/week in men or >8 drinks/week in women

Question 11

What is the effect of dairy on GI illness?

Answer 11

Fermented dairy products associated with LOWER PUD risk!

Question 12

What are some lifestyle modifications for GERD?

Answer 12

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

Question 13

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

Answer 13

prebiotics

Question 14

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

Answer 14

probiotics

Question 15

What are some common strains of probiotics?

Answer 15

Lactobacillus, Bifidobacterium, Saccharomyces, non-pathogenic strains of E. coli

Question 16

What kind of probiotics are often seen in fermented dairy products?

Answer 16

Lactobacilli

Question 17

______ growth encouraged by fructo-oligosaccharides, which are found in prebiotic foods

Answer 17

Bifidobacterium

Question 18

_____ have a high amount of fiber

______ have live bacteria and yeast

Answer 18

prebiotics

probiotics

Question 19

What is constipation characterized by? What is considered the cornerstone of tx? What is the goal?

Answer 19

Infrequent stools
Hard stools
Difficult stool passage

Increasing fiber intake is a cornerstone of treatment!

goal of 30/gram of fiber daily, with emphasis on fruit and veggies

Question 20

_____ are considered an excellent source of fiber. Prunes, in particular, also contain the compound ______. May be associated with increased gas and bloating

Answer 20

Dried fruits

sorbitol

prunes: sorbital: increased gas and bloating

Question 21

Give some examples of fiber additives. What are the SE?

Answer 21

dextrin, methylcellulose, psyllium, calcium polycarbophil

gas, bloating, flatulence, abdominal pain

Question 22

Need to also have lots of ______ in addition to fiber to help with constipation. What is the goal?

Answer 22

WATER!

1.5-2.0 L of fluid per day, increased physical activity may help promote GI peristalsis

Question 23

What is considered diarrhea? What is considered chronic diarrhea?

Answer 23

3 or more loose, watery stools per day

if greater than 4 weeks

Question 24

What is the definition of acute diarrhea? What is the normal cause? What is the recommended tx and diet? How long?

Answer 24

• less than 4 weeks

usually infectious in nature

electrolyte-rich fluids

BRAT(Y) Diet - easy-to-digest, less acidic foods that result in fewer bowel movements
Bananas, Rice, Applesauce, Toast

+/- Yogurt: with active cultures and no sugars/artificial sweeteners

probiotics may be helpful

**Not for long-term - nutritionally incomplete

Question 25

What is the diet recommendation for chronic diarrhea? Give some examples of things to eat and things to avoid.

Answer 25

low-FODMAP diet

Temporary elimination diet where foods are removed and gradually re-introduced to see which foods are tolerated and which are not