GI Disorders (C) Flashcards
What are the primary GI organs?
Mouth, esophagus stomach, small intestine, large intestine
What are the secondary GI organs?
Liver, gallbladder, and pancreas
What are the symptoms of dyspepsia (indigestion)?
Heartburn, bloating, abdominal pain
What may cause dyspepsia?
Food, appendicitis, kidney/gallbladder/colon disease, or psychological stress
What are the symptoms of esophagitis?
Heartburn and dysphagia
What causes esophagitis?
GERD— hiatal hernia, reduced LES pressure, vomiting, overweight, or smoking
Which condition makes esophageal cancer life-threatening?
GERD
What is a hiatal hernia?
Stomach protrudes through the diaphragm into the thoracic cavity. Food mixes somewhat with gastric juices but cannot move normally
What is the dietary treatment for a hiatal hernia?
Small, frequent meals, avoiding irritants and foods that cause the LES to relax (fatty/fried foods and caffeine.) In some cases, losing weight, and avoid lying down after eating
What is a peptic ulcer?
The erosion of the mucous membrane in either the stomach (gastric ulcer) or duodenum (duodenal ulcer)
What are the causes of peptic ulcers?
Genetics, increased hydrochloric acid, excessive analgesics, smoking, or the bacteria heliobacter pylori
What are the symptoms of peptic ulcers?
Burning gastric pain (relieved with food or antacid), sometimes hemorrhage (which requires surgery)
What is the (non-diet) treatment of peptic ulcers?
Antibiotics and cimetidine (inhibits acid secretion). Calcium antacids may also neutralize the stomach acid.
What is the dietary treatment for peptic ulcers?
No more than 0.8g protein/kg (1-1.5 if blood loss.) Moderately increase fat. Supplement iron for hemorrhage. 3 balanced meals. Avoid irritants.
Why is smoking harmful to patients with peptic ulcers?
Reduces pancreas secretions that buffer stomach acid
Why should fat be moderately increased for peptic ulcers?
Delay gastric emptying, but moderate because clients are prone to atherosclerosis
What are diverticulosis and diverticulitis?
Little pockets inside of the colon. Diverticulitis occurs when feces collects and bacteria breeds. If the pockets rupture, surgery is necessary.
What is the cause of diverticulosis?
A low fiber diet
What is the treatment for diverticulosis?
Antibiotics; begin with a clear-liquid diet, then transition to low-residue, and finally high-fiber after healing
What are the characteristics of IBS (previously spastic colon/colitis)?
Functional issues, not damage— Abdominal pain for three months thrice a month
What are possible causes of IBS?
Genetics, food sensitivity, bacteria, hormones, altered neurotransmitters or psychological issues
What food irritate IBS?
High-fat foods, lactose, alcohol, caffeine, and sweetened drinks
What is the dietary treatment for IBS?
Low-FODMAP diet: less honey, corn syrup, fruits with pits/seeds, milk, wheat, onions/garlic, beans, and sugar alcohols
What are the two IBDS?
Ulcerative colitis (ulcers in colon, rectum, or entire large intestine); Crohn’s disease (progressive autoimmune disorder affecting both the small intestine and large intestine)
What is the dietary treatment for inflammatory bowel diseases?
Replace lost electrolytes, fluids, vitamins, and minerals (diarrhea) and iron/protein (bleeding); low residue diet and 100g protein. In severe cases, temporary TPN.
What is an ileostomy/colostomy?
A temporary or permanent nickel-sized stoma created from the ileum (if the entire colon has been removed) or colon (if the rectum and anus are removed)
What should be kept in mind after an ileostomy/colostomy?
Give food by mouth to foster bowel adaptation (also adapts better when colon is present)
What is short bowel syndrome?
Decreased intestine length and transit time leading to malabsorption and fluid loss
What is the (non-diet) treatment for short bowel syndrome?
Medicate to control gastric secretions and hyper motility; anti-secretory and anti-diarrheal
What is the dietary treatment for short bowel syndrome, with the goal of nutritional autonomy?
Give pancreatic enzymes, rehydration drinks, and soluble fiber. Initially, six small meals. Supplement vitamins C, B12 (monthly injections), ADEK, and minerals (gummy vitamin)
What is celiac disease (gluten-sensitive enteropathy/sprue)?
Antibodies attack the intestine when the protein in wheat, barley, or rye is ingested
What are the symptoms of celiac disease?
Diarrhea, constipation, weight loss, cramping, bloating, joint pain, and anemia
What proportion of people have the genes for celiac disease?
1/3– 1/133 actually have it
What percent of those with celiac disease are undiagnosed?
83%
How long does it take for celiac disease to be diagnosed?
Average 6-10 years
How is celiac disease diagnosed?
Celiac panel (blood tests) and biopsy
How is gluten sensitivity (with a lack of villi damage) diagnosed?
An elimination diet
What disease is two times as common as IBDS and CF combined?
Celiac disease
What celiac grain must be labeled on a product?
Gluten (barley and rye not required)
What are some celiac-friendly grains?
Rice, millet, amaranth, arrowroot, corn, flax, buckwheat, soy, and nut flour
What are grains that should not be consumed by someone with celiac?
Barley (beer and malt), wheat, rye, farro, spelt, triticale, and farro
What nutrients are transported to the liver?
All, except certain fatty acids
What does the liver distribute and synthesize?
Distributes amino acids; synthesizes protein, enzymes, urea, glycogen/glucose, bile, and cholesterol
What is stored in the liver?
Iron, copper, zinc, magnesium, ADEK, and B vitamins
What does the liver convert?
Glucose to glycogen (and reverse), and fat to lipoproteins
What is cirrhosis?
A general term for liver disease and cell loss, most often by alcohol
What are complications associated with cirrhosis?
Fatty infiltration and fibrosis; upset blood flow, HTN, anemia, and hemorrhage in the esophagus. Sometimes fatal metabolism disruption
What is the dietary treatment for cirrhosis (Cale and protein)?
25-35 calories and 0.8-1.0g protein per kg of body weight (less if coma imminent). Supplement vitamins and minerals. Reduce fluids and sodium if ascites, and reduce fiber if esophageal bleeding
In advanced cirrhosis, what percent of calories are from carbs?
50-60%. Sometimes fats or proteins are not tolerated
How is hepatitis contracted?
HAV: fecal-oral; HBV/HCV: body fluids
What complications can result from hepatitis B and C?
CAH (Chronic Active Hepatitis), leading to liver failure and ESLD.
What is the treatment for mild hepatitis?
Cell replacement
What are the symptoms of severe hepatitis?
Increased bile stasis, decreased blood albumin, nausea, headache, fever, fatigue, anorexia, and jaundice
How is severe hepatitis treated?
Bed rest and fluid
What is the dietary treatment for hepatitis (including cals and protein)?
35-40 calories per kg of body weight. Mostly carbs, moderate fat, and 70-80g protein (if mild necrosis. If severe, limit protein to not accumulate in the blood.) Small, frequent meals.
How does cholecystitis lead to cholelithiasis?
Cystitis inflames the gallbladder and causes cholesterol to harden, forming stones
What causes are associated with cholecystitis/cholelithiasis?
Obesity, TPN, low-calorie diets, fat overindulgence, and women
What are the symptoms of cholecystitis/cholelithiasis?
Pain, indigestion, and vomiting that worsens after intake of fatty foods
What is the (non-diet) treatment for cholelithiasis?
Medication, and possibly cholecystectomy if severe
What is the dietary treatment for cholecystitis/cholelithiasis?
Clear liquid diet, then a fat restricted diet (40-45g per day). Supplement water-miscible ADEK. If obese, lose weight.
Which disorders of the accessory GI organs can be either acute or chronic?
Hepatitis and pancreatitis
What are the causes of pancreatitis?
Infections, surgery, alcohol, or medication
What are the symptoms of pancreatitis?
Abdominal pain, nausea, steatorrhea (increased fat in feces), ADEK malabsorption, and weight loss; diabetes if islets of Langerhans destroyed
What is the dietary treatment for pancreatitis?
Parenteral nutrition, then a mostly carb liquid diet (to not stimulate pancreatic secretions), then small meals with carbs, protein, and little fat and fiber. NO alchohol.
How many grams of fiber are consumed on a low residue diet?
5-10 grams
