Lecture 10: GI Diet Flashcards
What is eosinophilic esophagitis? (EoE)
Chronic, allergic, inflammatory condition, with eosinophilic infiltration of the lining of the esophagus.
What characterizes EoE?
- Odynophagia
- Dysphagia
Resulting food impact, inability to eat, and reflux.
What are the long-term effects of EoE?
- Scarring
- Strictures
What are the suggested dietary modifications for someone with EoE?
- First-line: Elimination diet of milk.
- Second-line; 4FED (four-food elimination diet)
- SFED (six-food elimination diet), more conservative.
- Elemental diet (Nutrient-rich amino acid formulas)
What falls under a 4FED diet?
- Milk
- Wheat
- Eggs
- Soy
What is a SFED? What are the six?
Diet based on removing the 6 most common allergy-causing foods. No other diet restrictions.
* Milk
* Wheat
* Eggs
* Soy
* Peanuts/tree nuts
* Fish/shellfish
How efficacious is a SFED?
- Histologic response in 69%.
- Symptom response in 87%.
What is an elemental diet? What makes it up?
Diet based on nutrient-enriched amino acid formulas.
* Totally replace table food to meet nutritional need.
* Limiting flavoring/sweeteners
* 2-6 weeks only (SHORT PERIOD)
* They just eat amino acids mixed with sugars, fats, minerals, and vitamins.
Who usually does an elemental diet?
Children with EoE most commonly.
How efficacious is an elemental diet?
- Histologic response in 95%.
- Symptom response in 100%.
What is GERD?
Gastroesophageal Reflux Disease, characterized by recurrent retrograde acid reflux in the esophagus.
How is GERD typically described? What is the main concern with long-term GERD?
- Burning pain, shortly after eating
- Dysphagia
- Regurgitation of food.
Long-term damage to the esophagus
How do we treat GERD?
- Lifestyle changes
- Medications
- Diet changes
What is dyspepsia?
Chronic, recurring, upper abdominal discomfort. (symptom)
How is dyspepsia commonly described?
- Burning pain
- Bloating
- Early satiety
- Gassiness
- Nausea
What is peptic ulcer disease?
Open sore/ulcers that form on the mucosal membrane of the stomach for duodenum.
What are the MCC of PUD?
- NSAID use
- H. pylori
- Gastrinomas
How do we treat PUD?
- Medication
- Surgery
- Diet changes
What diet changes are recommended for GERD, dyspepsia, and PUD?
- Carbs: Avoid simple carbs and increase fiber (medi diet)
- Protein: no change
- Fats: High-fat foods and fried foods may trigger symptoms.
What should people with GERD, dyspepsia, and PUD avoid?
- Acidic foods (tomato-based, citrus, carbonated)
- Spicy (Capsaicin)
- Gastric irritants (Coffee, tea, tobacco, alcohol, peppermint)
- Others: fried/fatty foods, large meals, chocolate.
- Alcohol
- Dairy (fermented dairy = lower PUD risk)
- CAM/herbals (mixed evidence)
What are some simple lifestyle modifications can help with GERD?
- Small, frequent meals
- Avoiding laying flat after eating
- Elevating the head of the bed
- Avoid tobacco, alcohol, caffeine
- Avoid tight clothing
- Weight loss of 10% or more!
What are prebiotics?
Foods high in non-digestible fiber that promote the growth of healthy bacteria.
What are probiotics?
Food containing live commensal organisms associated with health benefits.
What are the commensal bacteria/yeast in probiotics?
- Lactobacillus
- Bifidobacterium
- Saccharomyces
- Non-pathogenic E. coli
