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(C) Nutrition > Lecture 10: GI Diet > Flashcards

Lecture 10: GI Diet Flashcards

1
Q

What is eosinophilic esophagitis? (EoE)

A

Chronic, allergic, inflammatory condition, with eosinophilic infiltration of the lining of the esophagus.

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2
Q

What characterizes EoE?

A
  • Odynophagia
  • Dysphagia
    Resulting food impact, inability to eat, and reflux.
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3
Q

What are the long-term effects of EoE?

A
  • Scarring
  • Strictures
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4
Q

What are the suggested dietary modifications for someone with EoE?

A
  • 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)
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5
Q

What falls under a 4FED diet?

A
  • Milk
  • Wheat
  • Eggs
  • Soy
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6
Q

What is a SFED? What are the six?

A

Diet based on removing the 6 most common allergy-causing foods. No other diet restrictions.
* Milk
* Wheat
* Eggs
* Soy
* Peanuts/tree nuts
* Fish/shellfish

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7
Q

How efficacious is a SFED?

A
  • Histologic response in 69%.
  • Symptom response in 87%.
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8
Q

What is an elemental diet? What makes it up?

A

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.

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9
Q

Who usually does an elemental diet?

A

Children with EoE most commonly.

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10
Q

How efficacious is an elemental diet?

A
  • Histologic response in 95%.
  • Symptom response in 100%.
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11
Q

What is GERD?

A

Gastroesophageal Reflux Disease, characterized by recurrent retrograde acid reflux in the esophagus.

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12
Q

How is GERD typically described? What is the main concern with long-term GERD?

A
  • Burning pain, shortly after eating
  • Dysphagia
  • Regurgitation of food.

Long-term damage to the esophagus

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13
Q

How do we treat GERD?

A
  • Lifestyle changes
  • Medications
  • Diet changes
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14
Q

What is dyspepsia?

A

Chronic, recurring, upper abdominal discomfort. (symptom)

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15
Q

How is dyspepsia commonly described?

A
  • Burning pain
  • Bloating
  • Early satiety
  • Gassiness
  • Nausea
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16
Q

What is peptic ulcer disease?

A

Open sore/ulcers that form on the mucosal membrane of the stomach for duodenum.

17
Q

What are the MCC of PUD?

A
  • NSAID use
  • H. pylori
  • Gastrinomas
18
Q

How do we treat PUD?

A
  • Medication
  • Surgery
  • Diet changes
19
Q

What diet changes are recommended for GERD, dyspepsia, and PUD?

A
  • Carbs: Avoid simple carbs and increase fiber (medi diet)
  • Protein: no change
  • Fats: High-fat foods and fried foods may trigger symptoms.
20
Q

What should people with GERD, dyspepsia, and PUD avoid?

A
  • 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)
21
Q

What are some simple lifestyle modifications can help with GERD?

A
  • 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!
22
Q

What are prebiotics?

A

Foods high in non-digestible fiber that promote the growth of healthy bacteria.

23
Q

What are probiotics?

A

Food containing live commensal organisms associated with health benefits.

24
Q

What are the commensal bacteria/yeast in probiotics?

A
  • Lactobacillus
  • Bifidobacterium
  • Saccharomyces
  • Non-pathogenic E. coli
25
Q

What food usually has lactobaccilus?

A

Fermented dairy products.

26
Q

What food usually has bifidobacterium?

A

Fructo-oligosaccharides (prebiotics)

27
Q

What characterizes constipation?

A

1+ of the following.
* Infrequent stools
* Hard stools
* Difficult stool passage

28
Q

What are the complications associated with constipation?

A
  • Hemorrhoids
  • Diverticulosis
  • Anal Fissures
29
Q

What is the cornerstone treatment for constipation?

A

30g/day of fiber, with an emphasis on fruit and veggie fiber.

30
Q

What kind of fruit has a lot of fiber and sorbitol?

A

Dried fruits in general, but prunes specifically have sorbitol, which may cause increased gas and bloating!

Helps to pass stool easier but can have SE.

31
Q

What are the fiber additives?

A
  • Dextrin
  • Methylcellulose
  • Psyllium
  • Calcium polycarbophil
  • Often has associated SE of gas, bloating, flatulence, abd pain.

Often used for children who refuse to eat fiber.

32
Q

What must be taken alongside fiber to ensure it works?

A
  • Water hydration.
  • Fiber specifically absorbs water into the GI lumen to increase stool bulk.
  • You need 1.5-2L of water a day.
33
Q

Are probiotics recommended for constipation?

A

NO

34
Q

What is diarrhea? Chronic?

A

3+ loose OR watery stools a day.

Chronic is 4+ weeks.

35
Q

What is the most common underlying etiology in acute diarrhea?

A

Infectious

36
Q

How should we manage acute diarrhea?

A
  • Electrolyte-rich fluids
  • BRAT(Y) diet
  • Probiotics may help
37
Q

What is the BRAT(y) diet?

A
  • Bananas
  • Rice
  • Applesauce
  • Toast
  • Yogurt (sometimes)

Yogurt must have active cultures, no additive sweetners.

38
Q

How should we manage chronic diarrhea?

A

Trial a low-FODMAP diet.

39
Q

What is a low-FODMAP diet?

A
  • Fermentable Oligosaccharides
  • Disaccharides
  • Monosaccharides
  • And Polyols.

You then slowly reintroduce these one by one to see which ones are tolerable.

Avoid artificial sweeteners long-term.

(C) Nutrition (12 decks)

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