LGI large intestine Flashcards
chronic, recurring abdominal discomfort/pain and altered bowel habits
Irritable Bowel Syndrome (IBS)
IBS is ____% of the US population
more common in _____ gender
usually develops around age _____
10-20%
women
~20
cause of IBS?
IBS is increased intestinal ______ and ______ in response to GI and environmental stimuli
unknown
sensitivity and motility
exaggerated IBS response to
- psychosocial factors
- GI distention
- Dietary factors
symptoms of IBS include…
- abdominal discomfort or pain that is ________
- chronic _____, ______, or both
- abdominal _____ and ____
- sensation of ________ of stool
- _____ pain
- Increased GI distress associated with ______ issues
relieved by defecation
diarrhea, constipation
bloating and gas cramps
incomplete evacuation of stool
rectal pain
psychosocial
constipation predominant IBS
IBS-C
diarrhea predominant IBS
IBS-D
mixed constipation and diarrhea IBS
IBS-M
medical management of IBS
antidepressants (nortriptyline, citalopram)
serotonin type 3 receptor antagonists (e.g., alosetron)
anticholinergic agents (e.g., dicyclomine)
loperamide, osmotic laxatives
Stress reduction techniques
Traditional MNT for IBS
Avoid consuming _________
Eat on a regular ________
Limit _________
Avoid excess dietary _____
Limit __________
Reduced _______ if lactose intolerant
Adequate fluid intake (______ L/day)
Omit gas-forming foods- if not tolerated
Avoid consuming large meals
Eat on a regular schedule
Limit caffeine
Avoid excess dietary fat
Limit sorbitol, xylitol, & mannitol
Reduced lactose if lactose intolerant
Adequate fluid intake (2 L/day)
Omit gas-forming foods- if not tolerated
Newer Evidence Based MNT for IBS
low FODMAPs Diet
low FODMAP diet is
diet lower in fermentable oligo
di
monosaccharides
and polyols (sugar alcohols)
FODMAPs are poorly absorbed in the _______, are highly ______, and rapidly ________
small intestine
osmotic
fermented by bacteria
for FODMAPs, avoid foods that contain ____ in excess of glucose.
Limit the amount of _____ at every meal
if lactose intolerant, avoid lactose foods
avoid fermentable carbohydrates and polyols
fructose
fructose
foods with excess fructose
apples
pears
peaches
mango
sugar snap peas
watermelon
canned fruit in natural juice
dried fruit
fruit juice
honey
HFCS
foods with excess lactose
dairy products
foods with large amount of Oligosaccharides
artichokes
asparagus
beets
brussel sprouts
garlic
onions
peas
chickpeas
lentils
kidney beans
baked beans
watermelon
apples
peaches
large amounts of wheat or rye
foods with large amounts of Polyols
apple
apricots
cherries
pears
peaches
plums
watermelon
prunes
avacado
cauliflower
mushrooms
snow peas
sorbtiol
mannitol
xylitol
lower FODMAP fruits to swap
bananas
most berries
oranges
grapes
pineapple
grapefruit
lower FODMAP vegetables
carrots
green beans
bell peppers
cucumbers
squash
spinach
tomatoes
potatoes
zuchinni
eggplant
concerns with the low FODMAPs diet
very restrictive with decreased nutritional value
due to concern with low FODMAPs diet, patients should be prescribed ________
MVI with minerals
why would someone do a FODMAP diet
- individuals with significant symptoms that have not responded to the traditional MNT
- individual has a diet high in FODMAPs
- avoid long term use, this is a temporary thing
Low FODMAP diet is followed strictly for ________ until symptoms resolve and then slowly add foods back into the diet because person may be ______
2-6 weeks
reactive to certain foods more
another option from a STRICT FODMAP diet is to use __________
selective FODMAPs reduction
what is Diverticulosis
Sac-like herniations of the colonic wall
- usually involves the sigmoid colon
diverticulosis incidence increases with _______
higher incidence in ____________
age
westernized cultures with increased intake of refined grains
etiology of diverticulosis ?
May result from _____
unknown
increased colonic pressure due to long term constipation
diverticulosis symptoms
most people have no symptoms
complication of diverticulosis
inflammation of the diverticula in the colon which is called Diverticulitis
MNT for Diverticulosis
higher fiber diet - increase GRADUALLY
high fluid intake - 2-3 L/day
Clinical manifestations of diverticulitis
left lower quadrant (LLG) pain
diarrhea
abdominal distention
N/V
Fever
possible bleeding
complications of diverticulitis
abscess formation
severe bleeding
obstruction
perforation - sepsis
may require surgical intervention
MNT for Diverticulitis initial and long term
initially NPO with IVF
then advance to a low fiber diet
adequate intake of protein and iron
Rx MVI with minerals
gradually advance to normal fiber intake as inflammation decreases
