LGI large intestine

Question 1

chronic, recurring abdominal discomfort/pain and altered bowel habits

Answer 1

Irritable Bowel Syndrome (IBS)

Question 2

IBS is ____% of the US population
more common in _____ gender
usually develops around age _____

Answer 2

10-20%
women
~20

Question 3

cause of IBS?

IBS is increased intestinal ______ and ______ in response to GI and environmental stimuli

Answer 3

unknown

sensitivity and motility

Question 4

exaggerated IBS response to

Answer 4

• psychosocial factors
• GI distention
• Dietary factors

Question 5

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

Answer 5

relieved by defecation
diarrhea, constipation
bloating and gas cramps
incomplete evacuation of stool
rectal pain
psychosocial

Question 6

constipation predominant IBS

Answer 6

IBS-C

Question 7

diarrhea predominant IBS

Answer 7

IBS-D

Question 8

mixed constipation and diarrhea IBS

Answer 8

IBS-M

Question 9

medical management of IBS

Answer 9

antidepressants (nortriptyline, citalopram)
serotonin type 3 receptor antagonists (e.g., alosetron)
anticholinergic agents (e.g., dicyclomine)
loperamide, osmotic laxatives

Stress reduction techniques

Question 10

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

Answer 10

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

Question 11

Newer Evidence Based MNT for IBS

Answer 11

low FODMAPs Diet

Question 12

low FODMAP diet is

Answer 12

diet lower in fermentable oligo
di
monosaccharides
and polyols (sugar alcohols)

Question 13

FODMAPs are poorly absorbed in the _______, are highly ______, and rapidly ________

Answer 13

small intestine
osmotic
fermented by bacteria

Question 14

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

Answer 14

fructose
fructose

Question 15

foods with excess fructose

Answer 15

apples
pears
peaches
mango
sugar snap peas
watermelon
canned fruit in natural juice
dried fruit
fruit juice
honey
HFCS

Question 16

foods with excess lactose

Answer 16

dairy products

Question 17

foods with large amount of Oligosaccharides

Answer 17

artichokes
asparagus
beets
brussel sprouts
garlic
onions
peas
chickpeas
lentils
kidney beans
baked beans
watermelon
apples
peaches
large amounts of wheat or rye

Question 18

foods with large amounts of Polyols

Answer 18

apple
apricots
cherries
pears
peaches
plums
watermelon
prunes
avacado
cauliflower
mushrooms
snow peas
sorbtiol
mannitol
xylitol

Question 19

lower FODMAP fruits to swap

Answer 19

bananas
most berries
oranges
grapes
pineapple
grapefruit

Question 20

lower FODMAP vegetables

Answer 20

carrots
green beans
bell peppers
cucumbers
squash
spinach
tomatoes
potatoes
zuchinni
eggplant

Question 20

concerns with the low FODMAPs diet

Answer 20

very restrictive with decreased nutritional value

Question 21

due to concern with low FODMAPs diet, patients should be prescribed ________

Answer 21

MVI with minerals

Question 22

why would someone do a FODMAP diet

Answer 22

• 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

Question 23

Low FODMAP diet is followed strictly for ________ until symptoms resolve and then slowly add foods back into the diet because person may be ______

Answer 23

2-6 weeks
reactive to certain foods more

Question 24

another option from a STRICT FODMAP diet is to use __________

Answer 24

selective FODMAPs reduction

Question 25

what is Diverticulosis

Answer 25

Sac-like herniations of the colonic wall
- usually involves the sigmoid colon

Question 26

diverticulosis incidence increases with _______
higher incidence in ____________

Answer 26

age

westernized cultures with increased intake of refined grains

Question 27

etiology of diverticulosis ?

May result from _____

Answer 27

unknown

increased colonic pressure due to long term constipation

Question 28

diverticulosis symptoms

Answer 28

most people have no symptoms

Question 29

complication of diverticulosis

Answer 29

inflammation of the diverticula in the colon which is called Diverticulitis

Question 30

MNT for Diverticulosis

Answer 30

higher fiber diet - increase GRADUALLY
high fluid intake - 2-3 L/day

Question 31

Clinical manifestations of diverticulitis

Answer 31

left lower quadrant (LLG) pain
diarrhea
abdominal distention
N/V
Fever
possible bleeding

Question 32

complications of diverticulitis

Answer 32

abscess formation
severe bleeding
obstruction
perforation - sepsis
may require surgical intervention

Question 33

MNT for Diverticulitis initial and long term

Answer 33

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