Notes Flashcards

Question

``` Lactococcus lactis Lactobacillus brevis Lactobacillus rhamnosus Leuconostoc mesenteroides Candida kefir Torulaspora delbrueckii Saccharomyces cerevisiae Streptococcus lactis ``` Those microorganisms are involved in?

Answer 1

Sauerkraut/kimchi

Answer 2

L plantarum

Answer 3

Glucaric acid (glucarate) Indole-3-carbinol

Answer 4

Saccharomyces cerevisiae

Answer 5

``` Leuconostoc spp. Lactobacillus spp. Streptococcus spp. Pediococcus spp. Lactococcus spp. Bifidobacterium spp. ``` Involved in yoghurt, kefir, idli, sauerkraut, kimchi, dosa, olives, pickles

Answer 6

Rhizopus oligosporus * not reliable probiotic food

Answer 7

Aspergillus oryzae Saccharomyces rouxii *unlikely to have probiotic effect

Answer 8

A nondigestible food ingredient that beneficially affects the host by selectively stimulating the growth and/or activity of one or a limited number of bacteria in the colon.

Answer 9

1. Neither be hydrolysed nor absorbed in the stomach or small intestine; 2. Act as a selective substrate for one or a limited number of potentially beneficial commensal bacteria in the large intestine; 3. Change the colonic microflora ecosystem towards a healthier composition; and 4. Induce luminal or systemic changes that improve the health of the host.

Answer 10

FOS GOS Lactulose Lactitol β-glucoolimers Raffinose Xylooligosaccharides

Answer 11

PREbiotics very specific | Colonic foods lack specificity.

Answer 12

Slippery elm Pectin Psyllium husk Guar gum Green tea Dark cocoa Almonds Larch aabinogalactans

Answer 13

Inulin - largest; extracted from chicory roots Oligofructose - medium; from inulin using enzymatic hydrolysis Neosugar - short; fungal organism that converts sucrose to FOS

Answer 14

``` Onion Artichoke Rye Dandelion Barley Asparagus Leek Garlic Banana Wheat Chicory Salsify Burdock Ya on ```

Answer 15

Enhance bifidobacteria Enhance immunity Absorption of calcium Improved bioavailability of phytoestrogens Efficacy of medicinal herbs, esp post-antibiotic therapy Hyperlipidemia Damaged intestinal or colonic mucosa Tx atopic eczema and prevent atopy development Promote satiety

Answer 16

10g/day of FOS (4-40g/day have been shown to have bifidogenic effect) Dosages of <3g/day are unlikely to cause sig alterations in GIT

Answer 17

Fructose | Galactose

Answer 18

Enhances growth of lactobacilli AND bifidobacteria Candidiasis Constipation Prevention of colon cancer Damaged Intestinal or Colonic Mucosa - trophic and healing effects on the GIT Alcoholic Liver disease Lowered immunity Colon acidifier Endotoxemia Prevention UTI Tx of atopic eczema and prevent atopy Tx UC

Answer 19

10g, 2x/day | 3-20g/day

Answer 20

β-galactosidases β-linked glycosides are resistant to digestion by host-secreted enzymes in the small intestine - reach the terminal ileum & colon intact - become available to those members of the colonic microbiota metabolically equipped to metabolize these specific oligosaccharides

Answer 21

Enhances growth of lactobacilli AND bifidobacteria Constipation Prevent atopic disease Increased resistance to infections IBS Calcium absorption Metabolic syndrome Prevent GIT infections Prevent Travellers diarrhea

Answer 22

2.5-15g/day

Answer 23

Foods entering the colon and serving as substrates for the endogenous colonic bacteria, thus indirectly providing the host with energy, metabolic substrates and essential micronutrients.

Answer 24

``` Resistant starch Plant cell wall polysaccharides Hemicelluloses Pectins Gums ```

Answer 25

Contain both probiotic and PREbiotic agents

Answer 26

1) enhance the survival of the probiotic bacteria through the upper GIT, 2) improve implantation of the probiotic in the colon, and 3) have a stimulating effect on the growth and/or activities of both the exogenously provided probiotic strain(s) and the endogenous inhabitants of the bowel

Answer 27

1) well-characterized and researched probiotic strains 2) “prebiotic” substance meets requirements to be considered prebiotic 3) “prebiotic” demonstrates enhance growth of exact probiotic strain in the product 4) both agents included in therapeutic dose

Answer 28

``` Clean drinking/bathing water More C-sections More pre-term and infant AB usage Widespread AB use through life Reduced breastfeeding rates Increased use of antibacterial soaps, creams, sprays Early childhood PPI use Dysbiosis-inducing and/or restrictive diets PPI exposure in life and pregnancy ```

Answer 29

``` PPI Chemotherapy Metformin NSAIDs Atypical antipsychotics Statins Polypharmy in elderly Radiotherapy ```

Answer 30

Artificial sweeteners=sucralose, saccharin Dietary emulsifiers=carboxymethylcellulose, polysorbate-80 Environmental chemicals=glyphosate High protein-low carb Keto diet SAD

Answer 31

Citrus seed extract High-dose and long-term berberine Enteric-coated essential oils Biofilm busting products

Answer 32

``` PREbiotic daily Diversity of plants Live on a farm/organic gardening Raw fruits, veggies, nuts, seeds Exercise PRObiotic supplants, ferments Fecal microbial transplant Resistant starch-rich foods ```

Answer 33

At least 10 g/day

Answer 34

at least 5ml/day

Answer 35

at least 3g/day

Answer 36

at least 3g/day

Answer 37

• at least 5g/day

Answer 38

Fruit-blk elderberries, currants, blueberries, cherries, strawberries, blackberries, plums, raspberries, red apples, black grapes Nuts and seeds-flaxseed meal, chestnuts, hazelnuts, pecans, black tahini Vegetables-purple carrots, red carrots, purple/red potatoes, red cabbage, spinach, red onions, broccoli, carrots, red lettuce Grains-red&black rice, quinoa, whole grain rye bread Other-black olives, olive oil

Answer 39

``` Asparagus Banana Barley Burdock Chicory Dandelion Garlic Artichoke Leek Onion Rye Salsify Wheat Yacon ```

Answer 40

``` Beetroot Borlotti beans Brocc Chick peas Fennel Haricot beans Lentils-green, red Lima beans Oats Onion Radish Red kidney beans Rye bread Soy beans Wheat ```

Answer 41

``` Brown rice Carrots Black currants Dark cocoa Almonds Green tea ```

Answer 42

RS1 - grains, seeds, legumes RS2 - starchy foods, raw potatoes, plantains, green bananas RS3 - when root veggies and whole grains are cooked and cooled. Also, legumes RS4 - human-made via chemical process

Answer 43

Bacteroides - associated with diets rich in animal protein and saturated fats Prevotella - plant-based diet Ruminococcus - most prevalent now

Answer 44

``` Modulate immune system Enhance GIT motility and function Improved digestion and nutrient absorption Produce B and K vitamins Xenobiotic metabolism Colonization resistance Production of SCFAs Production of polyamines Weight management Dysbiosis ```

Answer 45

Butyrate Propionate Acetate

Answer 46

Insoles Phenols Hydrogen sulphide Ammonia

Answer 47

Increase: E.coli.& Desulfovibrionaceae; Decreases: Bifidobacteria

Answer 48

Bilophila wadsworthia

Answer 49

Mostly symptom based picture plus a recent history: AB, high stress, dietary risk factors, suffer from 1+ diseases

Answer 50

PREbiotics Probiotics Colonic foods Antimicrobial herbs

Answer 51

Bifidobacteria lactis HN019 | Lactobacillus rhamnosus GG

Answer 52

Allium sativum -garlic Pomegranate husk Green tea extract

Answer 53

Berberine-rich herbs Enteric-coated essential oils Antibiotics

Answer 54

``` LES incompetence Delayed gastric emptying Impaired esophageal acid clearance Hiatal hernia Decreased salivation ```

Answer 55

``` Genetic disposition Medications Smoking Pregnancy Psychological stress High BMI ```

Answer 56

Alcohol | Coffee

Answer 57

Alcohol Chocolate Coffee Fatty meals

Answer 58

Alcohol | Peppermint essential oil

Answer 59

Alcohol | Fatty food/meals

Answer 60

Tomato/citrus juice Soft drinks Spicy food Alcohol

Answer 61

``` Fermentable Oligosaccharides Disaccharides Monosaccharides And Polyols ```

Answer 62

GI demulcents

Answer 63

``` D-limonene (demulcent) Melatonin Meadowsweet (demulcent) Chamomile (demulcent) Licorice (demulcent) Comfrey leaf (demulcent) Aloe vera (demulcent) Calendula flowers (demulcent) Curcumin ```

Answer 64

Alcohol Chocolate Caffeine Fatty foods

Answer 65

Diary free diet Carob powder Althaea radix powder

Answer 66

Zinc | B-carotene

Answer 67

Lactobacillus reuteri protectis

Answer 68

Drug use: oral corticosteroids, aspirin, NSAIDS Lifestyle: stress, smoking, alcohol abuse, low dietary fiber

Answer 69

``` Green tea - inhibits growth Cranberries - goes dormant Cranberry juice - not as good as AB Dark grapes Berries 90% eradication ```

Answer 70

Lactobacillus acidophilus NAS - 43% Lactobacillus reuteri MM53 +omeprazole 60% Lactobacillus acidophilus LA5 & bifidobacterium lactis Bb12 - decreased density Saccharomyces cerevisiae var boulardii biocodex 12%

Answer 71

Lactobacillus acidophilus LA5 & bifodobacterium lactis Bb12

Answer 72

Lactobavillus reuteri MM53

Answer 73

Rheum emodi - rhubarb Nigella sativa - ground seeds Brocc sprouts Mastic gum

Answer 74

Vitamin C and E Zinc carnosine Lactoferrin

Answer 75

``` Melatonin L-tryptophan Zinc carnosine Cabbage juice Mastic gum Licorice ```

Answer 76

N-acetyl Cysteine (NAC)

Answer 77

Wheat allergy - IgE antibodies CD - autoimmune mediated Gluten sensitivity - IgG antibodies

Answer 78

Avoid wheat only

Answer 79

Avoid gliadin (wheat, spelt, kamut, triticale), secalin (rye), horedin (barley), avenin (oats) peptides because they resist digestion in the upper GIT Lifelong strict avoidance of all gluten-containing foods and drinks

Answer 80

Gluten-free diet Lifelong strict avoidance of all gluten-containing foods and drinks

Answer 81

Dermatitis herpetiformis 10-20% patients Symmetrical rash on elbows, knees, back, buttocks

Answer 82

Small bowel biopsy

Answer 83

4 slices bread (2 for children) per day for 6 weeks

Answer 84

Gold standards ⭐️ small bowel biopsy Biocard celiac test Anti-gliadin antibody (AGA) IgA Intestinal permeability lactulose:mannitol ratio

Answer 85

Unexplained raised liver enzymes: AST, ALT Unexplained Iron deficiency Delayed puberty Infertility

Answer 86

Serum zonulin Anti-gliadin Antibody (AGA) IgG Trial of GF diet and subsequent open/blinded challenge

Answer 87

Nutritional supplementation: ‣ Fe, B12, homocysteine, serum 25-hydroxyvitamin D ‣ Zinc, selenium, calcium, magnesium, vitamin B6, vitamin e, vitamin k ‣ Hookworm infection ‣ Gluten-digesting enzymes (glutenases) e.g. germinated barley and sphingomonas capsulatum Probiotics: ‣ Bifidobactrium lactis ‣ Bifidobacteria infantis (Natren strain) ‣ Saccaromyces cerevisiae var boulardii (Biocodex strain) Tumeric, curcumin L-glutamine Prebiotics CLA

Answer 88

Fructose Ingested in 2 forms: free fructose, sucrose

Answer 89

Carrier mediated facilitated diffusion = GLUT5

Answer 90

occurs when the amount of fructose consumed is more than the small intestines can metabolise and absorb

Answer 91

Breath hydrogen testing + methane Blinded fructose tolerance test Empirical trial of low-fructose diet

Answer 92

chemotherapy, radiotherapy, giardiasis, viral and bacterial gastroenteritis

Answer 93

GI, fatigue, HA, diminished concentration, myalgia, arthralgia, depression

Answer 94

Lactose intolerance NOT fructose malabsorption

Answer 95

Reduce fructose Eliminate sorbitol and other sugar alcohols Avoid: fruit, dried fruit, sweeteners, drinks, sauces, others OK food: ‣ Fruit: Papaya, avocado, banana, blackberry, blueberry, coconut, cranberry, fig, grapefruit, jackfruit, kiwifruit ‣ Sucrose in mod, glucose, maple syrup, molasses Low FODMAP diet, which is not great, so to manage negative microbiota impact add: GOS, PHGG (5G or 10g) Add glucose which enhances fructose absorption and upregulate GLUT2 activity Add amino acids/protein with fruit consumption

Answer 96

Tryptophan Folate Zinc

Answer 97

avocado, babaco, banana, blackberry, blueberry, coconut (grated and dried), cranberry, fig (fresh), grapefruit, jackfruit, kiwifruit, kumquat, lemon, lime, mandarinβ, orange (Valencia is higher in fructose), passionfruit, pepino, pineappleβ, rhubarb, tamarillo, tangelo, raspberryβ, strawberry

Answer 98

Grains – wheat Vegetables – asparagus, globe artichoke, garlic (small doses usually OK), Jerusalem artichoke, leek, onion, shallot, spring onion, zucchini Other – fructooligosaccharide (FOS), lactulose, larch arabinogalactans, and inulin supplements

Answer 99

Eliminates many healthy foods | Negative effects on microbiota

Answer 100

GOS | PHGG

Answer 101

``` Giardia lamblia (aka G. intestinalis or G. duodenalis) ```

Answer 102

Giardiasis

Answer 103

``` Ab pain Nausea Lack of appetite Diarrhea Vomiting Flatulence Burping Tiredness ```

Answer 104

1. inhibit G. lamblia growth, replication and/or attachment to enterocytes 2. promote giardial-defence mechanisms 3. minimise unpleasant symptoms

Answer 105

Wheat germ - 60% reduction Insoluble fiber

Answer 106

Lactobacillus plantarum 299v L acidophilus LA5 and L rhamnosus GG Saccharomyces cerevisiae var boulardii (Biocodex strain) Saccharomyces cerevisiae (Biocodex strain)

Answer 107

Eat whole foods, high fiber Reduce fat Minimize lactose (<12g) and simple sugars Consume flavonoid-rich food Blueberries are good

Answer 108

Psidium guajava leaf - guava leaf Garlic Berberine Mangifera indica leaf - mango Plantago major leaf - plantain Punica granatum husk - pomegranate

Answer 109

Galactose and Glucose

Answer 110

Indicates the brush border lactase activity is a small fraction of the infantile level

Answer 111

Indicates that a sizable fraction of a dosage of lactose in not absorbed in the small bowel and thus is delivered to the colon

Answer 112

Indicates that the malabsorbed lactose produces symptoms (linked to the quantity of lactose)

Answer 113

Northern European descent Lactase persistence was rare in Northern Europeans prior to diary farming

Answer 114

Genetically programmed reduction in lactase synth 70% of the world has lactase nonpersistence, but not all are lactose intolerant

Answer 115

False Not every malabsorbed has symptoms of intolerance

Answer 116

Loss of lactase activity in people with lactase persistence or infants. Occurs as a result of any trauma or illness that damages the microvilli of the small intestine Deficiency that is usually reversible with recovery from the disease E.g. intestinal infection, CD, giardiasis, gastroenteritis, radiotherapy, chemotherapy, rotavirus gastroenteritis

Answer 117

12g >80% lactose maldigesters report Sx after 50g lactose. Single dose >18g associated with greater risk of S&S

Answer 118

Breath testing-analyze excreted gases Genotyping Lactose challenge ⭐️ may be the gold standard

Answer 119

Low lactose diet | Lactase enzymes

Answer 120

``` Fortified soy/rice/almond milk Spinach Sardines w/bones Chinese cabbage Tahini Tofu Almonds Figs Molasses ```

Answer 121

Kluyveromyces lactis OR | Asperigillus oryzae

Answer 122

Lactobacillus casei Shirota and Bifidobacterium breve Yakult Lactobacillus acidophilus LA5

Answer 123

``` Low lactose diet Supplemental lactase Appropriate probiotic strain supplementation Lactulose supplementation Lactose colonic adaptation ```

Answer 124

Saccharomyces cerevisiae var boulardii Biocodex

Answer 125

Small ingestion bacterial overgrowth Heterogenous syndrome characterized by increase number and/or abnormal type of bacteria in the small bowel >10^5 CFU of bacteria/mL

Answer 126

Gram-positive bacteria from upper respiratory tract and oral cavity - failure of gastric acid barrier Colonic/Coliform bacteria - failure of intestinal clearance / small bowel anatomic alterations

Answer 127

``` PPI Narcotics Opiates Gastrectomy Chronic pancreatitis Dysmotility AIDS Diabetic neuropathy Elderly >75yo Small bowel intestinal disorders (causing dismobility) Large bowel disorders ```

Answer 128

Lactulose breath test It measures hydrogen+methane after lactulose ingestion. Poor specificity, poor sensitivity. There is no gold standard for testing for SIBO

Answer 129

Jenjunal aspirate and culture

Answer 130

Glucose breath test | Triple sugar testing * profs prefered testing

Answer 131

``` Remove contributing factors (PPI, narcotics) Anti-microbial therapy (ABs) Diet? Pro/PREbiotics? Nutritional supplements Sm intestinal motility enhancers Gut healing agents ```

Answer 132

Enteric-coated Mentha piperita oil - peppermint oil

Answer 133

``` Punica granatum (fruit rind) - pomegranate Allium sativum - garlic Syzygium aromaticum oil - clove Thymus vulgaris oil - thyme Origanum vulgare oil - oregano Berberine ```

Answer 134

``` Punica granatum (fruit rind) tea polyphenols Allium sativum (fresh best) Origanum vulgare oil propolis Plantago major Syzygium aromaticum oil Thymus vulgaris oil ```

Answer 135

``` tea polyphenols Allium sativum Syzygium aromaticum oil Thymus vulgaris oil ```

Answer 136

``` Origanum vulgare oil, Trachyspermum copticum oil, Mentha piperita oil, Allium sativum (fresh), Coptis chinensis, Punica granatum (fruit rind), tea polyphenols, Thymus vulgaris oil Syzygium aromaticum oil ```

Answer 137

``` Punica granatum (fruit rind) tea polyphenols, Allium sativum, Coptis chinensis (berberine) Thymus vulgaris oil Syzygium aromaticum oil, Origanum vulgare oil ```

Answer 138

``` Punica granatum (fruit rind), Allium sativum, Origanum vulgare oil and infusion, Thymus vulgaris oil, Syzygium aromaticum oil ```

Answer 139

Punica granatum (fruit rind) Allium sativum – fresh is best; or high allicin Green tea polyphenols Origanum vulgare oil Thymus vulgaris oil Syzygium aromaticum oil

Answer 140

No dietary approach is clinical prevent

Answer 141

Lactobacillus rhamnosus GG Lactobacillus plantarum 299v ``` Lactobacillus casei Shirota, Bifidobacterium breve Yakult, and GOS (in combination) ```

Answer 142

Lactulose PHGG (Partially-hydrolysed guar gum) GOS

Answer 143

Lactulose Synbiotics: L. rhamnosus GG and B. lactis Bb12 with inulin Probiotic strain: 1) Bifidobacterium lactis DN-173010 2) Bifidobacterium lactis HN019 Reduce stress Minimise snacking Iberogast Ginger

Answer 144

Lactulose PHGG Saccharomyces cerevisiae var boulardii Biocodex L-Glutamine

Answer 145

Betaine HCL Digestive enzymes at meals Herbal bitters

Answer 146

Chronic inflammatory bowel disease

Answer 147

Inappropriate inflammatory response to intestinal microbes in genetically-susceptible host

Answer 148

Rectal bleeding Abdominal tenderness or masses

Answer 149

Stool tests Colonoscopy and endoscopy Imaging (CT, barium xray) ESR and CRP

Answer 150

Mucosal healing

Answer 151

Glutamine Whey protein Saccharomyces cerevisiae var boulardii CNCM I-745

Answer 152

Stop smoking | Reduce oxidative stress

Answer 153

``` NAC Vit E + C Dietary antioxidants Eliminate alcohol Yeast free diet Avoid Lactose Avoid fructose Low FODMAP diet Semi-vegetarian ```

Answer 154

Proacthocyanidins: dark-coloured grapes, red rice Anthocyanins: blueberries, bilberries, black currants, raspberries, black rice, cranberries, purple/blue corn Chlorophyll: leafy greens (silver beet, English spinach, watercress, lettuce), celery Carotenoids: Butternut pumpkin (squash), carrots, sweet potatoes, tomatoes, red capsicums (peppers)

Answer 155

Zinc | Vit D

Answer 156

Lactobacillus rhamnosus GG Lactobacillus johnsonii LA1

Answer 157

FOS and lactulose didn’t provide significant improvement

Answer 158

Wormwood Turmeric Boswellia Mastic gum

Answer 159

Rotavirus gastroenteritis

Answer 160

Lactobacillus rhamnosus GG Lactobacillus reuteri MM53

Answer 161

Carob powder Cooked green bananas Avoid gluten Avoid juices and soft drinks

Answer 162

Potentilla tormentil - rose family Tannin-rich herbs (cinn, blackberry/raspberry) Nutmeg

Answer 163

Saccharomyces cerevisiae var boulardii Biocodex

Answer 164

Functional GI disorder characterized by altered bowel habit and ab pain

Answer 165

Dx of exclusion

Answer 166

Recurrent ab pain 1 day per week in the last 3 months associated with 2+ of the following: 1. Related to defecation 2. Change in freq of stool 3. Change in form of stool

Answer 167

Lactobacillus plantarum 299v

Answer 168

Fiber Fluid Exercise

Answer 169

``` Ground flaxseed Slippery elm powder Psyllium husk Oat bran Chia seeds Pectin ```

Answer 170

Bifidobacterium animalis DN-173 010 Bifidobacterium lactis HN019

Answer 171

Straining at stool Abdominal pain Abdominal bloating

Answer 172

``` Cardamom Caraway seeds Peppermint Spearmint Dill seeds Fennel seeds Mandarin peel Ginger Chamomile Lemon balm cramp bark ```

Answer 173

Licorice root Chamomile Turmeric Melatonin

Answer 174

Bloody stools Weight loss Fever Family Fx colon cancer

Answer 175

``` Cigarette smoking Med use (AB) Insufficient duration breastfeeding SAD diet Vitamin D deficiency Stress NSAID use Alcohol intake ```

Answer 176

Diarrhea with blood

Answer 177

Colonoscopy and biopsy Supportive: elevated CRP, ESR, fecal lactoferrin and calprotectin

Answer 178

``` Decrease n-6 fats Increase n-3 fats Antioxidant rich diet Wheatgrass juice Psyllium seeds - increase butyrate ``` Eliminate alcohol, dietary emulsifiers, packaged junk foods, white bread, sulphuric dried fruits, dehydrated veggies, packaged fruit juices, animal protein (putrefaction), dairy, potato-family

Answer 179

``` Margarine Sunflower Corn Safflower Soybean Cottonseed Sesame Peanut oils ```

Answer 180

``` Sardines Salmon Herring Ocean trout Mackerel Mullet True all a Arctic char Tuna Tailor Flaxseed oil, ground chia seeds, ground flaxseed Walnuts, hemp seeds ```

Answer 181

Lactulose | FOS

Answer 182

``` Vitamin D Aloe vera gel Boswellia Serratus Turmeric Silymarin -extracted milk thistle Andrographis Bilberry ```