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Gastro > Nutrition and diet in the management of GI disease in adults > Flashcards

Nutrition and diet in the management of GI disease in adults Flashcards

1
Q

What are the two types of IBD

A

Crohn’s and Ulcerative colitis

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2
Q

What are the clinical features of Crohn’s

A

Abdo pain
Diarrhoea
Anorexia and weight loss
malaise and fever

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3
Q

What are the clinical features of Ulcerative colitis

A

Bloody diarrhoea
Colicky abdominal pain
Urgency

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4
Q

What is the main difference between ulcerative colitis and crohn’s

A

Crohn’s affects the whole of the GI system

Ulcerative colitis affects the large bowel only

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5
Q

What are the nutritional considerations in IBD

A

Nutrients in pathogenesis
Management of malnutrition
Nutrition as therapy

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6
Q

What is thought to lead to a micro flora change in the gut

A

Relation to refined western diet (sugar and fats)

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7
Q

What can contribute to Crohn’s disease greatly?

A

Smoking

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8
Q

What has a protective role for Crohn’s and UC

A

Fruit and fibre

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9
Q

What two nutrients in pathogenesis are associated with IBD

A

Lack of breast feeding

Hypersensitivity to cow’s milk

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10
Q

Why does the protein-energy malnutrition occur?

A

Malabsorption
Increased requirements
Poor dietary intake

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11
Q

What are IBD standards

A

Tailoring nutritional advice to the specific patient

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12
Q

Who is involved in the IBD team

A 
Gastroenterologists
Surgeons (not always)
Clinical nurse specialists 
Dietitian
Pharmacist
Pathologist 
GI radiologist
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13
Q

What is involved in the Dietetic assessment

A 
MUST assessment 
frequency of bowel movements
Investigations (what is affected/ likelihood of surgery)
medications (number of days)
Detailed dietary history (observation)
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14
Q

What food should be avoided

A 
High fibre foods
Fatty foods
Lactose
Spices or other things that cause that specific patient problems 
Alcohol
Vitamin / mineral supplements
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15
Q

What foods are encouraged

A

Calcium, vitamin D, other fat soluble vitamins, zinc, iron and vitamin B12
Serum vitamin B12 is best measure annually
IV iron replacement

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16
Q

What are the therapeutic options in the management of IBD

A

Nutritional therapy - exclusive enteral nutrition
Liquid feeding 6-8 weeks
Either oral or via NG tube may avoid adverse effect of steroids most often used in conjuction

17
Q

What foods do we start to reintroduce

A

Low fibre, fat limited

Carbohydrates

18
Q

What is the most useful way to improve nutritional status before pre-op

A

Parenteral Nutrition

19
Q

What is IBS

A

Chronic functional disorder of the GI tract

20
Q

At what age do symptoms tend to appear of IBS

A

usually 20-30 years

21
Q

What are the symptoms of IBS

A

Abdominal pain, discomfort, bloating or distension, win d or flactulence, change in bowel habit

22
Q

What are the causes of IBS

A

Related to increase in visceral sensitivity
Occasionally linked to previous GI illness
Stress

23
Q

What do IBS patients need to be screened for

A

Caeliac’s disease

24
Q

What are some of the first line dietary / lifestyle advice for IBS

A 
Eat 3 regular meals a day 
Don't eat late at night 
Take time to eat meals and chew food well 
choose smaller meals 
Limit alcohol intake 
Ensure adequate fluid intake 
Limit caffeine intake
Cut down on rich or fatty foods
Take regular exercise 
Take time to relax 
Food and symptom diary
25
Q

What are some of the stage 2/3 dietary advice

A 
Adjustment of fibre intake 
Limit fruit juice / fizzy drink
Polyols/ sugar alcohols
Resistant starch 
Trial of probiotics
Low lactose diet 
What free diet 
Elimination diet
26
Q

What are probiotics thought to do?

A

Increase the transit time

27
Q

What medications can be used for IBS

A 
Anti spasmodics
Amtimuscarniics
Antimotility drugs
Laxative 
Amatriptolene
28
Q

What is a low fodmap diet?

A

Recent advance
for those who dont respond to 1st line dietary advice
to do with short chain carbs
used for 4-8 weeks

29
Q

What is coeliac disease?

A

An auto-immune condition affecting 1% of the population

Female: Male ratio is 2:1

30
Q

What is the treatment of coeliac disease

A

Removal of gluten from the diet

Gastro (67 decks)

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