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Nutrition and GI disorders Flashcards

1
Q

The gastrointestinal system consists of the organs of digestion and can be split into 2 main groups:

A
  • The gastrointestinal tract
  • The accessory structures
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2
Q

What three words can describe the primary roles of the digestive GI system?

A
  • Digestion
  • Absorption
  • Transport
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3
Q

GI system carries these out in synergy with two major communication systems of the body:

A

Neural and endocrine

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4
Q

Explain oesophageal disorders:

A
  • Dysphagia: discomfort, difficulty or pain when swallowing may be due to inflammation
  • Oseophagitis: associated with acid reflux (GORD/GERD)
  • Cancer
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5
Q

Explain “Peptic Ulcers”

A
  • Peptic ulcer is the collective term that includes ulcers of the stomach and the duodenum (upper small intestine)
  • Open sores that develop on the inside lining of the stomach and the upper portion of the small intestine
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6
Q

What are the symptoms of peptic ulcers?

A
  • Burning stomach pain
  • Feeling of fullness, bloating or belching
  • Fatty food intolerance
  • Heartburn
  • Nausea
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7
Q

Peptic ulcers include:

A
  • Gastric ulcers
  • Duodenal ulcers
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8
Q

What were the treatments to neutralise the acids (peptic ulcers)?

A
  • Milk and dairy products to buffer the acid
  • Eat less fat and oils
  • Avoid spicy foods
  • If the ulcers did not heal, they were surgically removed
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9
Q

What is coeliac disease?

A
  • Gluten-sensitive enteropathy
  • Immune disease
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10
Q

How does the immune system reacts in coeliac disease?

A

When gluten is ingested, tissue transglutaminase antibodies (tTGA) and endomysial antibodies are produced.
Immune system mistakes gliadin protein -found in gluten- as a threat to the body and attacks gliadin through these antibodies causing swelling and damage to the small intestine.

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11
Q

How does Coeliac diseases is diagnosed?

A

By the presence of anti endomysial antibodies

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12
Q

What are the common features of coeliac disease in childhood?

A

Weight loss
Failure to thrive
Anaemia
Diarrhoea

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13
Q

What are the common features of coeliac disease in adults?

A

Fatigue
Mouth ulcers
Anaemia
Vitamin B12 or folic acid deficiency
Fertility issues
Neurological: numbness to hands or feet
Abdominal: loose stools, cramps, sometimes constipation

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14
Q

The clinical features of CD can be confused with those of:

A
  • IBS
  • Wheat intolerance
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15
Q

What is one hypothesis of delayed onset of CD?

A

improved breastfeeding duration

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16
Q

Some nutritional consequences of CD include:

A
  • Iron deficiency anaemia
  • if there is steatorrhea, there may be limited absorption of calcium and fat soluble vitamins
  • Low serum folate concentrations
  • Low levels of B12 in the serum
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17
Q

What is the treatment for CD?

A
  • Gluten free diet for life
  • Avoiding barley, rye and wheat (sometimes oats)
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18
Q

Explain ulcerative colitis:

A
  • An inflammatory disease that affects the mucosa of the colon starting from the anus and extending proximally.
  • The colonic mucosa in UC is inflamed and swollen with an increased blood flow.
  • Severe disease may affect the whole colon
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19
Q

What are the clinical features of Ulcerative Colitis?

A
  • Diarrhoea and rectal bleeding with the passage of mucus
  • Occasional blood loss leading to anaemia
  • Abdominal pain, especially after eating
  • Healing may result in the development of scarring
  • Long term increased risk of colon cancer
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20
Q

How does nutrition aids in Ulcerative Colitis?

A
  • There may be a link between the gut microbiota and UC
  • Periods of relapse and remission are supported by dietitians
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21
Q

What foods are allowed in limited quantities in Ulcerative colitis?

A
  • Eggs
  • Poultry
  • Yoghurts
  • Pasta
22
Q

What foods are contraindicated in Ulcerative colitis?

A
  • Red meat
  • Processed foods
  • Sugar
23
Q

What is Crohn’s disease?

A
  • It is a chronic inflammatory disorder of the whole GI tract.
  • Characterised by periods of relapse and remission.
  • It most often affect the terminal ileum and colon
  • The ulceration may occur in patches
  • The ulceration may break through the mucosal wall
24
Q

What are the symptoms and clinical features of Crohn’s disease?

A
  • Abdominal pain and diarrhoea
  • Weight loss
25
Which foods are linked as possible factors of Crohn's disease?
- Refined sugars - Cornflakes - Bakers yeast - Margarine - Different types of fat
26
What is the percentage of patients with Crohn’s disease malnourished?
85%
27
Why patients with Crohn’s Disease have reduced nutritional intake?
Because an increased losses from the damaged gut mucosa
28
Explain mal-absorption in Crohn’s disease:
- Absorptive area of the small intestine may be reduced as a result of inflammation ir surgery - Damage to ileum reduces the absorption of B12 - Loss of terminal ileum to mal-absorption of fat soluble vitamins
29
What are some intestinal losses in Crohn’s disease?
- Loss of albumin and iron as a result of leakage of blood and plasma - Rapid intestinal transit may lead to loss of fluid and electrolytes
30
Why there is an increased protein requirement in people with Crohn’s disease?
Inflammation leads to increased production of cytokines, eicosanoids, and glucocorticoids, this leads to a catabolic response, breaking down protein and negative nitrogen balance
31
What are the protein requirements in people with Crohn’s disease?
1-2g/kg bw depending on disease severity
32
What can reduce calcium absorption and increase urinary excretion?
Steroids
33
Where does inflammations occurs in Ulcerative colitis?
Colon and continuous
34
Where does inflammations occurs in Crohn's disease?
anywhere along the GI tract, most common areas are the terminal ileum and the colon. But pattern is patchy
35
What is diverticular disease?
Diverticulosis is the presence of small pouches (diverticula) in the muscular wall of the large intestine that form in weakened areas of the bowel. Usually occur in the sigmoid colon
36
What causes diverticular disease?
Too little fibre in the diet
37
Mention some complications of diverticular disease:
- infection or inflammation (diverticulitis) - bleeding - obstruction
38
What is the treatment for diverticulitis?
- antibiotics - increased fluids - special diet (high fibre and increased of fluid intake)
39
People with diverticulitis should be careful about:
pips, seeds and tough skins of fruits and vegetables which could get caught in the pouches and cause inflammation or infection
40
Explain microbiota:
The microorganisms that live in an established environment
41
What is microbiome?
The full complement of microbes, their genes, and genomes in a particular environment
42
What is dysbiosis?
Imbalance in the different types of micro-organisms
43
Explain gut microbiome:
- Complex community of microbes - estimated to contain 200 trillion cells - gut microbiome is 150x larger than the human genome
44
What are the functions of gut microbiome?
- to prevent colonisation by pathogens - educates the immune system - participates in drug metabolism - deconjugates bile acids - metabolic role - caloric salvage
45
What does the gut microbiome produce?
- short chain fatty acids - Vit K and folate
46
What are the factors linked to the microbiome?
- diet - stress - pharmaceuticals - geography - lifecycle stages - birthing process - infant feeding
47
Alterations in gut microbiota have been linked with:
Physical health: - Functional bowel disorders - Metabolic diseases - Inflammatory bowel disease - C Diff infections - Coeliac disease - Autism - Obesity - Malignancy - Type I DM - Allergies Mental health: - Depression - Anxiety
48
What are the characteristics of effective probiotics?
- Able to survive the passage through the digestive system - Able to maintain good viability - Non pathogenic and non toxic - Capable of exerting a beneficial effect on the host - Able to utilise the nutrients and substrates in a normal diet - stability
49
What are prebiotics?
Non-digestible substances that provide a beneficial physiological effect for the host by selectively stimulating the favourable growth or activity of a limited number of indigenous bacteria
50
Name some foods naturally high in prebiotics:
Tomatoes Artichokes Onions Garlic Chicory Dandelion greens Asparagus Leeks Berries Bananas Flax seed Legumes
51
What are synbiotics?
A synbiotic is defined as a mixture of probiotics and prebiotics that beneficially affects the host by improving the survival and activity of beneficial microorganisms in the gut
52
What bacteria is associated with Peptic ulcers?
H. Pylori bacterium

Nutrition in Practice (15 decks)

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