Nutrition in GI dz Flashcards
Nutrition routes
Enteral via
includes
helps to maintain
Problem
Enteral or parenteral
oral consump or tube into gut
liquid diets w all essential nutrients
guts digestive and absorptive/immunological fxn
dz may compromise GI tracts ability to breakdown/absorb nutrients, make enteral feeding hard
Parenteral feeding method, use
Containing
greater degrees of nutrition results in
requires placing
IV access, adjunct or meet total needs (TPN)
Carbs (glucose btw 10-70%)
Protein (AA), lipid (essential FA/TG)
osmotic load inducing phlebitis of PV- must occur in central veins
Central venous cath- concern w compliactions (thrombosis, PTX, hematomas, infec)
TPN comps
can result in
hyperglycemia, elec abnormalities, hepatic dys
liver steatosis, cholestasis, gallbladder stasis- acalc cholecystitis
IBD has high rate of
all inflamm dz inc
dec food intake bc
significant involvement of SI
diarrhea loses (6)
mal/wl
met rate, needing additional cals to maintain energy supplies
anorexia, pain, NV
lose absorptive surface, dim macro/micro nutrients
Zinc, K, Mg, fat soluble V, Ca, Copper
IBD micro nutrient def include (5)
Sulfasalzaine or methotrexate dim
patients at risk for
All pt req
Trigger foods
CD needs to
VD/VB12/Fe/Ca/Zn
Folic acid
osteoporosis
additional dietary supplements w cals/prot/V/M- remission is better/less relapses
worsen/relapse dz- alcohol, caffeine, lactulose, high fiber
limit high fiber foods (fruit/veg/bean/whole grain)
Pancreatitis
bowel rest assoc w
management
Mild sx return diet in
Diet initiated when, type of diet
Severe panc needs
diet
TPN used as
impair pancreatic enzyme release, dec digestion/absortion
mucosal atrophy, infection- bacterial translocation across ab wall
enteral nut/parenteral diet
1 wk of dx
vomiting resolved/pain improves (low residue/fat)
NG feeding w/in 48 hrs
high protein/low fat
last resort
Chronic panc results in
result in destroyed endo/exocrine fxn
also have factors reducing intake
greatest def in
Carbs maintained by
Proteins
Lingual/gastric lipase
Common findings
irreversible damage/fibrosis/calcification
panc insuff/DM
chronic pain/anorexia
lipids
Salivary amylase/BB disacch
Gastric pepsin/BB peptidases- mucosa absorbs AA/di/tri peps
minimal role- panc lipase is essential
steatorrhea, loss of fat soluble vitamins
Chronic panc recommendations
supplement w
also
eat freq, small meals low in fat/fiber (absorb enzymes)
medium chain TG- absorbed by intestinal epithelial cells
pancrelipase (lipase/amylase/protease)
CF
pulm dysfunc leads to
additional loss of
develop panc insuff
complications
pt needs diet
supplement w
w panc involvement, supplement w
hypermetabolic state from inc work of breathing
Na
mal fat/fat sol V
cholestatic liver dz, CF DM, SB bacterial overgrowth
inc caloric uptake, individualized based on needs
Ca/Na
fat sol V/panc enzymes
Cirrhosis
malnutrition leads to high rate of
develops bc of
complations
hepatic abnormalities
BA def leads to
Reduces glycogen stores, impairing
Hypoglycemia bc
high rate of complications/mortality
hepatic abnormalities/reduced intake
encephalopathy (A/N), ascites (satiety)
red prot syn, BA def, abnormal carb met
maldigestion of fat
gluconeo, resulting in using lipid for energy
limited ability to generate glucose w fasting
Cirrhosis assume
wg/wl unreliable due to
Lab values inconsistent- products synthesized by
creatinine low bc
Managed w
avoid
supplement w V/M including (3 of them)
restrict
malnutrition
Na/H2O retention, diuretics
liver, expect low (mal vs wl)
dec hepatic synth, inc renal secretion
caloric/prot supplement
low prot diet (enceph)
FSV, Zn, Se
Na
Diverticulosis assc w diet
this diet results in
Manage w, such as
low fiber/high red meat/sat fat
low vol stools w altered colonic motility, inc intraluminal pressure- diverticulosis
fiber suplements (psyllium bran/isaghula)
IBS typically not due to
Restrict
resoning
Fructose Lactose Fructans Galactans Polyols
Pain predom sx avoid
Const predom sx use
Diarrhea predom sx avoid
diet content
fermentable oligo/mono/disacchs/polyols
malabsorption, inc gas production
Fruits/honey Dairy Wheat/onion/garlic Beans/lentils/soy Sorb/man/xyl/malt- avocado/apricots/sweet fruit
Gas producing food- beans/onions/celery/carrots
fiber supplement
food lax (sweeteners/fructose)
