Nutritional Management of GI Disease

Question 1

Clinical Features of Crohn’s Disease

Answer 1

Abdominal pain
Diarrhoea
Anorexia and weight loss
Malaise and fever

Question 2

Clinical features of Ulcerative colitis

Answer 2

Bloody diarrhoea
Colicky abdominal pain
Urgent

Question 3

Why is nutrition more important in Crohn’s disease?

Answer 3

In CD inflammation can occur anywhere in the tract where as in UC only the colon is affected

Question 4

What are the effects of inflammatory bowel disease on nutritional status?

Answer 4

loss of body cell mass, muscle strength and micronutrient deficits

Question 5

How is the diet assessed?

Answer 5

MUST assessment
check frequency of bowel movements
check medications
ask about diet history

Question 6

what nutritional support is suggested in IBD?

Answer 6

high calorie and protein
meals little and often
Include oral supplements

Question 7

What food should be avoided in IBD?

Answer 7

High fibre foods
Fatty foods
Lactose

Question 8

What should be monitored in IBD?

Answer 8

height, weight, diet history, haemoglobin, albumin, ferritin, Vitamin D, calcium, Vitamin B12 and folic acid

Question 9

Is tube feeding used in IBD?

Answer 9

only in Crohn’s disease not ulcerative colitis

Question 10

Is parenteral nutrition used in IBD?

Answer 10

Not recommended but may be useful to improve nutritional status

Question 11

What medications are used in IBS?

Answer 11

Anti spasmodics
Anti muscarinics
Anti motility drugs
Laxitives

Question 12

What is the first line dietary advice given in IBS?

Answer 12

have regular meals
Limit alcohol
Ensure adequate fluid intake
Limit caffeine intake

Question 13

What are the recommended alcohol limits for IBS?

Answer 13

2 units per day max

Question 14

What is the second line dietary advice given in IBS?

Answer 14

adjust fibre intake
Limit fresh fruit intake, fruit juice, resistant starch and sorbitol
Have a low lactose diet
Wheat free diet

Question 15

What does FODMAPs stand for?

Answer 15

Fermentable
Oligo
Disaccharides
Monosaccharides
And
Polyols

Question 16

How do the FODMAP groups trigger symptoms?

Answer 16

osmotically active

stimulate gas production

Question 17

What is coeliac disease?

Answer 17

An auto-immune disease in which ingesting gluten causes villi of small intestine to react by flattening, reducing the absorptive capacity of the intestine to nutrients e.g. iron, folate and calcium

Question 18

What are the symptoms of coeliac disease?

Answer 18

reduced appetite, weight loss, diarrhoea, anaemia, mouth ulcers and abdominal bloating

Question 19

What is the treatment for coeliac disease?

Answer 19

life long avoidance of gluten - avoidance of all wheat, barley and rye

Question 20

What are the problems with avoiding gluten?

Answer 20

risk of cross contamination

lack of options in the supermarket