Review Lower GI diseases

Question 1

1. Identify the general physiological cause of constipation. Identify the dietary contributors to constipation

Answer 1

1. colon absorbs too much h20 2. stool moves too slowly 3. colon’s contractions are too slow and sluggish normal transit 18-48 hours. chronic constipation if greater than 3 months, Diets low in fiber, and water most common cause, lack of exercise and mobility IBS, neurological symptoms, meds

Question 2

2. What are the recommendations related to fiber and water for the prevention of constipation?

Answer 2

1) 25-38 g/day adult ;children 1-8 (19 - 25g) day 2) Fluids minimum 2 qt/da

Question 3

Good source vs bad source of fiber

Answer 3

good source 3g/serving ; great source greater than or equal to 5g/serving

Question 4

3. Identify metabolic consequences of diarrhea? How does the use of antibiotics sometimes lead to diarrhea? Why is C. diff so potentially dangerous?

Answer 4

d: frequent evacuation of liquid stools w/ excessive loss of fluid and electrolytes (Na/K) mc: dehydration, hyponatremia/kalemia; acid-base imbalance. diarrhea is the leading caused of death in children world wide

Question 5

4. a osmotic diarrhea

Answer 5

hyperosmolar load; dumping syndrome; (fructose/lactose/sorbitol); cessation of eating will decreasing incidence T: Cessation of eating will decrease incidence

Question 6

4 b. Secretory diarrhea

Answer 6

caused by viruses/bacterial exotoxins; intestinal secretion of H20/electrolytes into GI cessation of foods will not help.

Question 7

4c exudative diarrhea

Answer 7

damage to the mucosa; H20 and mucous and electrolytes enter the G.I tract and have limited mucosal contact

Question 8

4d. Medication induced diarrhea

Answer 8

antibiotic; kill good bacteria; lose SCFA (help absorb electrolytes and H20 from colon) and increase G.I mobility

Question 9

5. Identify the general treatment goals and types of foods to be included in the treatment of diarrhea

Answer 9

correct nutritional deficiency, improve symptoms, low fiber diet, replace fluids, electrolytes (Na/K+), intractable TPN, limit lactose, fructose, and sucrose.

Question 10

6. How are SCFAs produced in the large intestine? Identify positive contributions of SCFAs

Answer 10

1. produced by good bacteria in the intestine from dietary fiber. Also produce VK, B12, thiamin, and riboflavin PC: enhance absorption of NaCl/H20,

Question 11

C. Diff

Answer 11

causes life threatening inflammation of the colon. Attack the colonic wall. often found in older adults in adult care facilities

Question 12

7. Pre vs pro biotics

Answer 12

1) prebiotics - non digestible fibers 2) probiotics - actual organisms

Question 13

8.Identify guideline regarding excretion of fecal fat which results in a diagnosis of steatorrhea.

Answer 13

1) Normal x less than 5 g; steatorrhea 60 g/day test: qualitative fecal fat: positive it x greater than 6g/24hr in stool