Nutrition Ch 24 & 25
Constipation is, in part, diagnosed by defecation frequency of fewer than _____ bowel movements per week.
3
Osmotic laxatives: poorly absorbed salts
Attract water and increase the liquidity of stools, which stimulates contractions.
Which bacteria is considered a predominant form found in the gastrointestinal tract?
Bifidobacteria
Nutrition therapy for ulcerative colitis
Diet requires few adjustments
Genetic disorders (Malabsorption)
Enzyme deficiencies
Symptoms of constipation.
Excessive straining, hard stools, incomplete evacuations
FODMAPs is the acronym for.
Fermentable oligosaccharides, disaccharides, monosaccharides, and polyols
Explain how high-fiber diets may increase flatulence.
Fibers remain undigested and pass into the colon where fermentation by bacteria occurs. Gas is a by-product. Soluble fibers, compared with insoluble fibers, are more readily fermented
Diarrhea
Frequent, watery stools
Acute pancreatitis
Frequently caused by gallstones or alcohol abuse Severe abdominal pain, nausea, and vomiting Oral fluids and food typically withheld until patient is pain-free Tube feedings used in severe cases
Surgeries (Malabsorption)
Gastric or intestinal bypass surgery Intestinal resection (short bowel syndrome)
Treatment of constipation
Gradual increase in fiber intake Consuming adequate fluid
Inflammatory Bowel Diseases
Growth failure, weight loss, or muscle wasting -High-kcalorie, high-protein diet -Oral supplements -Tube feedings Anorexia or pain with eating -Small, frequent meals -Oral supplements, as tolerated -Tube feedings if long-term (>5-7 days) Malabsorption -High-kcalorie diet -Nutrient supplementation Steatorrhea (fat malabsorption) -Low-fat diet -Medium-chain triglycerides -Nutrient supplementation Diarrhea -Fluid and electrolyte replacement -Nutrient supplementation Lactose intolerance -Avoidance of lactose-containing foods Nutrient deficiencies -Nutrient-dense diet -Nutrient supplementation Strictures, partial obstruction, or fistulas -Low-fiber diet -Liquid supplements Severe bowel obstruction, high-output fistulas, or severe exacerbations of Disease -Total parenteral nutrition
Foods That May Worsen Diarrhea
High-fiber foods: They increase colonic residue. -Breads and cereals with more than 2 g fiber per serving, fruits and vegetables with peels or skin Foods with indigestible carbohydrates: They contribute to osmotic diarrhea. -Artichokes, asparagus, brussels sprouts, cabbage, dried beans and peas, fruit, garlic, green beans, leeks, onions, wheat, zucchini Foods that contain fructose or sugar alcohols: They contribute to osmotic diarrhea. -Dried fruit, fresh fruit (except bananas), fruit juices, fructose-sweetened soft drinks, sugar-free gums and candies Milk products, if person is lactose intolerant They contribute to osmotic diarrhea. -Milk and milk products Gas-producing foods: They increase abdominal discomfort. -Foods with poorly digested or absorbed carbohydrates (including foods listed in the three rows directly above) Caffeine-containing beverages: They increase intestinal motility. Coffee, tea, cola beverages, energy drinks -Coffee, tea, cola beverages, energy drinks .
Nutrition therapy for Crohn's disease
High-kcalorie, high-protein diets Vitamin and mineral supplements
Fiber (bulk-forming agents)
Increase stool weight and aid in the formation of soft, bulky stools. Similar effects may be achieved by consuming a high-fiber diet. For mild to moderate constipation. Safe for long-term use
Prevalence (of diverticular disease)
Increases with age (50 to65 percent of 80 year olds)
Diverticulitis
Inflammation/infection of the diverticula
A cirrhosis patient has developed ascites. What is one significance of this condition?
It can cause malnutrition due to early satiety.
risk factors for constipation
Low-fiber diet, low food intake, inadequate fluid intake, low level of physical activity
Complications of cystic fibrosis
Lung disease, pancreatic disease, other complications
Cystic Fibrosis
Most common life-threatening genetic disorder among Caucasians
Irritable bowel syndrome (IBS)
Most frequently diagnosed digestive disorder in the United States
Fat
Nutrient most frequently malabsorbed
Short bowel syndrome (SBS)
Occurs when the bowel is surgically shortened to the extent that the remaining bowel is unable to absorb adequate levels of nutrients to meet the individual's needs
Causes of diarrhea
Osmotic diarrhea Secretory diarrhea Motility disorders
Liver disease (Malabsorption)
Pancreatic disorders Chronic pancreatitis Cystic fibrosis
Celiac Disease
People who have a first-degree relative with celiac disease, people with Down syndrome, and those with an autoimmune disease are at risk for celiac disease
Who is at risk for celiac disease?
People who have an autoimmune disease
Diverticulosis
Presence of pebble-sized herniations in the intestinal mucosa; may be increased with low-fiber diet
Chronic pancreatitis
Progressive, permanent damage to pancreatic tissue Frequently caused by excessive alcohol consumption Smoking often a risk factor Can lead to weight loss, malnutrition, and diabetes Pancreatic enzyme replacement
Stool surfactant agents (stool softeners)
Promote the mixing of water with stools; prevent formation of dry, hard stools.
CD is the abnormal response to a _____ fraction in wheat _____.
Protein, gluten
What is the most likely adaptation after intestinal resection?
The remaining section of intestine develops taller villi and deeper crypts.
The prevalence of constipation is higher in ______. _____ adults have an especially high prevalence of constipation.
Women, older
The most common causes of cirrhosis in the United States are _____.
alcoholic liver disease and hepatitis C infection
The use of probiotics may be most useful for which patient?
an individual suffering from pouchitis
Which type of anemia develops from a failure of stem cells to develop into red blood cells?
aplastic anemia
Celiac disease (CD) is a(n) _______ disorder.
autoimmune
An impacted gallstone within the bile duct can cause a condition that results in severe pain, sepsis and fever, known as _____.
bacterial cholangitis
Secretory diarrhea may be caused by _____.
bacterial food poisoning
When triglycerides accumulate in the liver, the liver _____.
becomes inflamed
What disease results in flattening of the intestinal mucosa due to shortening or absence of villi and overdeveloped crypts?
celiac disease
The condition of having infrequent or difficult bowel movements is called _____.
constipation
Diet therapy in chronic pancreatitis regularly includes _____.
enzyme replacements
When the kidneys detect reduced oxygen in the blood, they release _____.
erythropoietin
The lower GI tract disorders that affect nutrition most profoundly are those that cause _____ malabsorption.
fat
A major concern to prevent complications for the post-transplant patient is _____.
food safety
Cholesterol gallstones are most likely to be associated with _____.
gastric bypass surgery
Which type of diet should be avoided by a person experiencing an exacerbation of Crohn's disease?
high-fat
Individuals with diverticulosis are often advised to follow a _____ diet.
high-fiber
Which diet is most appropriate for a post-liver transplant patient?
high-kcalorie, high-protein snacks and supplements
How should hepatitis C be treated?
interferon alfa
What is a common disorder characterized by a disturbance in the motility of the GI tract that frequently occurs shortly after a person eats?
irritable bowel syndrome
What condition develops when bile pigments accumulate in the blood?
jaundice
High urinary oxalate favors the formation of _____.
kidney stones
Hepatic encephalopathy treatments include _____.
lactulose to reduce the amount of ammonia absorbed
Which condition is a risk factor for gallstones?
obesity
Elevated serum amylase and lipase serve as indicators of _____.
pancreatitis
Treatments under investigation for irritable bowel syndrome include _____.
peppermint oil
What nutrition support option is most appropriate for a patient with Crohn's disease who has been admitted to the hospital because of severe exacerbation of the disease?
total parenteral nutrition
Normally, the healthy liver removes ammonia from circulation and converts it to _____.
urea
Patients with cirrhosis may develop _____, which can cause excessive bleeding if ruptured.
varices
Intestinal disorders (Malabsorption)
•AIDS-related enteropath • Bacterial overgrowth •Celiac disease • Crohn's disease •Radiation enteritis
Intestinal infections (Malabsorption)
•Giardiasis •Nematode (roundworm) infections