Nutrition Chapter 18

An oral rehydration solution can be mixe from the following ingredients

1/2 cup salt; 1/2 cup salt substitute; 3/4 tsp baking soda; 1 1/3 tbs sugar; 1 liter drinking water

Clinical studies have found that individuals with lactose intolerance can tolerate up to ___ of milk a day without significant symptoms.

2 cups

Approximately ___ percent of people worldwide have some degree of lactose intolerance.

75%

Why should people increase fiber intake gradually when attempting to relieve constipation?

A sudden increase can increase intestinal gas.

Lactose intolerance is especially prevalent among which ethnic groups.

Asians, African Americans, Native Americans, Ashkenazi Jews, and Hispanic/Latino populations

Why is skipping breakfast discouraged with people experiencing symptoms of constipation?

Colonic motility is highest after a morning meal.

Corn and carbonated beverages are two forms of FODMAPs. True or False.

False

Sometimes skipping breakfast may be encouraged to reduce the symptoms of constipation. True or False

False

Symptoms of bloating and abdominal pain correlate with an increase in intestinal gas. True or False

False

The treatment of Crohn's disease and intestinal cancers may incude the surgical resection of a major portion of the large intestine. True or false.

False, small intestine

Following ileostomy procedure, patients are encouraged to limit salt in takes. True or False.

False, they are encouarged to use salt liberally and to drink electrolyte beverages

Probiotics can stimulate the growth of activity of the resident bacteria within the large intestine. True or False.

False; prebiotics do.

The symptoms of malabsorption of protein is more severe in patients with chronic pancreatitis. True or False

False; the malabsorption of fat is most severe

Due to the presence of glucose that enchances sodium and electrolyte absorption in commercial sports drinks, they are considered ideal for the use in oral rehydration therapy. True or False

False; their sodium content is too low

When attempting to relieve constipations, fiber supplements such as Metamucil, Fiberall, and Fiber-lax should be used with caution since they increase intestinal gas. True or False.

False; these fibers do not increase intestinal gas

Although lactobacilli are used to produce fermented foods like saurkraut, pickles, brined olives, and sausages, they retain few, if any live bacteria after they undergo typical food processing methods. True or False.

True

Bulk forming agents such as psyllium or methlcellulose can help to reduce the liquidity of stool. True or False

True

Chronic pancreatitis can lead to irreversible pancreatic tissue and permanent loss of function. True or False

True

Correcting the underlying medical problem is the first step in treating diarrhea. True or False

True

Foods such as artichokes, onions, cabbage, and dried fruit can worsen diarrhea. True or False

True

In individuals with a low fiber intake, the primary treatment for constipation is a gradual increase in fiber intake to at least 20-25 grams per day. True or False

True

Individuals with lactose intolerance can improve their condition by regular consumption of milk. True or False

True

People who develop lactose intolerance as a result of intestinal illness are generally advised to temporarily restrict milk and milk products. True or False

True

Probiotics may be beneficial for treating infectious diarrhea. True or False

True

Supplmentation of fiber supplements such as, Metamucil or Fiberall are recommended over a high-fiber diet to treat symptoms of IBS, true or false.

True; high-fiber diets may worsen symptoms by increasing flatulence.

Colonic motility is highester after ___.

a morning meal

Once a patient is pain free and experiences or no vomiting from pancreatitis, patients can usuaslly consume:

a regular diet

Individuals with celiac disease should eat only uncontaminated oats and limit intakes to:

about 1/2 cup of dry rolled oats, or 1/4 cup of dry steel cut oats per day.

Methods for increasing fiber intake with bran.

adding bran cereals and whole wheat bread to the diet, or mixing bran powder with beverages or foods.

In the treatment of diarrhea in formula fed infants, ___ or ___ are sometimes added to formulas to help thicken stool consistency.

apple pectin; banana flakes.

For diarrhea following ostomies, what are foods that may help thicken stool?

applesauce, banana, cheese, pasta, potatoes, vidual. (best determined by trial and error)

Foods to avoid to reduce gas and odors following ostomies.

asparagus, beer, brocoli, brussels sprouts, cabbage, cauliflower, dried beans and peas, eggs, fish, garlic, and onions.

Celiac disease is an immunde disorder characterized by an abnormal immune respose to a protein fraction in wheat glutenan d to related proteins in:

barley and rye

Gluten sources that may be overlooked:

beer; brewer's yeast, caramel coloring, coffee substitutes, communion wafers, imitation meats, malt syrup, medications, salad dressings, and soy sauce.

Gluten-free products can be purchased to replace common food items such as:

bread, pasta, and cereals

Foods that may help to reduce odors following ostomies.

buttermilk, cranberry juice, parsley, and yogurt.

Although fluid intakes must usually be increased to replace fluid losses, patients should avoid ____ as it stimulates GI mobility.

caffeinated coffee and tea

Supplements that can cause constipation

calcium and iron supplements

More serious cases of pancreatitis may lead to :

chronic pancreatitis, infection, systemic inflammatory response syndrome, or multiple organ failure.

Food intake recommended directly following surgery for colostomy and ileostomy,

clear liquids low in sugar, to regular foods as tolerated, low-fiber to reduce stool output

Severe or persistant diarrhea can cause ____.

dehydration and electrolyte imbalances.

Long term pancreatitis can lead to the development of ____ in 40-80 percent of patients

diabetes

Medical conditions associated with constipation

diabetes, hypothyroidism; nuerological conditions such as parkinson's disease, spinal cord lesions, and multiple sclerosis

____ is a frequent complication of tube feedings.

diarrhea

Primary symptoms of lactose intolerance

diarrhea and increased intestinal gas

Symptoms of short bowel syndrome

diarrhea, steatorrhea, drhydration, weight loos and growth impairment in children.

To acheive normal growth and appropriate weight, CF patients are encouraged to:

eat a high kcalorie, high protein diet, consume high-fat foods freely, eat frequent meals and snacks, and supplement meals with milkshakes or oral supplements.

The use of ____ may improve tolerance in patients with pancreatitis

elemental formulas

Less frequent causes of acute pancreatitis

elevated blood triglyceride levels or exposure to various drugs or toxins

At least ___ of chronic pancreatitis casess are caused by:

excessive alcohol consumption

Low-fiber diet, low food intake, inadequate fluid intake, or low level of physical activity has what effect on constipation

extend transit tiem, leading to increased water reabsorption within the colon and dry, hard stools that are difficult to pass.

If a large portion of the ileum has been removed, ____ may occur due to ____ and _____ may be required.

fat malabsorption may occur; due to bile acid depletion; Vitamin B12 injections may be required.

Fermentable dietary carbohydrates are often referred to as FODMAPs, an acronym for:

fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.

Diarrhea can be accompanied by other symptoms such as __.

fever, abdominal cramps, dyspepsia, or bleeding.

Consequences of short bowel syndrome include:

fluid and electrolyte embalances and multiple nutrient deficiencies

Secretory diarrhea is often caused by:

foodborne illnesses

Foods that might aggravate symptoms of irritable bowel syndrome

fried or fatty foods; gas-producing foods; wheat and other grains; milk products; and caffeinated beverages

About 70-80% of acute cases of pancreatitis are caused by __ or__

gall stones; alcohol abuse;

Protein needs for a patient with acute pancreatitis

generally high; between 1.2 and 1.5 grams per kilogram of body weight per day.

The presence of ___ in an oral rehydration solution enchances the sodium and water absorption.

glucose

Common causes of osmotic diarrhea

high intakes of poorly absorbed sugars; lactase deficiency; ingestion of laxatives that contain magnesium or phosphates.

Foods that may worsen diarrhea

high-fiber foods; foods with indegesitble carbohhydrates, foods that contain fructose or sugar alcohols.

Pancreatic disorders can lead to maldigestion and malabsorption due to:

impared secretion of digestive enzymes.

Recommendation for gradual fiber intake after inflammation from diverticular disease.

increase by 5 times a week until recommended intakes of 25-35 grams of fiber have been reached.

How do high-fiber diets help relieve constipation?

increase stool weight and fecal water content and promote a more rapid transit of materials through the colon.

The energy and protein needs are high in individuals with cystic fribrosis due to :

increased metabolism and nutrient malabsorption

Laxatives may improve a constipation problem by:

increasing stool weight; increasing the water content of the stool; or stimulation peristaltic contractions.

Diarrhea is a complication of multiple GI disorders and may also be induced by:

infections, medications, or dietary substances.

Chronic diarrhea can result from:

inflammatory diseases, motility disorders, chronic infecitons, radiation treatment and many other conditions.

When treating diverticular disease, the emphasis should be on what type of fiber?

insoluble fiber

Foods high in ___ following an ileostomy procedure are discouraged.

insoluble fibers

Possible unpleasant side effect of consuming a high-fiber diet

intestinal gas (flatulence)

Secretory diarrhea is often caused by foodborne illnesses, but can also be caused by:

intestinal inflammation or irritating chemical substances.

Nutrients at risk in people with Crohn's disease:

iron, zinc, magnesium, calcium, Vitamin D, folate, and Vitamin B12.

Restricting foods such as beans, peas, dates, and garlic has been found to improve intestinal discomfort in individuals with certain GI diseases such as ___.

irritable bowel syndrome

A deficiency in ___ can cause malabsorption of lactose, potentially leading to osmotic diarrhea.

lactase

Adequate consumption of ___ enhances the effect of an increased fiber intake when used to relieve symptoms of constipation.

liquid (1.5 to 2 liters daily).

For ulceritive colitis, a diet:

low in fiber may reduce irritation by minimizing fecal volume.

Eating style best suited for irritable bowel syndrome, to reduce flatulence, abdominal pain; bloating and diarrhea

low-FODMAP

The risk of constipation is increased in individuals with ____

low-fiber diet; low food intake; inadequate flui intake, or low level of physical activity

During disease exacerbations in individuals with Crohn's disease, a _____ diet provided in small, frequent feedings can reduce symptoms of malabsorptin.

low-fiber; low-fat

Malabsorption disorders can also cause considerable flatulence because the undigested _____ can be metabolized by colonic bacteria.

macromolecules

Irritating chemical substances that can cause secretory diarrhea

medications or unabsorbed bile acids

Name of fiber in citrucel

methylcellulose

List the fiber supplements that do not increase intestinal gas.

methylcellulose (citrucel), psyllium (metamucil, fiberall), and polycarbophil (Fiber-lax).

Dietary sources of probiotic foods in Europe and Asia

milk, yogurt, ice cream, oatmeal gruel, and soft drinks.

Foods to avoid with diverticular disease:

nuts, seeds, popcorn

Constipation is also a common side effect of several classes of medications including

opiate-containing analgesics, anticholinergics, anticonvulsants, diuretics, and calcium channel blockers

In mild-to-moderate cases of pancreatitis:

oral fluids and food are witheld until the patient is pain free and experiences no nausea or vomiting

The initial treatment for acute pancreatitis is supportive and includes:

pain control and intravenous hydration

___ is the main treatment for steatorrhea and other symptoms of malabsorption in patient with chronic pancreatitis.

pancreatic enzyme replacement

Name of fiber in Fiber-lax

polycarbophil

Crohn's disease often requires aggressive dietary management because it can lead to:

protein-energy malnutrition, nutrient deficiencies, and growth failure in children.

Patients with chronic pancreatitis who are hypermetabolic and underweight have high protein and energy requirements; protein needs may range between ___ and __ grams her kg of body weight per day, and energy intakes should be about ___ kcalories per kg of body weight.

protein: 1 -1.5; energy: 35

Consuming ___ or ___ is often recommended in the prevention or treatment of constipation because they contain compounds that have a mild laxative effect.

prunes or prune juice

Type of fiber in the supplement known as metamucil or Fiberall.

psyllium

Indigestible or poorly absorbed carbohydrates that may contribute to intestinal gas

raffionse and stachyose (beans); lactose; fructose; some sugar alcohols; some forms of resistant starch found in grain products and potatoes.

Consuming beverages or foods that stimulate GI motility worsen diarrhea by ___.

reducing water absorption.

During disease exacerbations of colitis emphasis is given to:

restoring fluid and electrolyte embalances; correcting deficiencies that result from protein and blood losses

Commercial sports drinks can be used in oral rehydration therapy as long as they are accompanied by __.

salty snacks

Common symptoms of acute pancreatitis:

severe abdominal pain, nausea, vomiting, and abdominal distention

Poorly absorbed sugars that can lead to osmotic diarrhea

sorbitol, mannitol, fructose

Sugar alcohols that can lead to intestinal gas

sorbitol; xylitol; mannitol

How does adequate fluid intake enhance increased fiber intake when taken to relieve constipation?

stool frequency; prevents excessive reabsorption of water from the colon.

Motility disorders may also result in diarrhea because they accelerate the transit of colonic residue, reducing ___.

the contact time available for fluid reabsorption.

During disease exacerbations of ulceritive colitis dietary adjustments are based on:

the extent of bleeding and diarrhea output

Risk of nutrient deficiency in individuals with CF depends on the degree of malabsorption; nutrients of greatest concern include:

the fat-soluble vitamins, essential fatty acids, calcium, iron, and zinc.

People with severe, intractable diarrhea sometimes require:

total parenteral nutrition

Acute cases of diarrhea are frequently caused by ___ infections

viral, bacterial, or protozoal infection

People with Crohn's disease may require supplementation of ___ due to malabsorption of the nutrient.

vitamin B12 injections

Chronic diarrhea can lead to___.

weightloss and malnutrition

Foods that increase stool weight the most:

wheat bran, fruits, and vegetables

Types of high fiber foods recommended for diverticular disease.

wheat bran, whole grains, fruits, and vegetables.

The gluten-free diet eliminates foods that contain:

wheat, barley and rye