Ch. 17

___ refers to the the general symptoms of pain or discomfort in the upper abdominal region; may include stomach pain, gnawing sensations, early satiety, nausea, vomiting, and bloating

dyspepsia

because of the many tasks involved in swallowing, _____ can result from a number of physical or neurological problems

dysphagia

impaired swallowing is called

dysphagia

_____ is characterized by frequent reflux backward flow) of the stomach's acidic contents into the esophagus, leading to pain inflammation, and possibly tissue damage

gastroesophageal reflex disease (GERD)

saliva substitutes for managing dry mouth: use over the counter saliva substitutes (available as ___, ___, and ___; especially at ____); try rinsing the mouth with a ____ of ____ or ____

gels; sprays; tablets; bedtime; teaspoonful; vegetable oil; softened margarine

air swallowing often accompanies ____, ___, rapid ___, drinking ____, and using a ____; omitting these practices generally helps to correct the problem

gum chewing; smoking; eating; carbonated beverages; straw

what is the common cause of chronic gastroesophageal reflux?

hiatal hernia

psychological stress by itself is not believed to cause ulcer, but it has effects on physiological processes and behaviors that may increase a person's vulnerability; the physiological effects of stress vary among individuals, but may include ___ changes that impair ___ and ____, increased secretion of ____ and ____, and rapid ____ (which increases the ___ load in the duodenum)

hormonal; immune response; wound healing; pepsin; hydrochloric acid; stomach emptying; acid

to minimize discomfort, people with dyspepsia are advised to avoid ___ or ___ meals, highly ___ foods, and the specific foods or substances that are believed to trigger symptoms

large; fatty; spiced

patients with peptic ulcers should follow a ____ diet that avoids dietary items that increase ____ or irritate the ____; examples include ____ beverages, ____, ____-containing beverages, ____ and ___ (even if it is ____), and ____ (although individual tolerances may vary; there's no evidence that dietary adjustments alter the rate of healing or prevent recurrence; in other words, the diet is meant to relieve ____ and maintain ____. It does not ____ or ____ the condition.

liberal bland; acid secretion; GI lining; alcoholic; chocolate; caffeine; tea; coffee; non caffeinated; pepper; symptoms; nutrition; prevent or cure

symptoms of dysphagia include: difficulty keeping ___; food/drink ___ from the mouth; ___ with food/drink; ____; and frequent bouts of ____

lips closed; spilling; coughing; aspiration; pneumonia

the ____ procedure removes a large portion of the stomach, leaving only a narrow gastric ___ (or ____) that holds only about ___-___ ounces (about ___ cup) of food

sleeve gastrectomy; tube; sleeve; 3-5; 1/2

Which nutrient deficiencies have an effect on developing dental caries?

vitamin A, vitamin D, Calcium, phosphorus, and fluoride

oral intakes after a gastrectomy are suspended until some healing has occurred; oral intakes may begin with small sips of ____, ____ (melted in the mouth), and ____; once fluids are tolerated, patients may be offered ____ meals (with no ____) at first; after ___ foods are started, meals may contain only one or two food items at a time so that ___ can be evaluated; ____ may become necessary if complications prevent a normal progression to ____

water; ice chips; broth; liquid; sugars; solid; tolerance; tube feeding; solid foods

once the diet progresses to solid foods, patients consume between ___-___ small meals and snacks per day; it is important for patients to go back to eating ___ and not just ___/___ throughout the day; meals ensure appropriate nutrients are consumed without additional calories; ___ must be consumed separately from meals to avoid excessive ____

3-6; meals; graze/snack; fluid; distention

chronic reflux is also associated with _____, condition in which damaged esophageal cells are gradually replaced by cells that resemble those in gastric or intestinal tissue; such cellular changes increase the risk of developing esophageal ___; GERD can also damage tissues in the ___, ___, and ___, resulting in eroded ___, sore ___, and ____

Barrett's esophagus; cancer; mouth; pharynx; larynx; tooth enamel; throat; laryngitis

peptic ulcers are a major cause of ____, which occurs in up to ___% of ulcer cases

GI bleeding; 15

a primary factor in peptic ulcer development is ___ infection, which is present in up to ___-___% of patients with gastric ulcers and ___-___% of patients with duodenal ulcers

H. pylori; 30-60; 70-90

Liquid Consistency levels of mechanically altered diets: Level 3- ____ includes: fluids that can be eaten with a ____, but do not hold their ___; ___, some ___ products, ___

HONEY-LIKE; spoon; shape; honey; yogurt; tomato soup

Liquid Consistency levels of mechanically altered diets: Level 2- ____ includes: fluids thicker than water that can be sipped through a ___; ___, ___, ___, ___

NECTAR-LIKE; straw; buttermilk; eggnog; tomato juice; cream soup

Liquid Consistency levels of mechanically altered diets: Level 4- ____ includes: thick fluids that must be eaten with a ___, but can hold their ___; ___, thickened ___

SPOON-THICK; milk pudding; thickened applesauce

What is the best response to a client asking why it so important to avoid sugars and sweets after gastric bypass surgery?

Sugars can draw water into the intestines and cause cramping and diarrhea

Liquid Consistency levels of mechanically altered diets: Level 1- ____ includes: watery fluids; ___, ___, ___, ___, ___, ____ desserts, ___, or ___

THIN; coffee, milk, tea, juice, carbonated beverages, gelatin dessert, ice cream, sherbet

___ food and beverages, such as ___ drinks, ___ fruits and juices, ___, and some ___, also contribute to the erosion of ____; ___ food items are more cariogenic when consumed ___ or ___ meals because they are less likely to be rinsed away by ___ or neutralized by ____ foods that may be consumed during the meal

acidic; cola; citrus; pickles; herbal teas; tooth enamel; acidic; between; after; saliva; alkaline

Levels of National Dysphagia Diet: Level 3 - Dysphagia _____: this diet is for patients with mild dysphagia and adequate chewing ability foods should be ___ and in ___ pieces when swallowed; foods with mixed ___ are included example foods: cereal with milk; scrambled eggs; fresh fruit or berries; chicken noodle soup; moist bread; shredded lettuce; rice avoid: dry, tough, or crusty foods; nuts/seeds; chowders; potato skins; raw veggies (EXCEPT shredded lettuce); chunky peanut butter; hard fruit (apples or pears) or fruit with skin, seeds, or stringy texture (mango/pineapple); popcorn; chewy candies

advanced; moist; bite-sized; textures

if pain or discomfort is present, the patient should avoid irritating foods and beverages; these often include ____ beverages, ____, ____ beverages, and ___ or ___ foods; this is referred to as a ____ diet

alcoholic; coffee; acidic; fried; fatty; liberal bland

what's a complication after gastric surgery?

bone disease

dental care for managing dry mouth: pay strict attention to oral hygiene (___ and ___ at least ___ daily; try to ___ immediately after each meal); avoid ___ and ___-containing mouthwashes that may dry and irritate that mouth; ask your dentist about ___ treatments to help prevent ____

brush and floss; brush; alcohol and detergent; fluoride; tooth decay

the development of dental caries is influenced by the type of ____ consumed, the frequency of ___ intake, the ___ of the foods that contain ____, and the availability of ___ to rinse teeth and neutralize ___; other factors include ___, ___ intake, and the composition of tooth ___, which together influence a person's susceptibility to caries; poor nutrition during ___, ___, or early ___ can impair the development of healthy teeth and increase vulnerability to dental caries

carb; carb; stickiness; carbs; saliva; acid; oral hygiene; fluoride; enamel; pregnancy; infancy; childhood

the most ____ foods are ___-containing foods that remain in contact with the teeth for prolonged periods, are difficult to clear form the mouth, or are consumed frequently or over an extended time period; examples include ___ or ___ that dissolve slowly in the mouth; ___ or ___ foods, such as ___ or ___; ___ snack foods, such as ___ or ___; and ___ beverages that are repeatedly sipped

cariogenic; carb; hard candy or lozenges; sticky or chewy; dried fruit; chewy bread; starchy; pretzels; chips; sweetened

medications for managing dry mouth: if dry mouth is caused by a medication, ask your physician about possible alternatives; ask your physician whether using a medication to stimulate saliva secretion may be beneficial (examples include: ___ (brand name ___) and ____ (brand name ___)

cevimeline (Evoxac); pilocarpine (Salagen)

dental diseases can also have adverse effects on health beyond teeth; periodontal pathogens induce an inflammatory process that may increase levels of ____ and other mediators that accelerate the progression of ___; in addition, periodontal bacteria may enter the ___ and contribute to the processes of ___ formation or ___; the chronic inflammation cause by periodontal disease can also exacerbate ___ and provoke events leading to ____; severe periodontal disease has also been linked to poor ____ in persons with diabetes; clinical studies suggest a link between ___ and poor oral health; in addition, dental treatment and improvements in oral health have been associated with significant reductions in ____ diseases in institutionalized older adults

cytokines; atherosclerosis; bloodstream.; arterial plaque; blood clotting; insulin resistance; type 2 diabetes; glycemic control; pneumonia; respiratory

In what way does gastric bypass surgery help with weight loss?

decreases ghrelin production and there lowers appetite

poorly controlled ____ is often associated with dry mouth, as is excessive ____ and conditions that directly affect ____ function (radiation therapies that treat head and neck cancers often damage ____, sometimes permanently)

diabetes mellitus; mouth breathing; salivary gland; salivary glands

___, ___ foods, such as toast, crackers, and pretzels may help to reduce nausea, whereas ___ foods and foods with strong ____ may worsen symptoms; foods that are ___ or ____ may be better tolerated than foods that are ___; individuals often have strong food ____ when nauseated, and tolerances vary greatly

dry; starchy; fatty; odors; cold; room-temperature; hot; aversions

in addition, individuals who have had gastric bypass are at risk of _____; thus the precise dietary guidelines vary depending on the type of procedure performed

dumping syndrome

some gastric surgeries increase the risk of ____, a group of symptoms that result when a large amount of food passes rapidly into the small intestine

dumping syndrome

______ is a common complication of a gastrectomy that is characterized by a group of symptoms resulting from rapid ____

dumping syndrome; gastric emptying

a person with ____ has difficulty passing materials through the esophageal lumen and into the stomach; its usually due to an ____ in the esophagus or a ___ disorder; the main symptom is the sensation of food ____ in the esophagus after it is swallowed

esophageal dysphagia; obstruction; motility; sticking

the feeling of bloating may be caused by ____ in the stomach, which accumulates when ___ is swallowed

excessive gas; air

dry mouth may cause a person to reduce ___ (thereby increasing risk of ____) and may also diminish ____ additionally, ___ and ___ foods may cause pain

food intake; malnutrition; taste sensation; salty and spicy

in ____, a ____ is placed around the uppermost portion of the stomach; adjusting the ____ level of the ___ can loosen or tighten it and alter the size of the opening to the rest of the stomach; a smaller opening slows the rate at which the ____ region is ____ and prolongs the sense of ____ after a meal

gastric banding; fluid-filled, inflatable band; fluid; band; upper; emptied; fullness

____ accounts for about ___-___% of bariatric surgeries; in this surgery, a small ___ is constructed to reduce ___ and thereby restrict ____; in addition the ___ is connected directly to the ___, resulting in significant nutrient ____ because the flow of food bypasses a large portion of the small intestine

gastric bypass; 45-50; gastric pouch; stomach capacity; meal size; gastric pouch; jejunum; malabsorption

note that patients who have had ____ surgery are at risk of multiple nutrient deficiencies due to ____, whereas the ____ and ____ procedures have little impact on nutrient _____ because none of the ____ is bypassed

gastric bypass; malabsorption; gastric banding; sleeve gastrectomy; absorption; small intestine

clinical studies indicate that the ___ and ____ surgeries usually result in greater weight loss than the ____ procedure

gastric bypass; sleeve gastrectomy; gastric banding

_____ is a general term that refers to inflammation of the gastric mucosa; acute cases of gastritis usually result from irritating substances or treatments that damage stomach tissue, resulting in tissue ___, ___, or ____; in most cases, gastritis results from ____ infection or the use of ____, which are both the primary causes of peptic ulcer disease as well

gastritis; erosion; ulcers; hemorrhaging; Helicobacter pylori (H. pylori); non-steroidal anti-inflammatory drugs (NSAIDs)

a complication of gastritis is that if hydrochloric acid secretions become abnormally low (called _____) or absent (called ____), absorption of ____ and vitamin ____ can be impaired, increasing the risk of deficiency; lack of intrinsic factor (a protein secreted by stomach cells) can result in vitamin ___ malabsorption and the vitamin ___-deficiency condition, known as _____

hypochlorhydria; achlorhydria; nonheme iron; B12; B12; B12; pernicious anemia

What is an example of a strategy used by dietitians to encourage clients on mechanically altered diets to eat adequate amounts?

identify a person's favorite foods and foods that have pleasant smells

dysphagia diets are highly ____ because ____ problems vary in severity and ___ ability can fluctuate over time

individualized; swallowing; swallowing

What is the main characteristic of gastritis?

inflammation of the lining of the stomach

after bariatric surgery, patients initially consume only ____ and liquids that are ____, ____, and ___; they then progress to a liquid diet (high in ___, low in ___ and ___), followed by ____ and/or ___ diets and then finally ____ foods

low-fat broths; sugar-free; clear; non-caffeinated; protein; sugars and fats; pureed foods; soft foods; solid

the ____ is the main barrier to gastric reflux, so GERD can result if the muscle is weak or relaxes inappropriately; other factors include high stomach ____ and inadequate ___ from the esophagus

lower esophageal sphincter; pressures; acid clearance

health practitioners should be alert to the various complications that may accompany dysphagia; if the condition restricts food consumption, ___ and ___ may develop; individuals who cannot swallow liquids are at an increased risk of ___; if aspiration occurs, it may cause ___, airway ___, or respiratory ___, including ___

malnutrition; weight loss; dehydration; choking; airway obstruction; infections; pneumonia

mechanically altered diets includes solid foods that are ___, ___, ____, or ___

mashed, minced, ground, or soft

people with chewing and swallowing difficulties should be put on a ____ diet

mechanically altered

Levels of National Dysphagia Diet: Level 2 - Dysphagia _____: diet is for patients with mild to moderate dysphagia; some chewing ability is required foods should be ___, ____, and ___ or ___ and should easily form a ___ example foods: moist oatmeal or cereals; soft eggs or cheese; cooked fruit without skin or seeds; soup/stew with tender meat and veggies avoid: dry or course foods; nuts/seeds; sausage; hard-cooked eggs; chowders; sandwiches; pizza; sliced cheese; rice; French fries; peanut butter; rubbery or fibrous veggies; popcorn

mechanically altered; moist; cohesive; ground or soft-textured; bolus

mechanically altered or soft foods diet: milk products (___, ____ with soft fruit, ____, and ___); fruit (canned or cooked fruit without ____ or ____, fruit ___ with small amounts of ___, and ripe ____); vegetables (___, ___ vegetables that are not ___ or ____ and well-cooked, moist ____); meat or meat substitutes (___, ____, or ___ meat, poultry, or fish with ___ or ___, ___, well-cooked, moist, ____; eggs that are ___ or ___); bread and cereals (___ cereals or ____, ___ cereals with minimal ___, ___ bread or ___, well-cooked ___ or ___ in ___ or ___)

milk; yogurt; pudding; cottage cheese; seeds; skin; juice; pulp; bananas; soft, well-cooked; rubbery; fibrous; potatoes; ground, minced, or tender; gravy; sauce; tofu; legumes; scrambled or soft-cooked; cooked; moistened, dry; texture; soft; pancakes; noodles; dumplings; sauce or gravy

pureed food diet includes: milk products (___, ___, ___, ___); fruit [___, well-mashed ___, pureed fruit, and fruit ____ (that contain no ___, ___, ___, or ___)]; vegetables (____, pureed ____ with ___, and pureed vegetables without ___, ___, or ____); meat and meat substitutes (pureed meat; smooth, homogenous ____; ___ or other pureed legume spreads; bread and cereals (smooth cooked cereals, such as ____, slurried ___ or ____, and pureed ___ or ___)

milk; yogurt; pudding; custard; bananas; applesauce; juices; pulp; seeds; skin; chunks; mashed potatoes; potatoes; gravy; seeds; skin; chunks; soufflés; hummus; Cream of Wheat; bread; pancakes; rice; pasta

candidates for bariatric surgery are ___ individuals with a BMI > ___ or a BMI between ___ and ___ accompanied by severe weight-related problems, such as ___, ___, or debilitating ____

obese; 40; 35-40; diabetes; hypertension; osteoarthritis

total and partial gastrectomies are generally performed for medically necessary reasons not relating to ____; in each of these surgeries, the _____ is removed; this is important to potential complications

obesity; lower esophageal sphincter

a person with _____ has difficulty transferring food from the mouth and pharynx to the esophagus; the condition is typically due to a ___ or ____ disorder that inhibits the swallowing ___ or impairs the ___ and ___ of the muscles involved in swallowing; symptoms include an inability to initiate swallowing, ___ during or after swallowing (due to ___), and ____; other signs include a ___ after swallowing, a ___ or ___ voice, or a ___; its common in ___ adults and frequently follows a ___

oropharyngeal dysphagia; neuromuscular; structural; reflex; strength or coordination; coughing; aspiration; nasal regurgitation; gurgling noise; hoarse or wet; speech disorder; older; stroke

in ____, only part of the stomach is removed and the remaining portion is connected to the duodenum or jejunum

partial gastrectomy

a ___ is an open sore that develops in the GI mucosa when gastric acid and pepsin overwhelm mucosal defenses and destroy mucosal tissue

peptic ulcer

to compensate for swallowing difficulties, a person with dysphagia may need to consume food and beverage that have been ___ so they are easier to swallow

physically modified

periodontal disease is more prevalent among people with diabetes mellitus, especially those whose diabetes is ___; people with diabetes often have impaired _____ responses and a greater susceptibility to ____; diabetes also favors the growth of ___ that infect ____ tissues; compared to healthy individuals, people with diabetes tend to have increase ___ accumulation and reduced ____

poorly controlled; immune; infection; bacteria; periodontal; plaque; salivary flow

dietary recommendations post-bariatric surgery: patients are generally instructed to consume liquid ____ supplements regularly and to eat high-___ foods before consuming other foods in the meal; to compensate for nutrient malabsorption, patients who have had ____ surgery usually require additional supplementation of vitamin ___, vitamin ___, ____ and ___; some foods may obstruct the gastric outlet (these include ____ or ___ breads and pasta products; ___; melted ____; vegetables that are ___, ___, or ___ (such as ___ or ____); foods with ___, ___, ___, or ___; ____; ___; and ___, ____ meats); to avoid symptoms of ____, patients who have had the gastric bypass procedure must carefully control food ____, avoid foods high in ___, and consume ___ between meals

protein; protein; gastric bypass; D; B12; Ca; Fe; doughy or sticky; rice; cheese; fibrous; stringy; raw; asparagus; celery; seeds; hulls; peels; skins; nuts; popcorn; tough, chewy; dumping syndrome; portions; sugars; fluids

types of mechanically altered diets include the ____, ____, and ____ diets

pureed foods diet; mechanically altered diets; soft foods diet

a more restrictive mechanically altered diet will contain mostly ___ food (____ diet), whereas a less restrictive diet may include ___ or ____ foods (___ or ___ diet) or soft, textured foods that easily form a bolus (___ diet)

pureed; pureed food; ground or minced; ground/minced or mechanically altered diet; soft food diet

Levels of National Dysphagia Diet: Level 1 - Dysphagia _____: diet is for patients with moderate to severe dysphagia and poor oral and chewing ability foods should be ____ or ___, ___ (without ___), and ___ example foods: Cream of Wheat; yogurt; well mashed bananas; pudding; pureed carrots avoid: dry breads/cereal; peanut butter; nuts/seeds; raw fruits/veggies; juices with pulp; sauces with chunks or seeds

pureed; pureed; well-mashed; smooth; lumps; cohesive

ordinarily, the ____ controls the rate of flow from the stomach to the duodenum; after some types of stomach surgery, ____ is no longer regulated and the stomach's ____ contents rush into the small intestine more quickly after meals, causing a number of unpleasant effects; early symptoms can occur within ___ minutes after eating and may include ___, ___, abdominal ___, ___, ____, rapid ___, and more; these symptoms are due to a shift of ___ from the ___ to the intestinal ___ that increases intestinal ___ and lowers ___; in addition, the accelerated release of _____ may alter both intestinal ___ and ____; several hours later, symptoms of ____ may occur because the unusually rapid spike in ___ following the meal (due to rapid nutrient ___ and ____) can result in an excessive ____ response

pyloric sphincter; stomach emptying; hyperosmolar; 30; nausea; vomining; cramping; diarrhea; light-headedness; heartbeat; fluid; bloodstream; lumen; distention; blood volume; GI hormones; motility; blood flow; hypoglycemia; blood glucose; influx; absorption; insulin

dietary measures after a gastrectomy are determined by the size of the _____ (which influences ____) and the _____ rate (which affects ____); a ____ food (___, lean ___, ___, or _____) should be included in each meal and it is generally recommended that the patient consume that first so that adequate ____ is obtained; patients should avoid ____ and ___ because they increase the ____ in the _____ and thereby increase the risk of ____; soluble ___ may be added to meals to slow ____ and reduce the risk of ____; liquids are ____ during meals (and for up to ___-___ minutes after meals) due to limited ____ and because liquids can increase ____ rate

remaining stomach; meal size; stomach-emptying; food tolerances; protein; fish; meat; eggs; cheese; protein; sugars and sweets; osmolarity; small intestine; dumping syndrome; fibers; stomach emptying; diarrhea; restricted; 30-60; stomach capacity; stomach-emptying

foods that stimulate ___ flow, neutralize mouth ____, or induce the clearance of food particles from the teeth can help prevent caries formation; examples include ___ (which increases ___ secretions and contains nutrients that ____); ___ (which reduces mouth ___ due to its nearly ___); and ____ (which require vigorous ____ and therefore stimulate ___; some foods contain substances that reduce ____ solubility, such as the ___ in ___ and an unidentified compound in ____; the sequence in which foods are eaten also influences caries development: for example, eating ___ after consuming an ____ fruit dessert can raise ___ and reduce caries risk; whereas drinking ___ with ___ at the end of a meal can prolong ____; chewing ___ after or between meals can help prevent caries by stimulating ___, pushing ___ into hard-to-reach ___ in and around teeth, and removing food particles from the teeth

saliva; acidity; cheese; salivary; neutralize acid; milk; acidity; neutral pH; raw vegetables; chewing; saliva flow; enamel; fluoride; tea; cocoa; cheese; acidic; plaque pH; coffee; sugar; plaque acidity; sugar-free gum; salivary flow; saliva; crevices

dry mouth is caused by reduced ____, is a ____ of many ___, and is associated with a number of diseases and disease treatments

salivary flow; side effect; medications

how to manage GERD: consume only ___ meals and drink liquids ____ so that the stomach does not become overly ____, which can exert pressure on the ____; limit foods or substances that increase gastric ____ (such as ___, ___, and ___) or weaken the pressure of the ____ (such as ____ beverages, ___, ____ or ____ foods, and ____); avoid eating ____ snacks or ____ after meals; avoid ____ and wearing ___ garments; avoid ____, which relaxes the ____

small; between meals; distended; lower esophageal sphincter; secretions; coffee; beer; wine; lower esophageal sphincter; alcoholic; chocolate; fried; fatty; peppermint; bedtime; lying down; bending over; tight-fitting; smoking; lower esophageal sphincter

___ is a risk factor for periodontal disease possibly due to its destructive effects on cellular ____; the likelihood of developing periodontal disease is increased if a person has a ___ that impairs ___ status, such as ___ or ____; strategies for reducing risk focus on improving oral hygiene (proper ___ and ___) and encouraging the cessation of ____

smoking; immune responses; chronic disease; immune; diabetes mellitus; HIV infection; brushing and flossing; smoking

goals of dietary adjustments for dumping syndrome are to slow the rate of ___, limit the amount of food material that reaches the ___, and reduce foods that increase ____; therefore, ___ are restricted during meals, ___ is limited, and ____ (including ___) are restricted

stomach emptying; intestine; osmolarity; fluids; meal size; sugars; milk sugars

lifestyle practices for managing dry mouth: chew ____ to help stimulate ___; avoid ___, ___, and ____ (which may dry the mouth); use a ___ during the night

sugarless gum; salivary flow; caffeine; alcohol; smoking; humidifier

saliva protects against caries by rinsing away the ___ and food ___ that remain on the teeth; it also has substances (such as ___, ___, and ___) that dilute and neutralize mouth acidity; saliva also contains ____ (____ and ____) that defend against bacteria and fungi; finally, the ___, ___, and ___ ions in saliva help to prevent the dissolution of ___ and promote ____; if salivary secretions are low or absent, the risk of developing dental caries and other dental diseases greatly increases

sugars; particles; proteins; bicarbonate; phosphates; antimicrobial proteins; immunoglobulins; lysozyme; calcium, fluoride, phosphate, enamel; remineralization

mechanically altered diets contain food that are modified in ____

texture

___ liquids are easier to swallow than ___ liquids, such as ___ or ____; to increase ___, commercial ____ can be stirred into beverages and other liquid foods, such as ____

thicker; thin; water; juice; viscosity; thickeners; soup broths

in _____, the surgeon removes the entire stomach and connects the esophagus directly to the small intestine

total gastrectomy

severe and chronic inflammation may lead to esophageal ____ with consequent ___; after healing begins, the ___ may narrow the inner diameter of esophagus, causing esophageal ____

ulcers; bleeding; scar tissue; stricture

nausea and vomiting accompany many illnesses and are common side effects of medications; when treatment is necessary, the main goal is to find and correct the ____; restoring ___ may also be necessary in some individuals

underlying disorder; hydration

food and beverage tips for managing dry mouth: take frequent sips of ___; suck on ___ or frozen ____ (unless coldness causes discomfort); consume food that have a high ___ content, such as soups, stews, sauces and gravies, yogurt, and pureed fruit; avoid ___ foods, such as toast, chips, and crackers; avoid ___ juices and ___ or ___ foods if they cause mouth irritation

water; ice cubes; fruit juice bars; fluid; dry; citrus; spicy; salty

dry mouth is medically called

xerostomia