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