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GI lectures > Dietary management of GI disease > Flashcards

Dietary management of GI disease Flashcards

1
Q

where is IBD most common?

A

in developed countries

UK, USA, Australia etc

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2
Q

what are the risk factors for IBD?

A 
Vit D deficiency
stress
smoking
diet
sleep
medications
genetic
appendectomy
microbiome
hygiene
physical activity
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3
Q

what are the clinical features of crohns?

A 
abdominal pain
diarrhoea
malaise, fever
anorexia & weight loss
(deeper, more associated with fistula and stricture)
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4
Q

what are the clinical features of ulcerative colitis?

A

bloody diarrhoea
colicky abdominal pain
urgency

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5
Q

how common is protein-energy malnutrition in IBD?

A

20-85% (esp crohns in small intestine)

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6
Q

where is the majority of absorption undertaken?

A

small bowel

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7
Q

where does ulcerative colitis mainly affect?

A

large intestine

so more hydration and electrolyte issues

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8
Q

what are the 4 stages of IBD management?

A

food first & symptom control
nutritional support via ONS or EN
elemantel module and semi-elemental options
Pre/post op PN & HPN

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9
Q

is enteral nutrition used in UC?

A

no

only useful in CD (not as useful as steroids in adults)

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10
Q

what is module?

A

product used as sole nutrition or supplement to diet
contains naturally occurring anti-inflammatory
helps to treat the disease and put it into remission if patient is compliant

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11
Q

does parenteral nutrition induce remission in UC or CD?

A

no

may be useful pre-op

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12
Q

when is TPN useful?

A

extensive active disease within small bowel
.
.
.

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13
Q

is malnutrition more common in CD or UC?

A

crohns

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14
Q

what is the best treatment for IBD?

A

…

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15
Q

what is the most common digestive condition?

A

IBS

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16
Q

what are the possible common causes of IBS?

A

related to visceral hypersensitivity
can be linked to previous GI disease
stress

17
Q

what is rome IIII criteria?

A

recurrent abdo pain on average 1 day per week in the last 3 months + 2 of:
- related to defecation
- associated with change in frequency of stool
- associated with change in stool form
symptoms must have started 6 months ago

18
Q

what can be mistaken for IBS?

A

coeliac disease
ovarian cancer
bowel cancer

19
Q

what is the first line dietary advice for IBS?

A

3 regular meals a day (smaller meals, chew more)
limit alcohol intake (max 2 unite per day)
Ensure adequate fluid intake (6-8 drinks per day)
Limit caffeine (max 3 cups per day)
Limit fizzy drinks
Cut down on rich/fatty foods and processed meals
Take time to relax
Limit fresh fruit to 3 portions a day
Food and symptoms diary can be helpful

20
Q

what other considerations are taken into account for IBS?

A

reduce gas producing foods
increase fibre for constipation, reduce for diarrhoea
avoid sugar free things (contain polyols)
Could trial probiotics (daily for 4 weeks)
Check for food intolerances (milk/lactose mainly)

21
Q

what is second line dietary advice for IBS?

A

low FODMAP diet

22
Q

how do fodmaps trigger symptoms?

A

fermentable carbohydrates should be digested and absorbed higher up in small intestine but reach large intestine so the gut draws water into the gut and gas produced as bacteria attack the carbohydrates causing luminal digestion and the classic symptoms

23
Q

is the low FODMAP diet long term?

A

no
only used short term (2-6 weeks) as investigative tool
reintroduction phase of FODMAPs to identify triggers and tolerance levels
Long term self management

24
Q

how successful is low FODMAP diet?

A

75%

25
Q

what kind of disease is coeliac?

A

life-long autoimmune

26
Q

how common is coeliac disease?

A

1 in 100

but only 24% are diagnosed

27
Q

what are the symptoms of coeliac disease?

A 
stomach pain
anaemia
diarrhoea
nausea & vomiting
lots of gas and bloating
TATT and fatigue
can have no gut symptoms
28
Q

when is coeliac disease usually diagnosed?

A

adulthood

29
Q

all suspected IBS patients should be screened for celiac disease, true or false?

A

true

30
Q

what is the requirement for an anti TTG test to be performed?

A

gluten in diet for 6 weeks

GI lectures (75 decks)

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