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CNM Nutrition 2 S1 > Detox & Gastro Health > Flashcards

Detox & Gastro Health Flashcards

Complete to slide 110

1
Q

Define detoxification. What is another word for it?

A

Biotransformation - the process of turning toxins into a less harmful or water soluble state.

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2
Q

The body has inherent detoxification processes, what 3 things can cause them to function inadequately?

A
  1. Interference with enzymes, hormones or neurotransmitters.
  2. Blockage of receptor sites.
  3. Oxidative damage.
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3
Q

State 3 aims to consider when working with someone who has clear toxic overload.

A
  1. Optimise secretion of stomach acid, bile, pancreatic juices.
  2. Restore microbiome.
  3. Repair gut integrity.
  4. Support liver detoxification.
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4
Q

How long is the small intestine, what is it’s function and what 3 parts make it up?

A

15-20 feet, majority of the absorption of the nutrients from food takes place in small intestine, made up of duodenum, jejunum and ileum.

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5
Q

What happens in the duodenum?

A

First section of the small intestine, food is mixed with bile produced by the liver and with other juices from the pancreas - much of the iron and calcium is absorbed here.

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6
Q

What happens in the jejunum?

A

Middle part of the small intestine responsible for digestion.

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7
Q

What happens in the ileum?

A

Last segment of the intestine where the absorption of fat-soluble vitamins A, D, E and K plus other nutrients are absorbed.

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8
Q

What calls secrete HCL and what nutrients is this dependent on?

A

Secreted by parietal cells in the stomach wall - dependent on B6 and Zn.

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9
Q

State 3 actions of HCL in the stomach?

A
  1. Denatures proteins and enhances nutrient absorption.
  2. Activates pepsin from pepsinogen.
  3. Inhibit the overgrowth of Candida.
  4. Stimulates secretion of pancreatic juices.
  5. Supports barrier defence against ingested microbes.
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10
Q

State 3 things which increases HCL production?

A
  1. Protein.
  2. Fat.
  3. NSAIDS.
  4. Caffeine.
  5. Milk.
  6. Stress.
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11
Q

State 3 things which decreases HCL production?

A
  1. Aging.
  2. H.Pylori infection.
  3. Antacids.
  4. Low B6 and Zn.
  5. Chronic stress.
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12
Q

State 5 common signs and symptoms of low gastric activity.

A
  1. Burping/flatulence 2-3 hrs after eating.
  2. Bloating, feeling of fullness.
  3. Undigested food in stool.
  4. Foul smelling stools.
  5. Iron deficiency.
  6. Diarrhoea/constipation.
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13
Q

What is a peptic ulcer?

A

Defect in the gastric or duodenal mucosa that extends through the muscularis mucosa.

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14
Q

What causes a peptic ulcer?

A

Peptic ulcers (mucosal injury) occurs when the balance between the aggressive factors (peptic acid secretion) and the gastroduodenal mucosal defensive mechanism is disrupted by things like NSAIDs, alcohol, H.pylori.

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15
Q

State 5 common symptoms of a peptic ulcer.

A
  1. Epigastric pain - burning sensation occurs 2 hrs after food, relieved by food or antacids, causes waking.
  2. Nausea/vomiting.
  3. Belching and bloating.
  4. Heartburn.
  5. Chest discomfort.
  6. Weight loss.
  7. Haematemesis - vomiting blood.
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16
Q

State 3 risk factors for peptic ulcers.

A
  1. NSAID’s.
  2. Aspirin.
  3. Stress.
  4. Overuse of laxatives.
  5. Smoking.
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17
Q

What are the 2 go-to allopathic treatments for peptic ulcers?

A
  1. Proton pump inhibitors – which inhibit and suppress acid production.
  2. Antibiotics – to kill bacteria (H.pylori).
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18
Q

State 3 naturopathic ways to help peptic ulcers?

A
  1. Investigate food sensitivities (IgE found in peptic ulcers, avoid milk as stimulated stomach acid production).
  2. Increase dietary fiber - associated with reduced duodenal ulcers.
  3. Raw cabbage juice - glutamine, flavonoids etc reduces pain and reports can heal fully.
  4. Avoid alcohol, coffee, tea.
  5. Avoid hot/spicy foods.
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19
Q

What is GORD?

A

Gastroesophageal reflux disease (heartburn, acid reflux, dyspepsia etc). Occurs when amount of gastric juice that refluxes into the oesophagus exceeds the normal limit.

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20
Q

State 2 allopathic treatment options for GORD.

A
  1. Antacids.

2. Proton pump inhibitors.

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21
Q

List 3 risk factors for GORD.

A
  1. Chocolate.
  2. Smoking.
  3. Alcohol.
  4. Eliminate salicylate-rich foods (tomatoes, almonds, strawberries etc).
  5. Obesity - increased intraabdominal pressure.
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22
Q

List 3 symptoms of GORD.

A
  1. Heartburn - worse when laying down.
  2. Regurgitation.
  3. Dysphagia – a sensation that food is stuck.
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23
Q

State 3 naturopathic interventions to help GORD.

A
  1. Avoid lying down post meals.
  2. Elevate head off the bed by approximately six inches.
  3. Stop smoking and loose weight.
  4. Cabbage juice if ulceration suspected.
  5. Investigate food sensitivities.
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24
Q

What 2 supplements might you consider for someone experiencing GORD?

A
  1. Digestive enzymes.

2. Slippery Elm.

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25
Q

State 3 symptoms of low pancreatic enzyme secretion (which breaks down carbohydrates, proteins and fats).

A
  1. Fatty stools (steatorrhoea)
  2. Reflux.
  3. Bloating/pain.
  4. Drowsiness after meals.
  5. Loss of appetite.
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26
Q

State two foods we can eat which contain high levels of digestive enzymes and state the enzyme name.

A
  1. Pineapple - bromelain.

2. Papaya - papain.

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27
Q

State 2 actions/functions of bile.

A
  1. Acts as an emulsifier to break fat into smaller globules.

2. Detoxify bacterial endotoxins.

28
Q

State 3 things low bile production might cause.

A
  1. Fatty stools (steatorrhoea).
  2. Constipation.
  3. Fatty food intolerance.
  4. Gallstones.
29
Q

State 3 things we can do to support bile production.

A
  1. Stay hydrated.
  2. Rice fibre - shown to increase bile excretion.
  3. Olive oil - stimulate body’s secretion of bile.
  4. Amino acid taurine - essential component.
30
Q

What are Choleretics?

A

Substances that increase the volume of secretion of bile from the liver.

31
Q

State 2 herbal choleretics.

A
  1. Danelion root.
  2. Globe artichoke.
  3. Turmeric.
32
Q

How larage is the GI mucosal membrane surface?

A

400 square meters - over 200x larger than surface area of the skin.

33
Q

Describe leaky gut.

A

In a healthy GI tract the intestines tight junctions limit the transport of large molecules across the epithelium. In an unhealthy GI tract the junctions become leaky and larger molecules slip into circulation.

34
Q

State 5 risk factors for leaky gut.

A
  1. Alcohol.
  2. Chronic stress.
  3. NSAID’s.
  4. Premature birth.
  5. Whole food exposure before 4mo.
  6. Excessive sugar intake.
  7. Cancer - radiation and chemo.
35
Q

State 5 symptoms of leaky gut.

A
  1. Abdominal distention and pain.
  2. Cognitive and memory deficits.
  3. Fatigue.
  4. Fevers of unknown origin.
  5. Food intolerances.
  6. Skin rashes.
  7. Diarrhoea.
36
Q

State 5 conditions associated with leaky gut.

A
  1. Acne.
  2. Autism.
  3. Childhood hyperactivity.
  4. Eczema.
  5. Multiple food and chemical sensitivities.
  6. IBD, coeliacs disease, RA, T1D etc.
  7. Hepatic dysfunction.
37
Q

What is GALT?

A

Gut associated lymphoid tissue. 60% of the immune system and 80% of the immunoglobulin-producing blasts and plasma cells are located within the mucosa of the GIT.

38
Q

Define dysbiosis.

A

An imbalance in the colonies of the bowel flora, leading to disruption in health.

39
Q

State 5 foods which are good sources of prebiotics.

A
  1. Oats.
  2. Legumes.
  3. Beets.
  4. Leek.
  5. Artichoke.
  6. Onion.
  7. Rye.
40
Q

What are the 5 R’s to consider when trying to restore GI health?

A

Remove - dietary allergens, parasites, yeasts, toxins.
Replace - HCL (B6, zinc, bitters), enzymes, bile support.
Reinoculate - probiotics and prebiotics.
Repair - strengthen gut tight junctions with antioxidants, NAC, vitamins and minerals.
Re-balance - support stress, immune response and dietary balance.

41
Q

What are 5 symptoms of IBS not related to the GIT?

A
  1. Sexual dysfunction.
  2. Urinary frequency and urgency.
  3. Poor sleep.
  4. Menstrual difficulties.
  5. Headache.
  6. Fatigue.
  7. Lower back pain.
42
Q

Explain the link between IBS and the brain.

A

Brain and gut develop from same part of human embryo so share many nerve endings and chemical transmitters. Serotonin plays a role in peristalsis, secretion, sensation and 95% of 5HT (serotonin receptors) found in GIT.

43
Q

What 3 supplements can help support constipation?

A
  1. Vitamin C.
  2. Magnesium.
  3. Aloe vera juice.
  4. EPA/DHEA - increase bile flow.
  5. Probiotics.
44
Q

What are 2 orthodox treatments for diarrhoea?

A
  1. Adsorbents - clay-like substances reduce the water content of stools.
  2. Bulk-forming medications - water-soluble fibres absorb water from the stools.
  3. Opioid analgesics or antagonists - slow down peristalsis.
45
Q

State 5 nutritional/lifestyle interventions we can use to help support someone with IBS.

A
  1. Optimise fibre intake - psyllium husk, vegetables.
  2. Consider food allergy/intolerance.
  3. Avoid high refined sugar.
  4. Supplement 5-HTP - due to link with Serotonin.
  5. Supplement enteric coated peppermint oil - inhibits GIT smooth muscle action.
  6. Probiotics.
  7. Exercise and stress reduction techniques.
46
Q

What is SIBO?

A

Small intestinal bacterial overgrowth - small intestines not normally densely populated by bacteria. Bacteria uses our nutrients for fuel, when they use carbs it produces hydrogen and methane gases which casue symptoms.

47
Q

If SIBO is in the duodenum what are 2 symptoms likely to be associated?

A
  1. Bloating in upper abdomen.
  2. Burping.
  3. Reflux.
  4. Nausea.
  5. Loss of appetite.
48
Q

If SIBO is in the jejunum or ileum what are 2 symptoms likely to be associated?

A
  1. Bloating in the middle to lower abdomen.

2. Flatulence.

49
Q

Should we suggest probiotic supplementation to someone who we suspect may have SIBO? Why?

A

No - they can make the symptoms worse as they feed the bacteria.

50
Q

Explain the link between histamine and SIBO.

A

SIBO causes histamine to be produced which causes inflammation in the intestines. This can cause histamine intolerance - always suspect bacterial overgrowth when
histamine intolerance is present.

51
Q

What is the migrating motor complex? How is it affected in SIBO?

A

Autonomic response by the gastrointestinal
system activated between meals and sleep. Stimulates the mobilisation of bacteria from the small intestines to the large intestines, along with contents of the intestines. Many people with SIBO have abnormal MMC.

52
Q

State 2 things which can help activate the MMC.

A
  1. Prokinetic agents - such as ginger.
  2. Longer gaps between meals / intermittent fasting.
  3. Going to bed earlier.
53
Q

What symptoms would make you suspect SIBO? State 3.

A
  1. Persistent GIT symptoms.
  2. History of H.pylori.
  3. Symptoms better when eating ‘bad’.
  4. Anaemia that doesn’t improve with supplementation.
  5. Multiple food sensitivities.
  6. Non-responsive or worsening of symptoms when given pro or prebiotics.
54
Q

How do we test for SIBO?

A

Glucose breath testing for hydrogen and methane assessment when upper GI symptoms only are present - duodenal SIBO.
Lactulose breath testing for assessment of SIBO in jejunum and ileum.
Look for double peak - gasses rise twice over course of the day = positive.

55
Q

What diet would you suggest a client with SIBO follows?

A

Low fodmap - reduce the availability of carbohydrates and fibres that are likely to be fermentable.

56
Q

What is an elemental diet? How might it benefit someone with SIBO?

A

A form of modified fast, use supplemental replacement meals. They ensure sufficient nutrients are provided whilst minimising requirements for digestion and absorption. After 14 days it can normalise breath test results for SIBO.

57
Q

What is the go-to treatment for SIBO recommended by GP’s?

A

Antibiotics, the longer the SIBO has been present the longer they are needed, can be needed for upto 12 weeks.

58
Q

How do we reduce production of proinflammatory mediators in a client with IBD? State 3 ways.

A
  1. Reduce or eliminate beef, liver, pork, lamb, and milk/dairy products.
  2. Reduce omega 6 / increase omega 3.
  3. Consume quercitin.
  4. Foods rich in mucopolysaccharides - oats, aloe.
  5. Remove wheat.
59
Q

What 7 steps would you consider to combat chronic candida?

A
  1. Identify and address predisposing factors - dietary, immunity, liver function, disease.
  2. Recommend the C. albicans control diet - remove sugar, dairy, yeast food (dried fruit, melons, peanuts).
  3. Provide nutritional support - multi-vit/mineral, antioxidants.
  4. Support immune function - stress management, sleep.
  5. Promote detoxification and elimination - 3-5g of soluble fibre, liver support.
  6. Probiotics - 5-10 billion.
  7. Use appropriate anti-yeast therapy - olive leaf, oregano, thyme, garlic or nystatin from GP - considered quite safe.
60
Q

State 3 functions of the liver.

A
  1. Detoxification.
  2. Normalisation of blood fats.
  3. Synthesis and normalisation of blood proteins.
  4. Manufacture of bile.
  5. Synthesis and storage of glycogen.
61
Q

State 3 symptoms of a compromised liver.

A
  1. Fatigue.
  2. Weakness.
  3. Elevated blood cholesterol.
  4. Bloating.
  5. Oedema.
62
Q

Define liver detoxification.

A

The biotransformation of a lipophilic compound, not able to be excreted in urine or bile, to a water-soluble compound.

63
Q

Explain phase 1 liver detoxification.

A

Primes a binding site on the toxin for conjugation (joining together) - uses oxygen to form a reactive site. Primarily via Cytochrome P450 enzymes.

64
Q

Explain phase 2 liver detoxification.

A

Conjugates resulting toxin with a conjugating agent for excretion via the kidneys or bowel.

65
Q

Explain phase 3 liver detoxification.

A

Antiporters (membrane protein involved in movement) pump toxins out of the cells for excretion.

CNM Nutrition 2 S1 (10 decks)

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