Chapter 18 Flashcards
What are common signs of dysphagia in patients? Who should be consulted if dysphagia is suspected?
signs: slow chewing, frequent throat clearing, repeated episodes of aspiration pneumonia, fatigue from eating, food “sticking” in throat, pocketing food in cheeks, and coughing/choking during eating
What are nutrition and lifestyle recommendations for GERD patients?
eat low fat meals, avoid eating 3-4 hours before bed, and eat sitting up
What causes most peptic ulcers? What’s the second most common cause? Should these patients eat a bland diet?
1st cause: H. pylori
2nd cause: NSAIDs
the patients should eat a well-balanced diet NOT a bland diet as those can impair healing and cause more harm than good
Which two nutrients are often recommended to limit in the general population, but you may not want to limit for patients with Cystic Fibrosis?
CF patients have higher calorie needs, don’t limit high fat foods or salt
How do we treat pancreatic digestive enzyme insufficiency for patients with CF? When do they need to take this medication?
we use pancreatic digestive enzyme in capsules before meals and snacks (1 before snacks, 3 before a meal)
What are two childhood environmental exposures that may increase risk for developing inflammatory bowel disease?
1) lack of breastfeeding
2) overuse of antibiotics
Does Crohn’s or Ulcerative colitis typically lead to more micronutrient deficiencies, and why? Which vitamin deficiency may occur because of ulcerative colitis?
Crohn’s can affect anywhere in the GI which leads to more nutrient deficiencies, ulcerative colitis affects colon and rectum only *VITAMIN K deficiency
What is the diet pattern most often used in IBS?
eliminate food allergies or intolerance, low FODMAP diet, consider pre and probiotics, food diary tracking emotions, stress, activites, symptoms
*must be highly individualized
How is the nutrition therapy for diverticulosis different than the nutrition therapy for diverticulitis?
diverticulosis - increase dietary fiber from 26 g/day to 45 g/day with adequate fluid intake
diverticulitis - NPO or clear liquids if blood diarrhea, low fiber diet until inflammation and bleeding resolves
Which body system does a food allergy affect? Which body system does a food intolerance affect? What is an example of a food intolerance?
food allergy: immune-mediated response that affect the immune system
food intolerance: GI system issues
ex) lactose and gluten intolerance
What is celiac disease?
an autoimmune disease that causes individuals to not tolerate proteins in gluten
How does exposure to gluten affect the lining of the GI tract for those with celiac disease?
it damages villi of the digestive tract by flattening them and decreasing surface area and absorption
What effect does this have on micronutrient and macronutrient absorption?
it greatly reduces absorption of both
What symptoms can occur due to the nutrient malabsorption that occurs?
diarhea, steatorrhea, progressive malnutrition, unintended weight loss
What is the first line treatment for non-alcoholic fatty liver disease?
10% weight loss (if warranted) and a balanced diet
Answer the following MNT questions for cirrhosis and hepatitis
OK
Number of meals per day, size of meals? Why?
4-6 small meals a day due to loss of appetite and ascites
How do these patients protein needs differ from the the general population? What changes if hepatic encephalopathy is present?
high protein is needed to regenerate the liver cells UNLESS hepatic encephalopathy is present (it can create a buildup of ammonia is high levels present)
What is the sodium recommendation and why?
limit sodium due to edema and excess fluid (hepatitis)
What are the five risk factors for developing choleithiasis (gallstones)?
1) obesity
2) physical inactivity
3) hormone replacement therapy
4) high intake of simple CHO
5) high intake of saturated fatty acids
What is the recommendation for fat intake for patients with gallstones?
control fat intake (<30% of calories from fat)
What are the MNT for mild to moderate pancreatisis?
1) hydration support during acute phase
2) pancreatic rest while receiving fluids/electrolytes
3) advance to oral feedings as early as tolerated
4) high protein and low fat diet
5) strict avoidance of alcohol and smoking
Why is parenteral nutrition only used as a very last resort in severe pancreatitis?
there are severe, severe complications with parenteral nutrition such as refeeding syndrome,
