Chapter 24 - lower GI Disorders

Question 1

Constipation: causes

Answer 1

-diet:
   >lower fiber
   >enough fiber but not enough fluid
-inactivity
-diseases/conditions:
   >neurological
   >pregnancy
   >diabetes 
-medications
-emotional stress

Question 2

Constipation: intervention

Answer 2

-gradual increase in fiber
    >males= 38g/d
    >females= 25g/d
-fluids
    >adequate amount
    >hot beverages
    >prune juice
-physical activity
-prebiotics and probiotics

Question 3

Diarrhea: types and causes

Answer 3

-acute: less than 2 weeks
-chronic: more thank 4 weeks
-common symptom of many GI diseases
-types:
>osmotic: resolves when pt NPO
>secretory: does not resolve when pt NPO
-causes:
>physiological
>emotional
>treatments
>medications
>food sensitivity or allergy
>clostridium difficile (c. diff)

Question 4

Diarrhea: dietary treatment

Answer 4

-avoid/limit:
    >higher fiber foods
    >gas producing foods
    >caffeine
    >ETOH
    >milk products: if lactose intolerant 
    >high fructose
    >high fat
    >high sugar beverages
    >sugar alcohols 
-use:
    >adequate hydration
    >perhaps BRAT
    >low fat
    >low lactose

Question 5

Malabsorption

Answer 5

-CHO: lactose intolerance
-PRO: protein-losing enteropathy
-FAT: steatorrhea > fat in stool
>diseases: pancreatitis, bone, cystic fibrosis, kidney stones
-loss of: energy, fatty acids, fat soluble vitamins (A,D,E,K), minerals(calcium, magnesium, zinc)
-diet
>fat restricted diet: 25-50 g/d
>use of MCT (medium chain triglycerides)
>still need essential fatty acids
>fat soluble vitamins&raquo_space; given in water soluble form

Question 6

Gluten conditions

Answer 6

-wheat sensitivity
-non celiac gluten sensitivity (NCGS)
>symptoms similar to CD but no CD antibodies
>small intestine not damaged
- celiac disease (CD)

Question 7

Celiac Disease

Answer 7

-an immune reaction to gluten consumption
-abnormal response to wheat, gluten, barley, and rye
-affects small intestine:
>the villi become more flat so they can’t absorb nutrients
>duodenum mostly affected and some parts of the jejunum

Question 8

Celiac signs and symptoms

Answer 8

-In GI
    >diarrhea
    >steatorrhea
    >flatulence
    >lactose deficiency 
-other locations
    >anemia
    >weakness
    >loss of bone density
    >skin rash
    >migraine like headaches
    >fatigue

Question 9

Celiac diet

Answer 9

-gluten free: eliminate wheat, barley, rye
>use: rice, corn, soybean, potato, tapioca, and gluten free products
-lactose free
*watch for cross contamination&raquo_space; in manufacturing

Question 10

Inflammatory bowel disease

Answer 10

-Crohns: formation of grove like structures
-Ulcerative colitis: erosion of tissue
-treatment:
>depends on part of GI thats involved
>nutrition very individualized
>may require TPN, TF
>need adequate fluids and electrolytes

Question 11

Crohns

Answer 11

• mainly: ileum and large intestine
• malnutrition from malabsorption, nutrient loses, decreased food intake, anemia, surgical resections
• increased risk for cancer of small intestine and colon

Question 12

Ulcerative colitis

Answer 12

• mainly: colon and rectum
• weight loss, fever, weakness, anemia, dehydration, fluid and electrolyte imbalances, diarrhea, abdominal pain, protein losses, possibly colectomy
• increased risk of colon cancer