Crohns & Colitis - 5 Flashcards
(150 cards)
1
Q
What is Crohn’s disease?
A
A type of inflammatory bowel disease (IBD) characterized by chronic inflammation of the gastrointestinal tract.
2
Q
What symptoms did Sabrina experience after eating?
A
Abdominal bloating, cramping, and pain.
3
Q
What dietary changes did Sabrina try to alleviate her symptoms?
A
Eliminating all vegetables, many fruits, red meat, and dairy.
4
Q
Did Sabrina’s dietary changes successfully improve her condition?
A
No, her cramps and pain continued despite her efforts.
5
Q
What type of diet was Sabrina advised to follow?
A
A low-fiber diet.
6
Q
True or False: Foods can cause or cure IBD.
A
False.
7
Q
What is the role of nutrition in managing IBD?
A
Maintaining general health, managing symptoms during disease flares, and contributing to quality of life.
8
Q
What should individuals with IBD avoid in their diet?
A
Foods that are difficult to digest, such as corn and potato skins.
9
Q
Who should individuals with IBD consult for dietary advice?
A
A registered dietitian (RD).
10
Q
What is the difference between a registered dietitian and a nutritionist?
A
Registered dietitians have completed specific education and internship programs, while nutritionists may not have minimum qualifications.
11
Q
What can happen if individuals avoid foods without scientific evidence?
A
It can affect their relationship with food and result in serious health consequences.
12
Q
What does the term ‘anorexia’ mean in the context of IBD?
A
Loss of appetite and the inability to eat enough to maintain weight.
13
Q
What are some common symptoms of malnutrition?
A
Weight loss, loss of appetite, muscle weakness, changes in skin, hair, nails, gums, eyesight, or mood.
14
Q
What are the risk factors for malnutrition in individuals with IBD?
A
Inadequate intake of nutrients, increased nutrient requirements, malabsorption of nutrients, increased losses of electrolytes, minerals, trace elements, and proteins.
15
Q
Fill in the blank: The most common indicator of malnutrition is _______.
A
significant loss of body weight.
16
Q
What dietary guidelines should people with IBD follow?
A
Individualized diets that consider personal tolerances, preferences, and health goals.
17
Q
What can contribute to systemic inflammation in IBD?
A
Cytokines produced in the inflamed intestine.
18
Q
How can diet help prevent malnutrition?
A
By ensuring adequate intake of calories and essential nutrients.
19
Q
What is the purpose of a nutrition plan for individuals with IBD?
A
To manage illness and achieve desired health outcomes.
20
Q
What is the significance of individualized diets for IBD patients?
A
They are tailored to the unique needs, tastes, and health conditions of each individual.
21
Q
What should individuals do if they experience symptoms associated with malnutrition?
A
Mention them to their doctor as soon as possible.
22
Q
What is a key dietary recommendation from Canada’s Food Guide?
A
Make half your plate fruits and vegetables.
23
Q
True or False: There is a single diet that works for everyone with IBD.
A
False.
24
Q
What role does diet play in the prevention of long-term complications in IBD?
A
It contributes to maintaining nutritional status and overall health.
25
Fill in the blank: Diet can also help with _______ management during disease flares.
symptom.
26
What is the recommendation for the proportion of fruits and vegetables on your plate?
Make half your plate fruits and vegetables.
27
What type of grains should you aim to include in your diet?
Make at least half your grains whole grains.
28
What type of milk should you switch to according to dietary recommendations?
Switch to fat-free or low-fat (1%) milk.
29
What should you compare when choosing foods like soup, bread, and frozen meals?
Compare sodium in foods and choose the foods with lower numbers.
30
What is a healthier alternative to sugary drinks?
Drink water instead of sugary drinks.
31
If IBD is under control, what dietary guidelines should be followed?
Follow the USDA MyPlate Food Guidance System or Canada’s Food Guide.
32
What is the role of diet in relation to IBD symptoms?
Diet plays an important role in maintaining nutritional status and symptom management.
33
What questions should you ask to determine if you need to modify your diet?
* Is my disease active or under control right now? * What symptoms am I currently experiencing? * What part or parts of my bowel are affected? * Are there any complications from my disease? * What effect does my treatment have on nutrient requirements? * Do my medications interact with nutrients? * Has surgery affected the amount of remaining bowel available for absorption?
34
What are the specific goals of diet modifications?
* Normalize bowel function * Minimize GI intolerance symptoms * Maintain hydration and electrolyte balance * Maintain or improve nutritional status * Continue or resume social participation and enjoyment
35
What are elimination diets?
Elimination diets significantly restrict or exclude one or more foods or major food groups.
36
What is the scientific consensus on the value of exclusion diets in IBD?
The value of exclusion diets has not been scientifically proven in IBD.
37
What are potential long-term consequences of following exclusionary diets?
* Development of nutrient deficiencies * Weight loss * Malnutrition * Food phobias or obsessions * Loss of enjoyment of eating
38
What is lactose intolerance?
Lactose intolerance is when your body cannot adequately digest the milk sugar lactose.
39
What causes lactose intolerance?
Lactase deficiency, which is the lack of the enzyme needed to break down lactose.
40
What are the classic symptoms of lactose intolerance?
* Bloating * Cramping * Gas * Diarrhea
41
What factors can contribute to lactose intolerance?
* Genetics * Acquired factors
42
What is primary lactase deficiency?
A natural decline in lactase production as we age.
43
Which ethnic groups are more likely to experience lactose intolerance?
* African * Jewish * Asian
44
What is secondary lactase deficiency?
A deficiency in lactase enzyme due to external factors such as medical treatment or disease.
45
What test is commonly used to diagnose lactose intolerance?
A hydrogen breath test.
46
What is a dose-dependent effect in relation to lactose consumption?
Many individuals can still consume small amounts of dairy, just not as much as before.
47
What does the lactose ladder indicate?
It lists dairy products and their lactose content from lowest to highest.
48
What are some hidden sources of lactose?
* Processed meats * Gravies * Breads * Cereals * Salad dressings * Cake mixes * Margarine
49
What is the recommended daily intake of calcium for adults?
1000 to 1300 mg per day, depending on age and gender.
50
What are some important nutrients for bone health besides calcium?
* Vitamin D * Phosphorus * Magnesium * Fluoride
51
What should individuals with IBD consider if they restrict dairy?
They need to consider increasing calcium and vitamin D intake from other sources.
52
What are enzyme supplements used for?
To help break down lactose for individuals who are lactose intolerant.
53
What is the impact of oxalates and phytates on calcium absorption?
They bind to minerals like calcium, reducing their bioavailability.
54
What compounds reduce the absorption of calcium from plant-based sources?
Oxalates and phytates
## Footnote
Oxalates are found in dark green leafy vegetables, while phytates are found in whole grains, nuts, seeds, and legumes.
55
How many servings of milk products are recommended for adults to obtain enough calcium?
Two to four servings per day.
56
What is the calcium content in 1 cup of cow's milk?
285–330 mg.
57
What should you consider if you cannot improve your calcium intake from food?
Calcium supplements with vitamin D.
58
What is the calcium content in fortified soy milk?
300 mg per 1 cup (250 mL).
59
What is the recommended maximum elemental calcium dosage at one time for optimal absorption?
No more than 500 mg.
60
What role does vitamin D play in calcium absorption?
Helps your body absorb calcium.
61
What factors can influence the body's ability to produce vitamin D from sunlight?
Geographic location, time of year, age, skin color.
62
True or False: Cottage cheese is a good source of vitamin D.
False.
63
What is the revised recommended amount of vitamin D intake for adults according to the IOM in 2010?
600 to 800 IU.
64
What are some food sources of vitamin D?
* Cow's milk
* Fortified soy milk
* Fortified orange juice
* Salmon
* Mackerel
* Sardines
65
What can excessive intake of water-soluble vitamins lead to?
Expensive urine.
66
What is a symptom of calcium and vitamin D deficiency in individuals treated with steroids?
Need for additional calcium and vitamin D.
67
What is the absorption location for vitamin B12?
Terminal ileum.
68
Fill in the blank: If you have Crohn’s disease affecting the terminal ileum, you most likely require _______ supplements.
Vitamin B12.
69
What should you do if you suspect you need to supplement specific nutrients?
Talk to your doctor.
70
What is the best way to determine if you need a multivitamin supplement?
Identify which food groups are not well represented in your diet.
71
What are some key micronutrients that may require supplementation?
* Calcium
* Vitamin D
* Iron
* Vitamin B12
* Folic acid
72
What type of calcium supplement should be chosen?
Those that also contain vitamin D.
73
What should you check on the labels of fortified foods?
Whether the fortification is with vitamin D3 and not vitamin D2.
74
What is the calcium content in 1 cup of fortified orange juice?
100 mg.
75
What is the recommended serving of salmon for vitamin D intake?
3 oz (90 g), cooked.
76
What is the role of vitamin K in the body?
Essential for blood clotting and bone health.
77
What should individuals on high-dose steroids consider regarding protein intake?
They may need extra protein.
78
What is a common source of vitamin D that should be avoided due to potential contaminants?
Cod liver oil.
79
What is the calcium content in 1 cup of cooked spinach?
130 mg.
80
What is the primary benefit of a well-balanced diet?
Good health and nutrient variety
## Footnote
A well-balanced diet can usually be eaten even if you have IBD.
81
What are standard adult multivitamins typically used for?
Meeting general nutrient needs
## Footnote
Special versions exist for specific groups, like prenatal or 'silver' for older adults.
82
True or False: Mega-doses of vitamins are usually more beneficial.
False
## Footnote
Excess vitamins are excreted or stored, which can be harmful.
83
What act regulates dietary supplements in the United States?
Dietary Supplement Health and Education Act (DSHEA) of 1994
## Footnote
Companies are responsible for the safety and claims of their supplements.
84
What should you look for in Canada to ensure a supplement is safe?
D.I.N. (Drug Identification Number) or G.P. (General Product) number
## Footnote
These indicate Health Canada approval.
85
What are the three types of liquid dietary supplements?
Polymeric, Semi-Elemental, Elemental
## Footnote
Each type has different levels of nutrient breakdown.
86
What is the purpose of polymeric liquid supplements?
Provide complete undigested molecules of nutrients
## Footnote
They are designed to mimic the form of nutrients found in food.
87
What are semi-elemental supplements?
Supplements with hydrolyzed protein into smaller molecules called peptides
## Footnote
These are easier to digest.
88
What distinguishes elemental supplements from other types?
Protein is hydrolyzed into free amino acids
## Footnote
They are designed for easier absorption.
89
What is the typical macronutrient distribution in most liquid supplements?
* 50% to 55% calories from carbohydrates
* 15% to 20% calories from protein
* Less than 30% calories from fat
90
What is a modular supplement?
A product designed to supplement a specific nutrient
## Footnote
Examples include Polycose (carbohydrate only) and MCT oil (fat only).
91
What can be a primary therapy for Crohn’s disease affecting the small bowel?
Nutritional supplements
## Footnote
They can help reduce inflammation and symptoms.
92
What is the recommended approach to taking fiber supplements?
Take them separately from other nutrients
## Footnote
Fiber may bind to some nutrients and interfere with absorption.
93
What are the two types of dietary fiber?
* Insoluble fiber
* Soluble fiber
94
What is the main function of soluble fiber?
Helps gel loose bowel movements and lowers cholesterol
## Footnote
It is fermented by bacteria in the large intestine.
95
What is the consequence of a long-term low-fiber diet?
Challenges in ensuring adequate vitamins and minerals
## Footnote
It may necessitate reliance on canned, cooked, or juiced fruits and vegetables.
96
What should you look for to avoid unhealthy juice cocktails?
Labels stating '100% fruit juice' or '100% juice blends'
## Footnote
These provide more vitamins and natural antioxidants.
97
What is fiber?
Structural part of plants that human digestive enzymes cannot break down
## Footnote
Some bacteria can ferment it to produce short-chain fatty acids.
98
What is the effect of insoluble fiber on stool?
Bulks stool and relieves constipation
## Footnote
It increases fecal weight and speeds up intestinal passage.
99
What dietary changes may be recommended during an IBD flare?
Limit fiber intake
## Footnote
This helps recover and improve quality of life.
100
What foods can help increase soluble fiber in your diet?
* Oat bran
* Chickpeas
* Lentils
* Barley
* Applesauce
101
What are some sources of insoluble fiber?
* Skins of fruits and vegetables
* Whole wheat and whole-grain breads and cereals
* Brown or wild rice
102
What are some sources of soluble fiber?
* Oat products
* Pectin
* Pulp of fruits
* Legumes with outer skin peeled
103
What is a source of soluble fiber?
Oat bran
## Footnote
Soluble fiber is beneficial for digestion and can help thicken stool.
104
What type of flour contains the bran and germ but looks like refined flour?
White whole wheat flour
## Footnote
It provides the same fiber as whole wheat.
105
Which food product is an example of a high source of fiber?
Kellogg’s All-Bran Buds cereal
## Footnote
Contains 3 g of soluble fiber and 9.7 g of insoluble fiber.
106
What is the primary effect of wheat bran?
Promotes bowel regularity
## Footnote
It is a source of insoluble fiber.
107
What dietary change can help slow high stool output?
Increase soluble fiber
## Footnote
Soluble fiber can help thicken stool when included at mealtime.
108
Name two foods known to thicken stool.
* Cheese
* Smooth nut butters
## Footnote
Other examples include pretzels and potato chips.
109
What should be reduced to manage high stool output effectively?
Dairy lactose
## Footnote
Alternatives should be consumed for calcium.
110
What is a recommended strategy for gas reduction?
Try commercial enzyme products
## Footnote
Products like Beano help digest fiber without gas formation.
111
What is the aim of adjusting meal sizes and timing?
To reduce stool frequency
## Footnote
Eating smaller meals and snacks can help manage symptoms.
112
What is the purpose of oral rehydration solutions?
To improve fluid absorption
## Footnote
Examples include Gastrolyte for adults and Pedialyte for children.
113
What are common symptoms of dehydration?
* Fatigue
* Increased thirst
* Dry mouth
* Stomach cramps
## Footnote
A rapid weight loss can also indicate dehydration.
114
Which two electrolytes are critical for body fluid regulation?
* Sodium
* Potassium
## Footnote
They are essential for maintaining hydration and electrolyte balance.
115
List two food sources high in sodium.
* Bouillon cubes
* Canned fish
## Footnote
Processed foods also contain high sodium levels.
116
What is a potential challenge of a fluid diet?
Getting enough nutrition
## Footnote
Fluid diets often lack adequate vitamins, minerals, and protein.
117
What type of diet is better than a clear fluid diet?
Full fluid diet
## Footnote
It includes dairy products and is slightly more nutritious.
118
What should be avoided to reduce the risk of dehydration?
Caffeinated beverages
## Footnote
They can lead to increased urine production.
119
Fill in the blank: A __________ diet should generally be limited to no longer than several days.
clear fluid diet
## Footnote
It is not a balanced source of nutrition.
120
What is the role of the ileal brake mechanism?
To slow transit time of food through the bowel
## Footnote
It regulates how quickly the stomach empties.
121
What should be done if diet modifications do not yield desired effects?
Consult a doctor or dietitian
## Footnote
It may indicate that medical therapy is required.
122
What are the two types of nutrition support?
* Total enteral nutrition (tube feeding)
* Total parenteral nutrition (intravenous feeding)
## Footnote
They are used when there is a risk of malnutrition.
123
What is total enteral nutrition (TEN)?
A method of nutrition support where nutritional supplements are delivered via a feeding tube when a person cannot consume enough by mouth.
## Footnote
Particularly helpful in children with certain forms of IBD, especially Crohn’s disease of the small intestine.
124
What are the two types of nutrition support?
* Total enteral nutrition (tube feeding)
* Total parenteral nutrition (intravenous feeding)
## Footnote
Both types are used when there is a risk of malnutrition or progression of malnutrition.
125
What is the purpose of tube feeding?
To reduce inflammation in the intestine and avoid the need for medications like steroids, while also enhancing growth in children.
## Footnote
Tube feeding allows continued oral fluid intake.
126
What is total parenteral nutrition (TPN)?
A specialized form of nutrition delivered via an intravenous line, allowing the gut to rest by providing nutrients directly into the bloodstream.
## Footnote
TPN is used when a person cannot consume enough nutrition by mouth or tube feeding.
127
What are some risks associated with TPN?
* Higher risk of infection
* Blood clots
* Metabolic intolerance
* Liver or gallbladder problems
* Abnormalities in cholesterol, triglycerides, and sugar levels
## Footnote
TPN can also lead to psychological effects, such as missing the experience of eating.
128
What do synbiotics refer to?
Both prebiotics and probiotics that contribute to maintaining intestinal health.
## Footnote
They help keep a sufficient number of 'good' bacteria in the intestine.
129
What are prebiotics?
Nondigestible carbohydrates that are fermented by colonic bacteria, promoting the growth of 'good' bacteria and producing short-chain fatty acids.
## Footnote
Found in foods like onions, bananas, and garlic.
130
What are probiotics?
Live bacteria that confer health benefits when administered by mouth, promoting immune system balance and downregulating inflammation.
## Footnote
Commonly found in yogurts and kefir.
131
Fill in the blank: Omega-3 fats are ________, while omega-6 fats are ________.
anti-inflammatory; pro-inflammatory
132
What are the two important omega-3 fatty acids mentioned?
* Eicosapentaenoic acid (EPA)
* Docosahexaenoic acid (DHA)
## Footnote
EPA and DHA are primarily obtained from fish and seafood.
133
What is the optimal intake of omega-3 for cardiovascular disease?
1000 mg of EPA plus DHA per day.
## Footnote
General recommendations suggest 400 to 500 mg per day for the public.
134
What is immunonutrition?
A field of nutrition focused on modulating the inflammatory response through diet.
## Footnote
It is particularly relevant in diseases with an inflammatory component, such as IBD.
135
What are functional foods?
Conventional foods or those similar in appearance that demonstrate a physiological health benefit.
## Footnote
Examples include omega-3 eggs and fish.
136
What is a common concern when using fish oil supplements?
They may contain environmental contaminants.
## Footnote
It is advisable to check ingredient labels for safety.
137
What is the significance of VSL#3?
A pharmaceutical probiotic preparation that has shown promise in preventing recurrent pouchitis.
## Footnote
Contains eight different bacterial strains and three billion viable bacteria per gram.
138
What did James's doctor suggest regarding diet and ulcerative colitis?
Diet alone cannot be relied on to prevent flares of colitis and should be combined with medication.
## Footnote
Consulting a registered dietitian was recommended for further diet therapy.
139
What are antioxidants?
Substances like vitamin E, vitamin C, carotenoids, glutathione, and selenium that may have beneficial effects on the immune system and inflammation.
## Footnote
Research is still at a biochemical level for specific recommendations.
140
What is often true about colitis flare-ups?
Colitis flare is not his fault and was not caused by a failure to stick with his diet
## Footnote
Flares often occur without apparent cause.
141
What are some examples of antioxidants relevant to IBD?
* Vitamin E
* Vitamin C
* Carotenoids
* Glutathione
* Selenium
## Footnote
The area of antioxidants and IBD looks promising, but studies are still at a biochemical level.
142
What potential benefits do antioxidants and fish oils have?
They may have beneficial effects on the immune system and inflammation
## Footnote
There may also be other foods or components that help maintain appropriate immune response.
143
What is an anti-inflammatory diet?
A dietary program recommendation that includes various foods to reduce inflammation
## Footnote
It ties the theory of food components into an overall dietary approach rather than single supplements.
144
List some foods included in an anti-inflammatory diet.
* Fish (especially higher in omega-3)
* Fruits (blueberries, blackberries, strawberries, raspberries)
* Vegetables
* Beans
* Nuts and seeds
* Olive oil
## Footnote
The diet avoids or limits processed foods.
145
What is currently being researched regarding the anti-inflammatory diet?
Whether following this type of diet will reduce inflammation in people living with IBD
## Footnote
As yet, there is no conclusive answer.
146
Is there a standard diet for IBD?
No, there is no standard diet for IBD
## Footnote
Diet modifications can help with symptom management.
147
When are diet restrictions usually applied for IBD patients?
During times of disease activity or postoperative recovery periods
## Footnote
Any diet modifications should be discussed with a doctor or dietitian.
148
What factors should be considered when making diet modifications for IBD?
* Religion
* Culture
* Ethnicity
* Beliefs
* Personal food preferences
* Tolerances
* Allergies
* Phobias
* Lifestyle
* Employment
* Sports
* Financial considerations
## Footnote
Diet modifications are individualized recommendations.
149
Fill in the blank: Any diet modifications should be discussed with your _______.
doctor or dietitian
150
True or False: Diet modifications for IBD are uniform for all patients.
False
## Footnote
They are individualized recommendations that work for each person.
