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Nutrition Y 2 Exam 1 > Detoxification and GI health > Flashcards

Detoxification and GI health Flashcards

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1
Q

What is meant by detoxification?

A

Transforming a toxin into a less harm or water soluble state.

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2
Q

What are 4 signs of toxic overload?

A

Bowel – halitosis, bitter taste, bloating, fatty stool, constipation/diarrhoaa
Immune – food allergies or skin issues
Hormonal – stress, infertility, PMS, overweight, depression
Nervous system – headaches, dementia, poor memory/conc

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3
Q

What is the difference between duodenum, jejunum and ileum?

A

Duodenum – absorbs iron and calcium, food is mixed with bile
Jejunum – responsible for digestion
Ileum – absorption of fat soluble vits– A, E, K, D

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4
Q

What are 4 functions of HCl?

A

Denature proteins, activates pepsin from pepsinogen, inhibit candida spp, stimulates pancreatic juice secretion, barrier defense against ingested microbes.

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5
Q

What are 6 signs of low gastric activity?

A

Bloating, belching and flatulence 1-2 hrs after eating, undigested food in stool, foul smelling stools, dysbiosis (candida, parasites), iron deficiency, diarrhea or constipation.

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6
Q

How do you prescribe HCl supplements?

A

Take betaine hydrochloride (600mg) one tablet a day and increase the dose each day until a warmth sensation is felt, then take one table lesson then that dose. Do not exceed 5 tablets.

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7
Q

Explain how HCl has an effect on H. pylori.

A

HCL inhbits h.pylori so low HCl = increase h.pylori

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8
Q

What is a peptic ulcer?

A

Defects in gastric or duodenal mucosa that extends to muscularis mucosal defense.

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9
Q

What are symptoms of peptic ulcer?

A

Epigastric pain (burning) 2-3 hours after a meal relieves by antacids or food, nausea, vomiting, dyspepsia, heartburn, anorexia

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10
Q

What are some complications of peptic ulcers?

A

GIT bleeding, perforation to abdominal cavity, penetration to adjacent liver/pancreas, scarring and swelling, severe vomiting

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11
Q

Explain how H.pylori is associated with peptic ulcers.

A

People who have peptic ulcer tend to have high levels of h pylori, which increases gastric levels to try and inhibit h.pylori. The acid levels result on erosion of mucous leading to ulcer formation.

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12
Q

What are the risk factors for peptic ulcers?

A

Alcohol, smoking, NSAIDs, aspirin (thins gastric mucosa), over use of laxatives, stress

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13
Q

What should you avoid with peptic ulcers?

A

Avoid spicy food, alcohol, smoking, milk (increase stomach acid production), coffee, tea, sugar, aspirin

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14
Q

What nutrients/food should be included and why?

A

Raw cabbage juice (increases mucin), bananas (protect gastric mucosa), zinc (increases mucin production), 5-6 meals a day, increase fibres (delays gastric emptying), address food allergies

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15
Q

What is the difference between function and mechanical pathophysiology of GORD?

A

Functional pathophysiology – weakening of lower oesophageal sphincter, mechanical – sphincter pressure

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16
Q

Explain why pressure in the stomach causes GORD.

A

Undigested food leads to fermentation then gas causing gastric pressure which causes pressure on cardiac sphincter and stomach so pressure on heart leading to heartburn.

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17
Q

What are some symptoms of GORD?

A

Heartburn worse when lying down or after eating, regurgitation, dysphagia (food is stuck)

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18
Q

What are the allopathic treatment of GORD?

A

PPIs, histamine H2 receptor antagonists, antacids

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19
Q

What are some risk factors associated with GORD?

A

Alcohol, coffee, chocolate, citrus juices, salicylate-rich foods, smoking, carminatives – peppermint/spearmint

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20
Q

What are some diet and lifestyle treatment of GORD?

A

5-6 meals a day, avoid lying down after meals, stop smoking, do a h.pylori test, avoid fatty foods, chocolate, coffee, salicylate-rich food

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21
Q

What are some signs and symptoms of low pancreatic enzymes secretion?

A

Reflux, drowsiness after meals, loss of appetite, food allergies, steatorrhoa (fatty stool), bloating, discomfort, pain, low zinc, b12, folate

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22
Q

List 2 functions of bile.

A

Emulsification of fats, detoxification of bacterial endotoxins,

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23
Q

What can we do to excrete and produce bile?

A

Adequate hydration, rice fibre, olive oil (stimulate bile secretion), taurine and phosphatidylcholine

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24
Q

Explain why the GIT membrane is so important. (2).

A

Detoxification is in mucosa, protects stomach from acid, protects from pathogens.

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25
Explain leaky gut.
Large undigested food passes through the gut and slip into circulation because tight junction in the epithelium have become leaky results in inflammation, food allergies, intolerances and coeliac disease.
26
What are 5 risk factors of leaky gut?
Alcohol, cancer, corticosteroids, stress, sugar, fasting, GI infections, NSAIDs
27
What are symptoms of leaky gut? (5)
Abdominal pain, memory deficits, diarrhea, fatigue, food intolerance, poor exercise tolerance, arthralgia, myalgias
28
What are the 3 functions of microflora in the colon?
Fermentation, vit synthesis, energy production, out-competing pathogens, support dev of GALT, immunomodulation
29
How can infants increase microflora?
Ingesting vaginal and faecal microflora at delivery, breast feeding
30
What is dysbiosis?
Imbalance in colonies of bowel flora leading to disruption in health
31
What factors affect dysbiosis?
Poor diet, stress antibiotics, decreased immune status, inadequate digestion, increased intestinal pH
32
What is the 5 R program to restoring GIT health?
Remove – allergies, intolerants, toxins, irritants Replace – HCl, enzymes, bile support Reinoculate – pro/pre biotics Repair – gut tight junction, antioxidants, quercetin, probiotics, B5 Rebalance – support stress, immune response, dietary balance
33
Explain how IBS is diagnosed.
Onset of pain associated with more freq bowel movement, onset of pain associated with looser bowel movement, pain relieved by defecation, visible abdominal bloating, incomplete evacuation, mucorrhoa
34
What are 5 extra-intestinal symptoms of IBS?
Sexual dysfunction, fibromyalgia, dyspareunia, urinary freq/urgency, poor sleep, lower back pain, fatigue chronic,
35
What is the pathophysiology of IBS?
Gut-brain connection (low serotonin = poor peristalsis), defects in 5HT signaling, patients with IBS respond to stress differently with prolonged stress response. Stress slows stomach emptying and cause diarrhea, dysbiosis
36
What are some complications of IBS-C?
Anal fissure, haemorrhoids, rectal prolapse, urinary incontinence
37
What are some risk factors of IBS-C?
Poor fibre, poor fluid, dysbiosis, decreased liver/bile function, lack of exercise, anxiety, drugs
38
What are the nutritional therapy considerations for IBS-C?
Increase fluid, regulate eating habits, increase fibre, rice bran (increase stool mass), psyllium seed husk, natural laxatives (prunes), aloe vera juice (laxative effect), probiotics, magnesium, vit c (both laxatives), B5 (stimulates peristalsis)
39
What are the common signs and symptoms of IBS-D?
Freq loose watery stools, mucus or blood in stool, abdominal pain, vomiting or bloating, fever
40
What are the orthodox treatments for diarrhea?
Opiod analgesics, absorbants, bulk forming medications, anti-microbial.
41
What nutrients are malabsorbed due to diarrhea?
B12, C, A Cu, Fe, Mg, K, Na, Zn
42
What are 5 nutritional therapy strategies for IBS?
Optimize fibre Consider food allergies Avoid high refined sugar Enteric coated peppermint oil (inhibits smooth muscle action) 5HTP, digestive enzymes, probiotics, ginger (antispasmodic), exercise and stress reduction.
43
Explain the difference in symptoms between UC and CD.
UC – blood diarrhea, pain is sometimes, fatigue | CD – abdominal is common and diarrhea, fatigue, inflammation and anaemia
44
What is the pathophysiology of IBD?
Autoimmune – T helper 1 dominance, vit D – modulates autoimmune response, microbial infection, antibiotic exposure
45
Explain why people get malnourished with IBD?
Malabsorption, latrogenic (restrictive diets), disease induced (pain), oral intake decreased, drugs, bacterial overgrowth
46
Explain 5 nutritional therapy consideration of IBD.
Reduce beef, liver, pork, lamb, diary, reduce omega 6 and increase omega 3, quercetin, reduce food rich in mucopolyscaccharides to reduce inflammation (oats, onion, slippery elm), consider food allergies, optimize protein, glutathione, zinc, iron
47
How is coeliac disease diagnosed?
Intolerance to gluten – normal intestine structure due to removal of dietary gluten, bulky, pale, frothy, foul-smelling stool, weight loss, multiple deficiencies, jejunal biopsy, blood/mucus in stool
48
What nutritional therapy considerations are needed for coeliac disease?
Eliminate gliadin, dairy, correct nutritional deficiencies, eliminate food allergies, remove oats
49
How can candida be diagnosed?
Stool test, antibody and antigen levels (antibodies for candida)
50
What are 5 pre-disposing factors to candida?
Impaired immunity, drugs, nutritional deficiency, alter bowel flora, decreased digestive secretions.
51
What is the 7 step protocol for chronic candida?
Step 1 – identify and address predisposing factors Step 2 – eliminate sugar, dairy, food with high yeast, food allergies Step 3 – nutritional support (multivit/mineral) Step 4 – support immune function Step 5 – promote detox Step 6 – probiotics Step 7 – anti-yeast therapy
52
What are some prebiotic foods?
oats, legumes, beets, cows milk, yoghurt, asparagus, banana, barley, garlic, onion, leek, artichoke
53
What are some symptoms of SIBO?
bacterial overgrowth get fermented in the small intestine so start to produce hydrogen and methane gases. Symptoms are bloating in upper abdomen, belching, reflux, pressure, nausea, loss of appetite
54
What is the difference between dominant hydrogen or dominant methane?
hydrogen - diarrhoea | methane - constipation worse with fibre intake as cellulose increases methane gas produced
55
What might worsen SIBO?
pre and pro biotics
56
how can inflammation take place with SIBO?
bacteria produce enzyme histidine decarboxylase enzymes so when amino acid histidine, histamine will be produced which increases inflammation
57
How does SIBO effect the brain?
brain fog, alters memory/conc because bacteria produces histamine, tyramine, oxalates, polyphenol metabolites
58
What is the migrating motor complex?
stimulates the mobilisation of bacteria from small intestine to large intestines
59
What can stimulate the MMC?
prokinetic agents - ginge, iberogast or Xiangbin | leave longer gap between meals, intermittent fasting, small meals, avoid snacking
60
When to suspect SIBO?
persistant symptoms - bloating, nausea, diarrhoea, gas; history of h.pylori, persistent anaemia, worse symptoms with pro/pre biotic, improvement with antibiotics, improvement when eating less healthy
61
What dietary therapies for SIBO?
low FODMAP - reduce fibre and histamine, increase bitter food - increases bile and stomach acid production
62
What is the elemental diet?
supplemental replacement meals because it gives nutrients as well as allows fasting (2 weeks only and only for severe cases)
63
What are the 5 main functions of liver?
detoxification, normalisation of blood fats, synthesis and normalisation of blood proteins, manufacture bile, synthesis and storage of glycogen
64
what are symptoms of a compromised liver?
fatigue, weakness, neurological symptoms, elevated blood cholesterol, anorexia, jaundice
65
What is phase I detox?
cytochrome P450 family of enzymes involving oxidation, reduction or hydrolysis turning non-polar lipid soluble into more polar less lipid soluble
66
What are 5 inhibitors of phase I and 5 inducers of phase I?
inhibitors - curcumin, watercress, garlic, naringenin, echinacea inducers - alcohol, caffeine, stress, toxins, nicotine
67
What are antioxidants and what are some examples?
antioxidants target free radicals which are produced from phase I biotransformation. Vit E, glutathione, quercetin, lipoid acid, vit C, green tea

Nutrition Y 2 Exam 1 (8 decks)

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