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Flashcards in GI disorders Deck (52)
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1

Natural Therapy of Peptic Ulcer

1) Check/Tx H. Pylori infection
2) Avoid mucosal irritants & gastric acid secretagogues
3) normal diet, fiber OK as tolerated
4) deglycyrrhizinated licorice
5) zinc

2

Licorice
--scientific name

glycyrrhiza glabra

3

licorice
--where it grows

cultivated throughout europe, the middle east, and asia

4

licorice
--parts of plant used

root

5

licorice
--active constituents

1) Glycyrrhizin
2) Flavonoids

6

licorice
--bioavailability

no information

7

licorice
--metabolism

1) Increased production of gastric protective mucin
2) Flavonoids & polysaccharides have been shown to inhibit H. pylori in vitro

8

licorice
--uses

1) peptic ulcer
2) GERD

9

licorice
--dosage & administration

1) DGL prep = 4:1 concentration TID chewed before meals
2) dried powdered root
3) fluid extract (not clinically tested)

10

licorice
--contraindications

1) liver & severe kidney disorders

11

licorice
--side effects

1) glcyrrhizin in large amounts can produce pseudoaldosteronism = elevated blood pressure, electrolyte disturbances, and <3 problems.
**Deglycyrrhizinated licorice (DGL) does NOT pose these risks**

12

licorice
--interactions with other botanicals and drugs

1) licorice
--influence corticosteroid
--add hypokalemic effects of thiazide & loop diuretics & may increase risk of digitalis (drug that stimulates <3 m) toxicity
2) DGL
--human fecal blood loss induced w/ aspirin

13

licorice
-use during preggers/lactation

contraindicated

14

GERD - Tx

1) avoid abdominal compression
2) avoid over eating
3) avoid sphincter inhibitors & irritants (smoking, alcohol, caffeine, spices, acids, chocolate, peppermint, spearmint)
4) Deglycyrrhizinated licorice (DGL)

15

Dx of gallbladder
(6 F's)

Fam Hx
Female
40
Fat
Fair (white)
Fertile (lots of kids)
w/ RUQ pain

16

prevention of gallbladder
disease

maintain low [biliary cholesterol] & high concentration of phospholipids & bile acids to prevent stone formation & progression.

17

diet & lifestyle changes for gallbladder disease

assoc w/ = animal fats, trans fat, eggs, obesity, high glycemic carbohydrates

18

supplements to Tx gallbladder disease

--only prescribed = Ox bile concentrations
--highly concentrated lecithin (phosphatidyl choline)
--lipotropic formulas
--ARTICHOKE, dandelion, milk thistle
--"gallbladder flush" = large dose of vegetable oil

19

celiac disease
--overview

--screen with anti-body test
--gluten-free diet for life
--initially avoid lactose
--digestive enzyme supplements may speed recovery; celiac-specific enzymes to improve gluten-tolerance during meals

20

Irritable Bowel Syndrome (IBS)
--overview

--R/O GI pathology & alternative Dx
--stress reduction & mind-body therapies
--increase dietary fibers
--food sensitivities
--peppermint oil
--melatonin @ bedtime
--consider probiotics

21

peppermint
--scientific name

menthe piperita

22

peppermint
--where it grows or is cultivated

europe & NA

23

peppermint
--part(s) of the plant used:

leaf, essential oil

24

peppermint
--active constituents

menthol/ methone

25

peppermint
--bioavailability

1) peppermint oil is rapidly absorbed in the upper digestive tract,
necessitating enteric=coated products when target tissue is the lower GI tract & upper GI tract actions are not desired

26

peppermint
--metabolism

1) eliminated mainly in the bile

27

peppermint
--physiological effects

1) carminative
--release gas
--enhances gastric emptying
2) antispasmodic
--(-) smooth muscle contraction in GI by antagonizing Ca2+
--reduced # of contractions & amplitude
--(-) gallbladder contraction

28

peppermint
--Hx/ traditional use

--spastic discomfort of upper GI & bile ducts
--irritable colon
--catarrhs of respiratory tract
--inflammation of oral mucosa
--external use for myalgia & neuralgia

29

peppermint
--clinical research

1) Irritable bowel syndrome
2) Non-ulcer dyspepsia (chronic indigestion)
3) Tension HA

30

Irritable bowel syndrome Dx criteria

12 weeks that do not have to be consecutive but must have 2/3 features
1) relieved with defecation
2) onset associated w/ change in frequency of stool
3) onset associated w/ change in form of stool.