GI Disorders

Question 1

Avoiding large, high fat meals, smoking, alcohol, caffeine, carbonation, acidic, spicy foods, eating 2-3 hours before lying down, elevate the head 6-8 inches while sleeping are all recommendations for what condition

Answer 1

GERD

Question 2

What do you need to evaluate in atrophic gastritis

Answer 2

need for B12, Fe, Ca

Question 3

Natural eradication of H.pylori can be accomplished with what

Answer 3

Green tea, broccoli, black currant oil, kimchi, probiotics (lactobacillus and bifidobacterium)

Question 4

Peptic Ulcers should avoid

Answer 4

Alcohol, spicy and triggers, limiting coffee and caffeine

Question 5

Rome III Criteria for Constipation Dx must include 2 or more of what for at least 3 months

Answer 5

Straining during 25% of defecations
Lumpy or hard stools 25%
Sensation of incomplete evacuations 25%
Sense obstruction 25%
Manual maneuvers to facilitate 25%
< 3 defecations/week
Loose rare w/o laxative
Cant dx IBS

Question 6

Pancreatic insufficiency
Gastric acid hypersecretion
Impaired bile production or secretion
Bacterial overgrowth
Enzymatic deficiency
Celiac disease
Crohn's disease
Allergies can all be possible causes of what

Answer 6

Malabsorptive Diarrhea

Question 7

Keys things to remember when recovering from diarrhea

Answer 7

Replenish fluids (electrolytes), Limit lactose, sugar alcohols, fructose and sucrose, Modest intake of soluble fiber. Try probiotics

Question 8

Pale, greasy, smelly stool, diarrhea w/o distention or gas are S/S of what

Answer 8

Fat malabsorption, 72 hour fecal fat test

Question 9

Edema and m. atrophy are possible S/S of what

Answer 9

Protein malabsorption, Fecal nitrogen, serum albumin

Question 10

Watery diarrhea, flatus, abdominal distention are possible S/S of what

Answer 10

Carb malabsorption, Hydrogen breath test

Question 11

Tachycardia, dry mouth are possible S/S of what

Answer 11

Fluid, electrolyte malabsorption, Serum electrolyte panel, creatinine, urea nitrogen

Question 12

Watery diarrhea is a S/S of what

Answer 12

Bile salt malabsorption, Serum 7α-hydroxy-4-cholesten-3-one

Question 13

S/S: Macrocytic anemia, glossitis

Answer 13

Folic acid malabsorption

Question 14

S/S: Macrocytic anemia, glossitis, fatigue, nerve issue

Answer 14

B12 malabsorption

Question 15

S/S: Cheilosis, angular stomatitis, glossitis, dermatitis, ataxia, sensory dysfunction

Answer 15

B-complex malabsorption

Question 16

S/S: Night blindness, follicular hyperkeratosis

Answer 16

Vit A malabsorption

Question 17

S/S: Muscle cramps, bone pain

Answer 17

Vit D malabsorption

Question 18

S/S: Decreased deep tendon reflexes

Answer 18

Vit E malabsorption

Question 19

S/S: Easy bruising, hemorrhage

Answer 19

Vit K malabsorption

Question 20

S/S: Microcytic anemia, fatigue, koilonychia

Answer 20

Iron malabsorption

Question 21

S/S: Taste atrophy, dermatitis, hair loss

Answer 21

Zinc malabsorption

Question 22

S/S: Tetany

Answer 22

Magnesium malabsorption

Question 23

S/S: M. pain

Answer 23

Selenium malabsorption

Question 24

S/S: Weakness

Answer 24

Copper malabsorption

Question 25

S/S: Paresthesia, tetany, cone pain, Trousseau sign

Answer 25

Calcium malabsorption

Question 26

What do Celiac, Crohn's, MS, IBS, and SIBO patients all potentially have in common

Answer 26

Leaky gut is found in these patients

Question 27

What is the MC test for Leaky gut

Answer 27

Lactulose-mannitol test. Collect urine samples for 6hr after consumption

Question 28

What are the nutritional symptoms of Celiac disease

Answer 28

Anemia, Inc. Fx risk, Clotting issues, Delayed growth, Lactas deficiency

Question 29

What are the possible extraintestinal symptoms of Celiac disease

Answer 29

Malaise, Arthritis, Dermatits herpetiformis, Infertility, Hepatitis, Ataxia, Pyschiatric syndromes

Question 30

What are the possible associated disorders with Celiac disease

Answer 30

Autoimmune cluster: T1DM, thyroiditis, hepatits, GI malignancy, IgA deficiency

Question 31

What is involved in Celiac disease

Answer 31

Immune system. Body attacks itself

Question 32

No immune response, possibly due to IBS, and Dx via and elimination diet describes what

Answer 32

Gluten sensitivity or intolerance

Question 33

What is the Nutritional Therapy for Celiac Disase

Answer 33

Gluten free for life avoiding wheat, rye, barley, malt. up to 50g of oats/day

Question 34

Patients who do not respond to a gluten free diet, and present with a severe malabsorptive diarrhea and weight loss may be suffering from

Answer 34

Refractory Celiac Disease

Question 35

Gluten free diets may be low in what

Answer 35

Fe, fiber, folate, niacin, riboflavin

Question 36

What may gluten free diets be high in

Answer 36

Saturated fat, starch, and sucrose

Question 37

What are the 2 intestinal brush border enzyme deficiency conditions

Answer 37

Lactose intolerance, Fructose malabsoprtion

Question 38

What are the 2 types of IBD

Answer 38

Crohn's and UC

Question 39

Which IBD has a more "spotty" distribution

Answer 39

Crohn's

Question 40

Which IBD is mostly in the 2nd half of the LI

Answer 40

Ulcerative colitis (UC)

Question 41

IBD inc. protein requirement to what

Answer 41

1.3-1.5 g/kg/d

Question 42

What supplements may be necessary with IBD

Answer 42

Folate, B6, B12, Fe, Zn, Mg

Question 43

If diarrhea is present with IBD what should be inc.

Answer 43

Zn, Se, K (fatty malabsorption MCTs)

Question 44

What should be supplemented if steroids are given with IBD

Answer 44

Vit. D and Ca

Question 45

IBS Rome III criteria

Answer 45

Recurrent abdominal pain 3 days/month for 3 months: Improve with defecation Onset associated with a change in frequency/appearance of stool

Question 46

What are the MC etiologies of Diverticular disease

Answer 46

Obesity, low fiber diet, Vit. D insufficiency, sedentary lifestyle, NSAID