Nutrition and diet in the management of GI disease in adults Flashcards Preview

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Flashcards in Nutrition and diet in the management of GI disease in adults Deck (30):
1

What are the two types of IBD

Crohn's and Ulcerative colitis

2

What are the clinical features of Crohn's

Abdo pain
Diarrhoea
Anorexia and weight loss
malaise and fever

3

What are the clinical features of Ulcerative colitis

Bloody diarrhoea
Colicky abdominal pain
Urgency

4

What is the main difference between ulcerative colitis and crohn's

Crohn's affects the whole of the GI system
Ulcerative colitis affects the large bowel only

5

What are the nutritional considerations in IBD

Nutrients in pathogenesis
Management of malnutrition
Nutrition as therapy

6

What is thought to lead to a micro flora change in the gut

Relation to refined western diet (sugar and fats)

7

What can contribute to Crohn's disease greatly?

Smoking

8

What has a protective role for Crohn's and UC

Fruit and fibre

9

What two nutrients in pathogenesis are associated with IBD

Lack of breast feeding
Hypersensitivity to cow's milk

10

Why does the protein-energy malnutrition occur?

Malabsorption
Increased requirements
Poor dietary intake

11

What are IBD standards

Tailoring nutritional advice to the specific patient

12

Who is involved in the IBD team

Gastroenterologists
Surgeons (not always)
Clinical nurse specialists
Dietitian
Pharmacist
Pathologist
GI radiologist

13

What is involved in the Dietetic assessment

MUST assessment
frequency of bowel movements
Investigations (what is affected/ likelihood of surgery)
medications (number of days)
Detailed dietary history (observation)

14

What food should be avoided

High fibre foods
Fatty foods
Lactose
Spices or other things that cause that specific patient problems
Alcohol
Vitamin / mineral supplements

15

What foods are encouraged

Calcium, vitamin D, other fat soluble vitamins, zinc, iron and vitamin B12
Serum vitamin B12 is best measure annually
IV iron replacement

16

What are the therapeutic options in the management of IBD

Nutritional therapy - exclusive enteral nutrition
Liquid feeding 6-8 weeks
Either oral or via NG tube may avoid adverse effect of steroids most often used in conjuction

17

What foods do we start to reintroduce

Low fibre, fat limited
Carbohydrates

18

What is the most useful way to improve nutritional status before pre-op

Parenteral Nutrition

19

What is IBS

Chronic functional disorder of the GI tract

20

At what age do symptoms tend to appear of IBS

usually 20-30 years

21

What are the symptoms of IBS

Abdominal pain, discomfort, bloating or distension, win d or flactulence, change in bowel habit

22

What are the causes of IBS

Related to increase in visceral sensitivity
Occasionally linked to previous GI illness
Stress

23

What do IBS patients need to be screened for

Caeliac's disease

24

What are some of the first line dietary / lifestyle advice for IBS

Eat 3 regular meals a day
Don't eat late at night
Take time to eat meals and chew food well
choose smaller meals
Limit alcohol intake
Ensure adequate fluid intake
Limit caffeine intake
Cut down on rich or fatty foods
Take regular exercise
Take time to relax
Food and symptom diary

25

What are some of the stage 2/3 dietary advice

Adjustment of fibre intake
Limit fruit juice / fizzy drink
Polyols/ sugar alcohols
Resistant starch
Trial of probiotics
Low lactose diet
What free diet
Elimination diet

26

What are probiotics thought to do?

Increase the transit time

27

What medications can be used for IBS

Anti spasmodics
Amtimuscarniics
Antimotility drugs
Laxative
Amatriptolene

28

What is a low fodmap diet?

Recent advance
for those who dont respond to 1st line dietary advice
to do with short chain carbs
used for 4-8 weeks

29

What is coeliac disease?

An auto-immune condition affecting 1% of the population
Female: Male ratio is 2:1

30

What is the treatment of coeliac disease

Removal of gluten from the diet

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