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Flashcards in Nutrition and GI Disease Deck (23)
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1

What % of patients with IBD have each of the separate disease?

2/3rds = ulcerative colitis
1/3rd = Chron's disease
(approximately)

2

Clinical features of Crohn's?

Abdo pain
Diarrhoea
Anorexia and weight loss
Malaise and fever

3

Clinical Features of Ulcerative colitis?

Bloody diarrhoea
Colicky abdominal pain
Urgency
Prevalence of obesity in ulcerative colitis patients is increasing

4

What may type of diet may IBD be related to?

Western diet (sugar and fats) - caused by changes in diet leading to alteration of intestinal microbiological flora rather than specific antigens in food

5

Why do IBD patients becomes malnourished? (3)

nutrient loss
increased requirement due to catabolic effect of inflammation
decreased intake e.g. due to pain)

6

What dietetic assessment

MUST assessment
Frequency of bowel movements
investigations
medications
detailed diet history
*MDT approach

7

Dietary advice given to patients with IBD?

nutritional support (high calorie and protein diet, little and often, supplement drinks)
Food avoidance (food intolerance unusual but sometimes they can become intolerant to lactose for example)
Possible triggers?

8

What must be continually monitored in IBD patients?

Nutrient levels e.g. do they require vitamin. mineral supplements

9

What is the second line of nutrition if oral route is insufficient

Enteral nutrition:
No role in treatment of UC
Alters inflammatory response in CD therefore may be useful

10

What is the most effective way for inducing remission in IBD?

Steroids

11

Parenteral nutrition in IBD?

Not a lot of indications for this apart from when the GI tract is not working

12

Dietary advice for UC?

Same as general population

13

What is the diagnoses criteria for IBS?

Rome III - recurrent abdo pain or discomfort at least 3 days per month in the last 3 months. Associated with 2 or more of the following:
Pain relieved by bowel movement
Onset of pain is related to frequency of stool
Onset of pain is related to a change in the appearance of the stool

14

Medications for IBS

Anti-spasmodics
Anti-muscarinics
Anti motility drugs
Laxatives
Bulking agents, antispasmodics and antidepressants for the treatment of IBS

15

Initial Dietary advice for IBS

Regular meals
Limit alcohol
Ensure adequate fluid intake
LiMIT caffeine intake

16

2nd stage dietary advice for IBS?

Adjust fibre intake depending on diarrhoea or constipation
Limit fruit juice/ fizzy juice
limit sorbitol
limit resistant starch
trial probiotics
lactose free diet
wheat free diet
elimination diet

17

3rd advice for IBS?

FODMAP diet

18

What are FODMAPs

Short chain carbs
poorly absorbed leading to fermentation and osmotic changes in the bowel

19

Treatment for coeliac disease?

Gluten-free diet

20

What contains gluten?

Wheat, barley and rye

21

Can oats be eaten if you have coeliac?

Oats can usually be eaten (they have a very small amount of gluten in them so if you try them and don't tolerate them you will need to stop eating them)

22

What can coeliac patients be prescribed?

Gluten free food

23

What disorder at coeliac patients at risk of?

Osteoporosis (malabsorption of calcium) -> less chance the earlier you start a gluten free diet