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© 2007 Thomson - Wadsworth Chapter 18 Nutrition and Lower Gastrointestinal Disorders
© 2007 Thomson - Wadsworth Common Problems of the Lower Intestine Constipation Intestinal Gas Diarrhea Bacterial Overgrowth Steatorrhea
© 2007 Thomson - Wadsworth Constipation Difficult or infrequent stools More prevalent among women Increases with age Correlates with Low food intake Low-fiber diets Inactivity Medical conditions Hypothyroidism Diabetes mellitus Chronic renal failure Parkinson’s Spinal cord lesions MS Some medications & dietary supplements
© 2007 Thomson - Wadsworth Treatment Gradual increase in fiber Wheat bran Fruits (prunes) Vegetables Adequate fluid Daily exercise Laxatives Medical intervention
© 2007 Thomson - Wadsworth Intestinal Gas Causes High-fiber diets Carbohydrates Fructose Sugar alcohols (sorbitol, mannitol, maltitol) Beans Some grains & potatoes Other causes Malabsorption problems Swallowed air
© 2007 Thomson - Wadsworth
Diarrhea Frequent, watery stools If severe, can cause dehydration & electrolyte imbalances Types Osmotic diarrhea Motility disorders Secretory diarrhea Acute diarrhea Infection Certain medications Chronic diarrhea Altered GI motility Intestinal inflammation Malabsorptive & endocrine disorders Infectious diseases Radiation treatment Others
© 2007 Thomson - Wadsworth
Bacterial Overgrowth Gastric acid protects stomach & intestine from bacterial overgrowth Overgrowth Disrupts fat digestion & absorption May develop fat-soluble vitamin & vitamin B 12 deficiencies Symptoms Chronic diarrhea Abdominal discomfort Bloating Weakness Weight loss Causes Impaired intestinal motility Reduced gastric acid secretions
© 2007 Thomson - Wadsworth Steatorrhea Excessive fat in stool Causes Reduced availability of bile Reduced availability of pancreatic lipase Fat malabsorption May need a fat- restricted diet Consequences of fat malabsorption Loss of food energy Loss of essential fatty acids Loss of fat-soluble vitamins Decreased absorption of calcium, magnesium, & zinc Increased risk of kidney stones
© 2007 Thomson - Wadsworth Malabsorption Syndromes Lactose Intolerance Pancreatitis Cystic Fibrosis Celiac Disease Inflammatory Bowel Diseases Short-Bowel Syndrome
© 2007 Thomson - Wadsworth Lactose Intolerance Loss or reduction of enzyme lactase that digests lactose in milk products Prevalent among certain ethnic groups Symptoms: diarrhea & intestinal gas Diet Milk: usually 2 cups/day divided & consumed with food is tolerated Chocolate milk Aged cheese Yogurt with live bacterial cultures Lactose-free milk Can take enzyme tablets before consuming dairy
© 2007 Thomson - Wadsworth Pancreatitis Pancreatic tissue is destroyed by activated enzymes Severe abdominal pain Acute Causes: gallstones, excessive alcohol, high triglycerides, toxins Withhold food & fluids Chronic Permanent damage to tissue 70% alcohol induced Food avoidance & malabsorption lead to weight loss & malnutrition
© 2007 Thomson - Wadsworth Cystic Fibrosis Unusually viscous exocrine secretions Complications involve lungs, pancreas, sweat glands Respiratory infections Malabsorption of protein, fat, & fat-soluble vitamins Salt losses in sweat Nutrition therapy Children may need 120-150% of normal energy needs High-kcalorie, high-fat foods Frequent meals & snacks Pancreatic enzyme replacement Liberal use of table salt
© 2007 Thomson - Wadsworth Celiac Disease Abnormal immune response to a protein fraction Need a gluten-free diet for life Wheat Barley Rye Oats Rice is allowed Check food labels carefully Symptoms Diarrhea, steatorrhea, flatulence Consequences Severe damage to intestinal mucosa Malabsorption Children: stunted growth & underweight
© 2007 Thomson - Wadsworth Inflammatory Bowel Diseases Chronic inflammatory conditions Genetic & environmental factors contribute Exact triggers are unknown Crohn’s disease & ulcerative colitis
© 2007 Thomson - Wadsworth Crohn’s Disease Can occur in any region of the GI tract Ulcerations, fissures, & fistulas Thick scar tissue may cause obstructions Malnutrition from reduced intake, malabsorption, & surgical resections
© 2007 Thomson - Wadsworth Healthy colon (left) vs. Crohn’s disease (right)
© 2007 Thomson - Wadsworth Ulcerative Colitis Only affects the rectum & colon Frequent urgent bowel movements Nutrient losses due to tissue damage, bleeding, & diarrhea Complications Weight loss Fever Weakness Anemia Dehydration Electrolyte imbalance Protein losses Colectomy prevents future occurrences
© 2007 Thomson - Wadsworth Healthy colon (left) vs. ulcerative colitis (right)
© 2007 Thomson - Wadsworth Treatment for Inflammatory Bowel Diseases Drugs Antidiarrheals Immunosuppressants Anti-inflammatory agents Nutrition therapy for Crohn’s Highly variable High-kcalorie, high- protein Liquid supplements Multivitamin Nutrition therapy for colitis May require few adjustments Restore fluids & electrolytes Low fiber or withhold food during severe illness
© 2007 Thomson - Wadsworth Short-Bowel Syndrome Can be the consequence of small intestine resections About 50% can be removed without serious nutritional consequences Intestine undergoes adaptation to improve absorptive capacity Diet Small, frequent meals Low fat, lactose restricted High carbohydrate Vitamin & mineral supplements At risk for kidney stones
© 2007 Thomson - Wadsworth
Disorders of the Large Intestine Irritable Bowel Syndrome Diverticular Disease of the Colon Ostomies Large intestine Moves undigested materials to the rectum Helps maintain fluid & electrolyte balance Bacteria ferment undigested materials
© 2007 Thomson - Wadsworth Irritable Bowel Syndrome Chronic & recurring intestinal symptoms Diarrhea & constipation Flatulence, bloating, & distention More common in women Excessive colonic response to meals, GI hormones, & stress Medicine Antidiarrheal agents Anticholinergics Antidepressants Laxatives Diet Increase fiber Limit caffeine, alcohol, fat, & milk products Small, frequent meals
© 2007 Thomson - Wadsworth Diverticular Disease Presence of pebble- sized outpockets in intestinal wall Prevalence increases with age High-fiber diet can be preventative May need to avoid nuts, popcorn, & food with seeds
© 2007 Thomson - Wadsworth Diverticulitis Inflammation or infection Most common complication of diverticulosis Symptoms Persistent abdominal pain Fever Alternating constipation & diarrhea Treatment Antibiotics, pain medication Clear liquid or bowel rest Surgery
© 2007 Thomson - Wadsworth Ostomies Surgical removal of some or all of large intestine Wastes exit through a stoma in abdominal wall Colostomy & ileostomy Temporary or permanent Chew food thoroughly to prevent obstructions Foods cause unpleasant odors Fish, eggs, dried beans & peas, onions, garlic, beer, others Foods that reduce odors Buttermilk, cranberry juice, parsley, yogurt
© 2007 Thomson - Wadsworth
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Large Intestine Working knowledge of physiological changes during disease processes & the effects of these on nutrition care.
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The Digestive System Maintenance Systems Unit 5. Learning Log What is the purpose of the digestive system? What pieces make up the digestive system?
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G.I. Disorders Lower G.I. and accessory organs. Irritable Bowel Syndrome Approximately 5 million people in the U.S. suffer with the syndrome Approximately.
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The Digestive System. Related Medical Terminology GI – Gastro-intestinal Colo- Colon Cheilo – lips Gastro – stomach Gingivo – gums -ia – condition Stomato.
Crohn’s disease - A Review of Symptoms and Treatment Brian Nguyen University of California - Irvine Medical Center, Orange, CA.
Upper Gastrointestinal Tract KNH 411. Upper GI – A&P Stomach - Motility Filling, storage, mixing, emptying 50 mL empty – stretches to 1000 mL Pyloric.
© 2007 Thomson - Wadsworth Chapter 16 Nutrition in Metabolic & Respiratory Stress.
Gluten Free Diet Accommodating the Gluten Free Diet in The PCH Setting.
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Conditions Affecting the Pancreas. Functions of the pancreas 1.The enzymes secreted in the pancreas help break down carbohydrates, fats, proteins, and.
Foods: Are they safe? All you need to know about why we eat, diets, and food safety.
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Divertcular Disease of the Colon Diverticulosis= out-pouching of the colonic diverticula through the muscularis mucosa layer. Often symptomless. Risk factors:aging.
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