Mnt 2 - Upper Gi Function

Front 1

Four Phases of Swallowing

Back 1

Oral Prepatory Phase
Oral Phase
Pharyngeal Phase

Front 2

Oral Prepatory Phase

Back 2

First phase
Food is chewed and mixed with saliva

Front 3

Oral Phase

Back 3

Secondary Phase
voluntary movement of bolus from front of the oral cavity to the back

Front 4

Pharyngeal Phase

Back 4

Third Phase
Directed into esophagous

Front 5

Esophageal Phase

Back 5

Final Phase
Food enters through esophageal sphincter

Front 6

Four basic functions of GI tract

Back 6

motility, secretion, digestion, absorption

Front 7

Dysphagia Diet 1 (NDD-1)

Back 7

"Dysphagia Pureed"

Pudding-like consistency (no lumps)

NOT ALLOWED:
Fruit yogurt, jello, Peanut Butter, scrambled, fried or hard cooked eggs

Front 8

Dysphagia Diet 2 (NDD-2)

Back 8

"Dysphagia Mechincally Altered"
Moist and Soft textured; tender ground or finely diced meats, soft vegs, and fruit

FOOD NOT ALLOWED:
Bread, dry cake, rice cheese cubes, corn and peas

Front 9

Dysphagia Mixed

Back 9

Customed Pureed (NDD-1)
that allows some mechincally altered NDD-2 items

Front 10

Mechanical Soft

Back 10

Alternative diet
Allows bread, cake and rice with NDD-2 Diet.

Front 11

Dysphagia Diet (NDD-3)

Back 11

"Dysphagia Advanced"
Includesmost regular foods except very hard, sticky or crunchy items.

NOT ALLOWED:
Hard fruit and vg, corn skins, nuts and seeds

Front 12

National Dysphagia Diet Task Force Viscosity listings

Back 12

Spoon-thick
Honey-like
Nectar-like
Thin Liquids (all liquids, deserts, and jello)

Front 13

GERD

Back 13

Gastroesophageal reflux disease

Chronic of recurrent gastric pain due to reflux of gastric secretions into the lower esophagous

Incompetence of LES sphincter

Front 14

Factors lowering LES pressure (GERD)

Back 14

Increased secretion of gastrin, estrogen, progesterone
Hiatal hernia
Cigarette smoking
Use of medications

Front 15

Symptoms of GERD

Back 15

Dysphagia
Heartburn
Increased salivation
Belching
Pain radiating to back, neck, or jaw
Aspiration
Ulceration
Barrett’s esophagus

Front 16

Barrett's esophagus

Back 16

a compliation of severe chronic GERD invovling changes in the cells of the tissue that line the bottom of the esophagus; thse esophageal cells become irritated when the contents of the stomach back up , and there is a small but definite incraesed risk of cancer of the esophagus

Front 17

Conditions that increase the likelihood of reflux

Back 17

Ascites
Delayed gastric emptying
eating large meals
Lying flat after eating
Obesity
Pregnancy
Wearing clothes that fit tightly

Front 18

Substances that lower LES pressure

Back 18

alcohol
caffeine
cigarettes
garlic
high fat foods
onions
peppermint / spearmint
progesterone

Front 19

Foods that relax LES

Back 19

peppermint / spearmint
alcohol
chocolate
coffee
fried foods

Front 20

Foods that increase gastric secretion

Back 20

alcohol
pepper
coffee

Front 21

Peptic Ulcer Disease

Back 21

ulcerations of the gastric mucosa that penetrate submucosa

Front 22

Pivotal Factor of PUD

Back 22

h.pylori|
92% of duodenal ulcers
70% of gastric ulcers

Front 23

PUD: Symptoms

Back 23

epigastric pain relieved or worsened by abdominal pain, burning sensation

Presence of blood in the stool or vomit

Front 24

PUD: Nutrition Interventions

Back 24

Restrict only those foods known to increase acid secretion
Black and red pepper, caffeine, coffee, alcohol, individually non-tolerated foods
Consider timing and size of meal
Do not lie down after meals
Small, frequent meals

Front 25

PUD: Symptoms

Back 25

epigastric pain relieved or worsened by abdominal pain, burning sensation

Presence of blood in the stool or vomit

Front 26

hemorrhage

Back 26

bleeding

Front 27

PUD: Nutrition Interventions

Back 27

Restrict only those foods known to increase acid secretion
Black and red pepper, caffeine, coffee, alcohol, individually non-tolerated foods
Consider timing and size of meal
Do not lie down after meals
Small, frequent meals

Front 28

hemorrhage

Back 28

bleeding

Front 29

perforation

Back 29

a break in the integrity of the tissue

Front 30

perforation

Back 30

a break in the integrity of the tissue

Front 31

obstruction

Back 31

blockage

Front 32

obstruction

Back 32

blockage

Front 33

vagotomy

Back 33

severing the vagus nerve
results in decreased acid production and decreased response to gastrin

Front 34

vagotomy

Back 34

severing the vagus nerve
results in decreased acid production and decreased response to gastrin

Front 35

Gastric Surgery - Nutrition Implications

Back 35

Reduced capacity
Changes in gastric emptying & transit time
Components of digestion altered or lost
Decreased oral intake, maldigestion, malabsorption

Front 36

Gastric Surgery - Nutrition Implications

Back 36

Reduced capacity
Changes in gastric emptying & transit time
Components of digestion altered or lost
Decreased oral intake, maldigestion, malabsorption

Front 37

Dumping Syndrome

Back 37

symptoms occurring with rapid passage of large amounts of food into the small intestine

Increased osmolar load enters small intestine too quickly from stomach
Release of hormones, enzymes, other secretions altered
Food “dumps” into small intestine

Front 38

Dumping Syndrome

Back 38

symptoms occurring with rapid passage of large amounts of food into the small intestine

Increased osmolar load enters small intestine too quickly from stomach
Release of hormones, enzymes, other secretions altered
Food “dumps” into small intestine

Front 39

Gastric Dumping - Early Dumping

Back 39

10-20 min.; diarrhea, dizziness, weakness, tachycardia

Front 40

Gastric Dumping - Early Dumping

Back 40

10-20 min.; diarrhea, dizziness, weakness, tachycardia

Front 41

Gastric Dumping - Intermediate Dumping

Back 41

20-30 min.; fermentation of bacteria produces gas, abdominal pain, etc.

Front 42

Gastric Dumping - Intermediate Dumping

Back 42

20-30 min.; fermentation of bacteria produces gas, abdominal pain, etc.

Front 43

Gastric Dumping - Late Dumping

Back 43

1-3 hrs.; hypoglycemia

Front 44

Gastric Surgery - Nutrition

Back 44

“Anti-dumping” diet
Slightly higher in protein & fat
Avoid simple sugars & lactose
Calcium & vitamin D
Liquid between meals
Small, frequent meals
Lie down after meals
Assess for weight loss, malabsorption, and steatorrhea

Front 45

Anti-Dumping Diet

Back 45

Slightly higher in protien and fat simple sugars avoided.