Nutrition For Patients With Disorders Of The Lower Gi Tract And Accessory Organs

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90 to 95% of nutrient absorption occurs in the

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first 1/2 of the small intestine

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the part of the GI tract - absorbs water and electrolytes and promotes the elimination of solid wastes

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large intestine

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For lower GI tract and accessory organs - Nutrition Therapy is used to improve or control symptoms by

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replenish losses and promote healing

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liver, gallbladder and pancreas are called ? plus the play a vital role in nutrient digestion

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accessory organs
liver, gallbladder, pancreas

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this part of the lower GI tract - absorbs simple sugars, fat, amino acids, vitamins, minerals, water

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duodenum/jejunum

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this part of the lower GI tract absorbs - electrolytes, short chain fatty acids produced by GI Flora and water

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colon

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this part absorbs bile, vitamin B12, electrolytes , lesser amounts or vitamins and minerals and water

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lleum

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defined as fewer than 3 bowel movement per week - most common cause low fiber or high fat diet

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constipation

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nutrition therapy to treat constipation treat the cause - for most people would be to

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increase fiber and fluid

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pectin and psyllium - found in oats, legumes, and certain fruits and veggie (dissolve in water)

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soluble fibers

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cellulose found wheat bran, fruit, veggie skins (soaks up -stimulate peristalsis)

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insoluble fibers

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protect against Coronary heart disease Adequate Intake (AI) for fiber for women is 25g/day and for men

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38g /day (men)

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is a common symptom of many GI disorders and infectious diseases and is a frequent side effect of chemotherapy and radiation

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diarrhea

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is a regular diet that substitutes whole grains for refined grains

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high-fiber diet
fiber rich foods fresh fruits, veggie, dried peas, beans

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hypokalemia

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metabolic acidosis

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example of this type of diarrhea - lactose intolerance, dumping syndrome, tube feedings, excessive intake of sorbitol or fructose

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osmotic diarrhea
(no enzyme)

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bacterial, viral, protozoan and other infections cause

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secretory diarrhea

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goal for diarrhea

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maintaining or restoring fluid and electrolyte balance

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may help lessen diarrhea related to use of antibiotics and lactose intolerance

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probiotics

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secondary to nutrient maldigestion or from alteration

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malabsoprtion

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dietary intervention for malabsorption

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increase calories 2000-3500 and protein 1.0-1.5 g

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simple sugars glucose and galactose is absent or deficient

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lactose intolerance

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lactase is secreted this is secondary to GI disorders for ex. IBD - what lactose is more severe

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secondary lactose

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Inflammatory bowel disease (IBD0 has two chronic inflammatory gi diseases are

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Crohn diseasde and ulcerative colitis

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caused by abnormal immune response between environment and ?

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genetic factors

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focus of IBD therapy for acute exacerbation of IBD is to correct

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deficiencies by nutrients in a form the patient can tolerate

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low fiber diet to min bowel stimulation - protein and calories are increased to facilitate healing

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for IBD patient

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genetic autoimmune disorder characterized by chronic inflammation of proximal small intestine = assoc to certain proteins foun din wheat, barley and rye are permanent intolerance

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celiac disease
no whey, barley,rye

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nutrition therapy for celiac disease patient

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eliminate gluten from the diet

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pure oats is

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gluten free

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occurs when the bowel is surgically shortened to extent that the remaining bowel is unable to absorb good levels of nutrients - loss of more than 50% to 70%

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Short bowel syndrome (SBS)

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patients with less than 100 to 140 cm of small bowel and no colon will likely need

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intestinal transplantation or permanent PN

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nutrition for SBS may be provided several different combinations

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oral diet with PN or EN or PN with EN

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one of the most frequently diagnosed digestive disorders in a functional bowel disorder

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Irritable bowel syndrome (IBS)

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is the condition which diverticula form with the intestinal lumen, most commonly in the sigmoid colon

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Diverticulosis

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excessive bacterial growth in the stomach or small intestine that impairs digestion and absorption may be caused by low gastric acidity

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bacterial overgrowth

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diverticulitis recommendation for diet

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high fiber

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surgically created opening (stoma) on the surface of the abdomen from the ileum

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lleostomy

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surgically created from colon

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colostomy

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flowing discharge

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effluent

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usually from treatment of severe IBD, intestinal lesions, obstructions or colon cancer

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ileostomy and colostomy

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highly active organ in metabolism of almost all nutrients

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liver

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fat accumulation in the liver with inflammation

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steatoheptitis

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inflammation of the liver caused by viral, alcohol, hepatotoxic

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hepatitis

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liver disease

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cirrhosis

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CNS advanced liver disease - short term memory loss and impaired ability to concentrate

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hepatic encephalopathy

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most frequent causes of hepatitis are

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hep a, b, c

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what does each hep a b c

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hep a = food
hep b = finger stick

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nutrition therapy for liver disease patient increase calories and protein - protein should be increase to

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1.0 to 1.2

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vitamin and mineral are needed along with high calorie and high protein diet

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liver disease patient

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is a treatment option for patients with sever and irreversible liver disease

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liver transplantation

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EN support is used if the patient tis unable to consume adequate amount of nutrition for

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5 to 7 days in liver transplantation patient

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is responsible for secreting enzymes needed to digest carbs, protein and fat

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pancreas

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pancreas also produces insulin therefore people with pancreatitis may also develop

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hyperglycemia

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70% cases of acute pancreatitis are caused by

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alcohol abuse and gallstones

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these serum level will be elevated with pancreatitis

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amylase and lipase
note: lipase break down fat

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risk factors for Chronic pancreatitis are

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alcohol abuse and cigarette

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mildly low fat diet and high protein

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CP diet

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nutrition therapy goal is to maintain weight, reduce steatorrhea, min pain, avoid acute attacks while meeting the patient's nutrient needs are all therapy of

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Chronic pancreatitis

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role in digestion is to store and release bile which prepares fat for digestion

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gallbladder

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formation of gallstones

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cholelithiasis

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inflammation of the gallbladder

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cholecystitis

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consists of the small and large intestines, rectum, and anus

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lower GI tract

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liquid or soft diet is recommended if regular textured foods irritate esophageal

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varices

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primary concern with people with ileostomies and colostomies are

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fluid and electrolytes

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this type of diet - may offer the most significant and sustained improvement in IBS syndrome

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low-FODMAP