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20 Cards in this Set
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Blind loop syndrome
Vit B12 def may occur because the increased bacterial population can consume the vitamin and damage bile so fat malabsorption occurs so fat passes directly into colon. |
-Vit b12 supplements and iron supplements
-LActose free diet-Avoid milk and cheese.Can have yoghurt -MCT-Found in coconut oil -Lactose,fructose ,alcohol sugars must be avoided.-They serve as fuel to bacteria. |
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Diverticulitis and diverticulosis
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Progress from npo(TPN) or elemental diet to liquids to low fiber at 6 weeks after discharge,high fiber ,no seeds
Diverticulitis- (Acute situation) Surgery Diet-Progression from NPO x ?days,liquid,soft,low fiber,(short term) Rationale-Minimal stimulation in acute phase and long term diet focus is on preventing straining, impaction and lowering colonic pressure. Diverticulosis-chronic -Low fiber to 6-8 weeks -High fiber -Prevent constipation -No seeds or avoid small seeds -Low fat food |
Progress from liquids to low fiber at 6 weeks after discharge,high fiber ,no seeds
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IBD-Inflammatory Bowel diseases
Crohns's & Ulcerative colitis Crohn's-GIT anywhere,especially small intestine-ileum UC-Colon specifically Rationale-A high nutrient dense diet when diseases in remmssion helps replete nutritional staus btw flare up |
Increase PRO,energy level,reduce fiber in acute phase,progress to high fiber after attack
Acute phase-progress from NPO (Enternal(tube feeding-considered best for chrons) & parenteral-if severe disease or obstruction) to clear liquids,progress to oral diet-low fiber,low fat,no wheat products,no alcohol,no caffeine and pepper spicy foods For recovery or Long term or chronic- High Kcal, high protein,high fiber,nutrient dense,low sodium if using steroids,omega 3 fatty acids,Vit and mineral supplements,small frequent meals |
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GERD & esophigitis-Refluxed gastric juices cause irritation, inflammation (esophagitis) and damage
Rationale-Large high fat food may delay GER emptying & increase latent acid production..LES pressure lowering foods should not be included as they lower pressure and cause acid to go back in the esophagus |
-Eat small frequent meals
-eat low fat, higher protein meals -Limi alcohol,smoking Avoid foods which lower LES pressure-Chocolate, coffee, mints, garlic*, onions*, cinnamon*. -Avoid drinking liquids with meals; drink between meals -Weight loss for abdominal obesity -Avoid acidic foods (citrus fruits, tomatoes) -Avoid spicy foods (red, black pepper) -Follow a bland, soft diet |
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Irritable bowel syndrome-
A functional GI disorder (FGIDs) Abdominal discomfort with altered bowel function(sometimes diarrhea,& sometimes constipation or with alternate stool pattern,gas) No structural/biochemical abnormality |
1)Elimination Diet-wheat, wheat-containing poducts (bread,pasta,rice,cakes.crisps),banana, corn, potato, milk, eggs, peas, and coffee
2)Reduce FODMAPs (75% pts improved -2008 trial Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols- 3)Food sensitivities, triggers 4)Establishment of normalized eating 5)Fiber / Fluid Soluble vs Insoluble 6)Lactose and fructose intolerance(they have same symptoms as IBS) 40%, 33% of pts 7)Probiotics (Live microorganisms like in yoghurt who can neutralize disease causing bacteria & prolong lifespan) |
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Hepatic encephalopathy-s a worsening of brain function that occurs when the liver is no longer able to remove toxic substances in the blood like ammonia which is a cerebral toxin.
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For suspected hepatic coma:
Moderate protein and use of BCAA supplement to lower NH3 level -Protein -40 gms -BCAA-branched amino acids-metabolized in muscle & brain ,not in liver -Veg protein and casein instead of meat protein.High fiber content of veg protein diet helps in excretion of nitrogenous compounds. -Probiotics & synbiotics (reduces ammonia in portal blood) |
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Liver diseases-Chronic liver diseases such as Cirrhosis-Liver is damaged because of some viral infection, chronic alcoholism,and chronic hepatitis(inflammation of the liver), so no bile produced
Diet is geared to repletion & ellivating symptoms |
For chronic disease state:
High energy through small frequent meals, high protein, moderate fat through dietary sources as nuts, avocados, fish and plant oils., low sodium (2 gram), fluid restricted (intake matched to output) for ascites, may need soft if esophageal varices(blood is high in protein) present, MCT if needed for fat malabsorption(as bile cant be produces as liver damaged),avoid alcohol completely CHO controlled diet for hyperglyemia -Vitamin & mineral supplements -Oral liquid supplements or enteral(tube)feeding. |
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Cardiovascular disease
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-Reduce Na (2 grams)
-Reduce Fat, SFA, TFA -Reduced fat dairy products -Legumes,skinless poultry & lean meats -Grains-6 servings -Fish-atleast 2 times in a week -Alcohol-1 drink for women & 2 drinks for men -Physically active-30 minutes in a day. -Dash diet for HTN-Adequate calcium,K(101-200mg or 2 gm) low fat dairy,generous fruits and veg.low sodium(2 grams-1 1/4 tsp). |
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Dumping syndrome-
control DS symptoms and hypoglycemia Rationale high protein,moderate fat are required for weight maintenance.Low CHO required.Intake of fibrous foods lower upper GI transit .Lactose is poorely tolerated because of the rapid transit time |
-High PRO, mod. Fat, low CHO
-Avoid concentrated sweetss -Smaller, more frequent meals -45 min. delay after eating for liquid intake -Lie down after eating -Avoid hypertonic liquids (pop, soup) -Possible functional lactose intolerance -Fe++ deficiency common -Need B12 supplement if total gastrectomy |
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kidney stones-oxalate combines with calcium to form calcium oxalate stones.fluid helps in elinination of stones in urea.
Source of oxalate-Chocolate,soy,whole wheat,rhubard,strawberries,beets,spinach,nuts,tea. |
Low oxalate-200mg/d
(contained in fruits and veges that binds calcium),high fluid(250 ml of fluid each meal to make < 2-2.5 L/urine),moderate protein,DRI for calcium-1000 mg per day) .Limit PRO to 70 gm/day.Sodium to 2 gm/day.lessen VIT C too. Consume orange juice & lemonade. |
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NGS (no gastric stimulants)
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Ulcer,gastritis
Avoid caffeine and caffeine containing beverages,pepper spicy foods |
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Fiber (residue)
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Increase or decrease as per lower GI disorders
Low residue is essentially a low fiber diet but milk is also omitted as it increase bowel activity |
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pancreatitis acute,hospitalized-
Pancreatitis is inflammation of the pancreas, an organ that produces several enzymes to aid in the digestion of food, as well as the hormone insulin, which controls the level of sugar (glucose) in the blood. Caused buchronic alcoholism, hypertriglycerdimea,biliary tract disease, gallstones, trauma,certain drugs. |
Acute pancreatitis-Pain is related to secretory mechanisms of pancreatic enzymes and bile.
Acute, hospitalized- -All oral and enteral feedings are stopped,- IV is introduced for hydration.- -Once a oral nutrition is started- -The diet is progressed as tolerated to easily digested food in 6 small meals -a low fat content,adequate PRO,increased calories -and then advanced as tolerated For severe acute pancreatitis, PN should be initated. Chronic Pancreatitis-episodes of pain over years. -Provide oral diet as in acute phase -TF can be used when oral diet is inadeqaute -Supplement pancreatic enzymes -Supplement fat-sol vit and vit B12 |
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Gastric ulcer,active-
rationale+diet |
Avoid tabacoo,coffee,alcohol,refined sugars,white-flour products,choclates,soft drinks,desserts,spices,citrus fruits.
Eat sources of vit A followed by a high fiber diet and seven or more servings of fruits and veges add more from book |
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Celiac disease-
rational+diet When people with celiac disease eat foods or use products containing gluten, their immune system responds by damaging or destroying villi—the tiny, fingerlike protrusions lining the small intestine. Villi normally allow nutrients from food to be absorbed through the walls of the small intestine into the bloodstream. Without healthy villi, a person becomes malnourished, no matter how much food one eats. |
life-long diet to avoid gliadin/gluten:
W - O (??) - R - B cereal fillers, thickening agents, beer and distilled spirits from cereals Supplementation with onega 3 fatty acids Vit & mineral supplementation substitute: potato flour, corn, soy, rice Oats may be acceptable for some, but should still be limited to ½ cup of dry oats or less/day |
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HTN
rationale+diet Potassium and sodium works to maintain water balance Calcium helps in heart contaction |
-Weight reduction
-Adopt a DASH eating pattern -2.3g/d or less sodium -moderation of alcohol consumption -Potassium-more -Adequate calcium and magnesium -Generous fruits & veg -Complex CHO -Low fat dairy products |
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Renal diseases (pre dialysis)
Rationale-Low protein prevents build up of urea & othr nitrogenous wastes no longer filtered by kidney adequately, low potassium to prevent accumulation which could result in heart failure,sodium is low to prevent edema |
Chronic disease before dialysis-
-Low protein(40 gms),low sodium(2 gms),low K(2 gms) -protein sources should be of high biological value -Energy level may need increase to prevent malnutrition. |
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Na restricted diets
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Congestive heart failure, chronic renal failure, CVD,including HTN
Medications like steroids and digoxin can cause fluid retention (edema & ascites) |
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Gastritis & peptic ulcers-Results when infections or H pylori disrupt mucosal lining of the stomach.USs of NSAIDS and stress,Hpylori and gsastritis causes PUD.PUD-GAstric and duodenal
Gastric ulcer,active-Ulcers in the stomach |
PUD-gatsric or dudodenal
No Gastric Stimulant (NGS): -Avoid caffeine/decaf -Avoid EtOH -Avoid pepper and seasonings -3 small meals -Individualized preferences -Antacids 1 to 3 hrs after meals -Have vit C, vit A,fiber -Increase intake of n-3 and n-6 fatty acids |
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Constipation
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Insol fiber,routine,excersise.
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