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Nutrition for patients with upper and lower gastrointestinal disorders…
Nutrition for patients with upper and lower gastrointestinal disorders
interesting facts
speech pathologist determines what kinds of foods the patient gets, not the nutritionist, because the speech pathologist does the evaluation
sometimes, patients with severe GERD don't feel pain
spicy foods don't
cause
ulcers
people with dumping syndrome should avoid sweets
WHAT ARE THE DISORDERS?
Anorexia (decreased appetite)
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caused by:
drugs
emotion
physical conditions
Nausea and Vomitting
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caused by:
decreased gastric acid (HCl, KCl, NaCl)
decreased enzyme secretion (lipase, protease)
decreased motility
infection
pancreas, liver, gallbladder disorder
bile is made in the liver and stored in the gallbladder
GI obstruction (ileus)
Dysphagia
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difficulty/ inability to swallow
RISK OF ASPIRATION
caused by:
physical obstruction
e.g. lodging during surgery
inflammation
neurological disorder
Stroke
Alzheimers
ALS
Cerebral Palsy
Parkinsons
Gastroesophageal Reflux Disease (GERD)
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caused by
pressure on esophagus
stomach hiatus (stomach protruding into mediastinum) through the diaphragm (has a hole that normally the esophagus passes through
obesity
pregnancy
weak esophageal sphincters
backflow into esophagus
symptoms
heart burn
radiating pain
nausea
throwing up
can
CAUSE
esophagitis (inflammation)
esophageal cancer
ulcer
bleeding, which can then lead to anemia
dysphagia & aspiration
Peptic ulcer disease
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symtoms
bloated
heart burn
vomitting
weight loss
erosion of stomach mucosa
caused by
H. pylori
Advil (NSAI) abuse
Alcohol Abuse
CAN
cause
bleeding (DARK red stool)
bowel perforation & leaking of things
Dumping Syndrome
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complication of
gastrectomy (parts of stomach removal)
other bariatric surgeries
rapid emptying of stomach 15-30 minutes after eating
dizziness, vertigo, cramps, tachycardia, epigastric fullness
can CAUSE
steattorhea
fat in stool
pernicious anemia
B12 deficiency b/c decreased intrinsic factor (macrocytic anemia), which is present in the stomach
fear of eating
--> causing... malnutrition
nausea
maldigestion/malabsoption
Solutions
Anorexia
attractively
served food
don't schedule medications and procedures during meal timetext
control pain w/ appetite stimulants
Remeron
Megas
Marinol (Marijuana Derivative)
wait 30 min. after meal to drink
limit fat
, which causes early fullness (satiety)
SMALL FREQUENT MEALS
Nausea and Vomitting
withold food
start with clear liquid (NPO)
then full liquids --> soft diet --> regular diet
small meals
good oral hygeine
limited liquids
room temperature/cold foods
NON SPICY NONFATTY FOODS
Dysphagia
Texture Modification (solid)
pureed (baby food)
some hospitals invest in molds
mechanically altered (e.g. dumplings;
Moist
)
advanced diet
NO nuts &
raw
fruits or vegetables
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Viscosity Modification (liquid)
Nectar (can sip through straw)
Honey
Pudding (solid shape)
regular
some stuff in this category that might be unexpected
watermalon
icecream
milk
use
Thickit
(canisters that increase viscosity)
Oral Supplementation
GERD (Gastroesophageal Reflux Disease) (Heart Burn)
alleviating factors
DONT:
eat while lying down
bend over right after eating
wear tight fitting clothes
LIFESTYLE (exercise, diet, quit smoking)
decrease AMOUNT consumed
elevate head during rest
don't lie down until 3 hours after eating
eat less spicy or
fatty
food
drink less coffee
neither regular NOR decaffenatd (bc it's the ingredients in the coffee itself, not the caffeine)
eat less chocolate
MEDICATION
H2 blockers
PPIs (proton pump inhibitors)
decrease HCl in stomach to improve the longevity of stomach mucous layer
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SURGERY
Peptic Ulcer
avoid coffee, alcohol, pepper, cafffeine
DONT eating within 3 hours of bedtime
don't eat what makes you feel bad
eat
low fat carbohydrates like toast
can only alleviate, not treat
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Dumping Syndrome
don't eat
high refined carb, carb foods
eat more proteins and FATS b/c difficult to digest
withhold water
small frequent meals
restrict lactose (b/c lactase enzyme is slow to get working)
drink liquids an hour before or after eating
