upper gastrointestinal disease. nutrition and gastrointestinal disorders nutrition and intestinal...
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UPPER GASTROINTESTINAL DISEASE
Nutrition and Gastrointestinal Disorders
• Nutrition and intestinal function are intimately
interrelated.
• The chief purpose of the gut is to digest and absorb
nutrients in order to maintain life.
• Consequently, chronic gastrointestinal (GI) disease
commonly results in malnutrition and increased
morbidity and mortality.
Causes of Upper Gastrointestinal Diseases
H. Pylori infection
Stress
gastritis
Aspirin and other NSAIDs
Repeated vomiting• Anorexia• Bulimia
Obesity
pregnancy smoking
Management
Medical
Manage
ment
• Reduce or withdraw use of NSAIDs.
• Use antibiotics, sucralfate, antacids.
Behaviora
l Ma
nagement
• Small, frequent meals of well-balanced diet.
• Stop eating 2 to 3 hours before bedtime.
• Stay upright for 3 hours after meals.
• sleep on a slight angle.
• Quit smoking.
• Omitting rapid eating, chewing gum to reduce bloating and stomach gas.
• Wear loose-fitting clothing around your abdomen.
Nutrition Manage
ment
• Decrease consumption of greasy and spicy foods and alcoholic drinks.
• Avoid carbonated beverages, citrus fruits and juices.
• Decrease consumption of caffeine.
• Increase intake of n-3 and n-6 fatty acids.
• Good chewing of food.
• Stop overeating.
• losing weight if you’re overweight or obese.
Sucralfate a drug used in the treatment of gastric and duodenal ulcers. It is a complex of aluminium hydroxide and a sulphate derivative of sucrose.
Recommendation
•Protein:• Receive no less than 0.8 gram of low-fat protein per kilogram of body weight.• If there has been blood loss, protein may be increased to 1 or 1.5 grams per kilogram
of body weight.
•Fat: Fat-free or low-fat diet.
•Carbohydrates have little effect on gastric acid secretion.
•Vitamin and mineral: • iron if there has been hemorrhage, may be prescribed.• People who avoid citrus juices because of their acidity should be encouraged to eat other sources of
vitamin C.
Dietary recommendations for Upper Gastrointestinal Diseases
Food Classification Suggested DailyServings
Recommended choices Limit or Avoid
MilkAnd milk products
2-3
Milk (fresh, dried or evaporated), cream, yogurt, cheese and
cottage cheese.
Limit high fat dairy
Meats and protein alternatives
2 servings(2-3 oz portions)
Fresh or frozen meat, poultry and fish,
canned meats (tuna and salmon), eggs,
nuts, seeds, dry beans or peas. Most meat & poultry choices should be lean or very lean.
Limit high fat, fried meats, or large
amounts of gravies.
Vegetables 1-4 cups (4-6 servings)
Fresh, canned or frozen vegetables
served in any form. 100% vegetable
juices.
Limit fried, augratin or cream sauces on
veg.
Food ClassificationSuggested Daily
ServingsRecommended choices Limit or Avoid
Fruits 1-2 ½ cups (2-5 servings)Fresh, frozen or canned
fruits and 100% juices of all kinds.
Limit Avocados
Grains and grain products 3-10
Use whole-grain or enriched breads, pasta, oatmeal,
breakfast cereals, tortillas, grits, white, brown or wild rice, popcorn, cornbread, crackers, pretzels, buns,
rolls, English muffins. It is recommended to use at least
3 servings of whole-grain cereals daily.
Go easy on high fat breads, muffins, biscuits, etc.
Nuts, seeds, and beans 4-5 a weekAll varieties of nuts, seeds
and beans.
Dietary recommendations for Upper Gastrointestinal Diseases
Food Classification Suggested DailyServings
Recommended choices Limit or Avoid
Fats and OilsUse sparingly not
generously 2-3 times a day
Margarine, butter, mayonnaise, butter,
salad dressing, gravies, cream sauces, sour
cream. Make most of your fats sources from fish, nuts & vegetable
oils (Olive & canola esp.)
Limit portions.
Sweets 1 or <1 per day
All sweets and desserts in limited portions and
amounts.
Limit high fat choices.
Fluids 6-8 cups
Water and other fluids, such as fruit juice, vegetable juice,
lemonade, or soups
Water and other fluids, such as fruit juice, vegetable juice,
lemonade, or soups.
Seasonings/ Condiments/ Sauces
As desired
Encourage limited quantities of all that are high in salt for normal
healthy diet.
Limit black pepper, garlic, cloves, and
chili powder
Dietary recommendations for Upper Gastrointestinal Diseases
Case study
• Noor is a 20-years-old female; 166 cm height and 49 kg weight. She lost her weight
lately, as she does not have the desire to eat. Since a year and half, she has been
drinking about 2-3 cups of black coffee daily and her eating is not very well as she
was anxious about her grades and accepting her as a freshman at KAU. Recently,
she has been felt a burn and noisy pain in her stomach, which after seeing a doctor,
it appeared to be at risk of advanced stage of ulcer.
Case study
Answer the following:
• 1_ Identify this patient’s risk factors for ulcer disease.
• 2_ Make the assessments you need to plan appropriate meals for Noor.
• 3_ What education and advices would you gave it to Noor?