Diet and gastrointestinal problems

2. Objectives
- Explain the uses of diet therapy in
gastrointestinal disturbances.
- Identify the foods allowed and not
allowed in the therapeutic diets discussed.
- Adapt normal diets to meet the
requirements of clients with these
conditions.

3. Gastrointestinal Tract
- Digestion and absorption of food occurs
in the gastrointestinal tract.
- Primary organs include the mouth,
esophagus, stomach, and small and large
intestines.
- The liver, gallbladder, and pancreas are
accessory organs.

4. Mouth and Dental Problems
- Tissues of the mouth reflect a person’s
basic nutritional status
- In malnutrition, tissues of the mouth
deteriorate, become inflamed and
vulnerable to infection

5. Example of mouth problems:
Gingivitis: inflammation of the gums
Stomatitis: inflammation of the oral
mucosa lining the mouth
Glossitis: inflammation of the tongue
Cheilosis: cracking and scaling at the
corners of the mouth

6. Gingivitis

7. Stomatitis

8. Glossitis

9. Cheilosis

10. Dietary management of mouth and
dental problems:
- Patients are given high-protein, high
calorie liquids and soft foods
- Non-acidic and non-spicy foods
- Temperature extremes are avoided
- Mouthwash with mild topical anesthetic

11. A client with severe diarrhea has been
placed on a low-residue diet.
What kinds of foods would you
recommend for the client?

12. - Milk, buttermilk (limit 2 cups/day)
- Cheese
- Butter and margarine
- Eggs, except fried
- Chicken, fish, sweetbreads, beef, and
lamb
- Soup broth

13. - Cooked vegetables without coarse fibers
- white crackers
- Macaroni and noodles
- Custard and vanilla ice cream

14. - Coffee, tea, cocoa, or carbonated
beverage
- Salt, sugar, or small amount of spices as
permitted

15. Peptic Ulcers
- Erosion of the mucous membrane
- Can occur in the stomach (gastric ulcer)
or the duodenum (duodenal ulcer)
- Predisposing factors: genetics, high
secretion of hydrochloric acid, stress,
excessive use of aspirin or ibuprofen,
smoking, Helicobacter pylori bacteria

16. Symptoms include gastric pain and
sometimes hemorrhage.
Treatment
- Drugs to control acid secretion and kill
bacteria
- Antacids, Proton pump inhibitors,
Histamine H2 blockers: Calcium,
Protonix, Pepcid

17. - Stress management
- Sufficient low-fat protein
- Avoid caffeine, alcohol, aspirin, and
smoking
- Well-balanced diet of three meals a
day

18. Diverticulosis and Diverticulitis
- Diverticulosis is an intestinal disorder
characterized by little pockets in the sides
of the large intestine where food gets
trapped.
- Diverticulitis can result from bacteria
breeding in these pockets.

19. - The cause is insufficient dietary fiber.
- Treatment includes clear liquid, then a
low-residue diet, progressing to a high-
fiber diet over several weeks.

20. Inflammatory Bowel Disease
A chronic condition causing inflammation
in the GI tract such as in ulcerative colitis
and Crohn’s disease
Ulcerative colitis: is inflammation and
ulceration of the colon, rectum or,
sometimes, the entire large intestine.
Crohn’s disease is a chronic progressive
disorder that can affect both the small and
large intestines.

21. Symptoms of Inflammatory Bowel
Disease
- Bloody diarrhea
- Cramps
- Fatigue
- Nausea
- Anorexia
- Malnutrition
- Weight loss

22. Nutrition therapy of Inflammatory
Bowel Disease
- Low-residue diet
- 100 g of protein, additional calories,
vitamins, and minerals
- Severe cases may require total
parenteral nutrition (TPN)

23. Celiac Disease
- Characterized by malabsorption of
virtually all nutrients
- Symptoms include diarrhea, weight loss,
and malnutrition; stools are foul-smelling,
light-colored, and bulky
- Can cause stunted growth in children
- Cause is unknown, but eliminating gluten
from the diet helps

24. Dietary treatment of Celiac Disease
includes:
- gluten-controlled diet.
Gluten is a protein found in barley, oats,
and wheat, which is difficult to avoid.
- Rice and corn may be used.
- Clients must read food labels.

25. Cirrhosis
- A general term for liver disease
characterized by cell loss.
- Liver disease may be acute or chronic.
- Most often caused by alcohol abuse
- Other causes include congenital defects,
infections, or other toxic chemicals.

26. - Dietary treatment consists of at least 25 to
35 calories or more per kg of weight, and
0.8 to 1.0 g of protein per kg of weight
each day.
- In advanced cirrhosis, 50% to 60% of the
calories should be from carbohydrates.

27. - Fats or proteins may not be well tolerated.
- Vitamins and minerals may be
supplemented.
- No alcohol is allowed.

28. Hepatitis
- Its inflammation of the liver.
- Caused by viruses or toxic agents such as
drugs and alcohol.

29. Symptoms include:
- Nausea, headache, fever, fatigue, tender
and enlarged liver, anorexia, and jaundice.
- Weight loss can be pronounced.
- Treatment involves bedrest, plenty of
fluids, and nutrition therapy.

30. Nutrition Therapy for Hepatitis
- Diet should provide 35 to 40 calories per
kg of body weight.
- Most calories should be provided by
carbohydrates.
- Fat intake should be moderate.
- If the necrosis is not severe, up to 70–80 g
of protein is needed for cell regeneration.

31. - If the necrosis is severe, proteins must be
limited to prevent the accumulation of
ammonia in the blood.
- Clients may prefer frequent, small meals
rather than three large meals.

32. High-Fiber Diet
- A high-fiber diet is often 25 to 35 g.
- Helps prevent diverticulosis, constipation,
hemorrhoids, and colon cancer
- Sources: whole-grain breads and cereals,
all fruits, vegetables (especially raw), and
legumes

33. Low-Fiber Diet
- 5 to 10 g of fiber a day is intended to
reduce the normal work of the intestines
by reducing food residue.
- May be used in cases of severe diarrhea,
diverticulitis, ulcerative colitis, and
intestinal blockage, and in preparation for
and immediately after intestinal surgery

34. Source
- Milk, buttermilk
- Cottage cheese
- Tender chicken, fish, ground beef, ground
lamb (must be baked, boiled or broiled)
- Soup broth
- Applesauce, canned fruits
- Refined breads and cereals
- Custard, sherbet

35. Conclusion
- A wide variety of therapeutic diets are
used for clients with gastrointestinal
disturbances.
- Peptic ulcers: drugs, avoidance of alcohol,
and caffeine
- Diverticulosis: high-fiber diet
- Diverticulitis: gradual progression from
clear liquid to high-fiber diet

36. - Ulcerative colitis: low-residue diet
combined with high protein and high
calories
- Cirrhosis: substantial, balanced diet, with
occasional restrictions of fat, protein, salt,
or fluids
- Hepatitis: full, well-balanced diet,
although protein may be restricted

37. - Cholecystitis and cholelithiasis: fat-
restricted diet and, in cases of overweight,
a calorie-restricted diet as well
- Pancreatitis: total parental nutrition to
individualized diet, as tolerated

38. Thank