Transcript Upper gastrointestinal disease

UPPER GASTROINTESTINAL
DISEASE
Nutrition and Gastrointestinal Disorders
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Nutrition and intestinal function are intimately
interrelated.
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The chief purpose of the gut is to digest and
absorb nutrients in order to maintain life.
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Consequently, chronic gastrointestinal (GI)
disease commonly results in malnutrition and
increased morbidity and mortality.
Causes of Upper Gastrointestinal Diseases
Stress
Obesity
H. Pylori infection
gastritis
Repeated vomiting
• Anorexia
• Bulimia
Aspirin and
other NSAIDs
pregnancy
smoking
• Use antibiotics,
sucralfate, antacids.
• 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.
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.
Nutrition Management
• Reduce or withdraw
use of NSAIDs.
Behavioral Management
Medical Management
Management
• 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.
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:
•
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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 Daily
Servings
Milk
And milk products
2-3
Meats and protein
alternatives
2 servings
(2-3 oz portions)
Vegetables
1-4 cups (4-6 servings)
Recommended choices
Limit or Avoid
Milk (fresh, dried or
evaporated), cream,
Limit high fat dairy
yogurt, cheese and cottage
cheese.
Fresh or frozen meat,
poultry and fish, canned
meats (tuna and salmon),
eggs, nuts, seeds, dry
Limit high fat, fried meats,
beans or peas. Most meat & or large amounts of gravies.
poultry choices should be
lean or very lean.
Fresh, canned or frozen
vegetables served in any
form. 100% vegetable
juices.
Limit fried, augratin or
cream sauces on veg.
Dietary recommendations for Upper Gastrointestinal Diseases
Food Classification
Suggested Daily
Servings
Fruits
1-2 ½ cups (2-5 servings)
Grains and grain products
3-10
Nuts, seeds, and beans
4-5 a week
Recommended choices
Limit or Avoid
Fresh, frozen or canned
fruits and 100% juices of all
Limit Avocados
kinds.
Use whole-grain or enriched
breads, pasta, oatmeal,
breakfast cereals, tortillas,
grits, white, brown or wild
rice, popcorn, cornbread,
Go easy on high fat breads,
crackers, pretzels, buns,
muffins, biscuits, etc.
rolls, English muffins. It is
recommended to use at least
3 servings of whole-grain
cereals daily.
All varieties of nuts, seeds
and beans.
Dietary recommendations for Upper Gastrointestinal Diseases
Food Classification
Fats and Oils
Sweets
Suggested Daily
Servings
Use sparingly not generously
2-3 times a day
1 or <1 per day
Fluids
6-8 cups
Seasonings/ Condiments/
Sauces
As desired
Recommended choices
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.)
All sweets and desserts in
limited portions and
amounts.
Water and other fluids, such
as fruit juice, vegetable juice,
lemonade, or soups
Encourage limited quantities
of all that are high in salt for
normal healthy diet.
Limit or Avoid
Limit portions.
Limit high fat choices.
Water and other fluids, such
as fruit juice, vegetable juice,
lemonade, or soups.
Limit black pepper, garlic,
cloves, and chili powder
Case study
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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:
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1_ Identify this patient’s risk factors for ulcer disease.
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2_ Make the assessments you need to plan appropriate meals for Noor.
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3_ What education and advices would you gave it to Noor?