Вы находитесь на странице: 1из 14

Lower GIT Disorders part 1 (Conditions

affecting the large intestine)

Irritable
Bowel

Syndrome

Irritable bowel syndrome is an intestinal disorder of


unknown cause that affects the lower bowel
characterized by abdominal pain,flatulence,diarrhea and
constipation
Causes
The causes remain unexact but the contributing
factors may include:

 Stress and anxiety:symptoms may worsen during


periods of psychological stress
 Hyposensitivity to intestinal destention:people
who have IBS may have exaggerated response to
normal meal transit and rectal distention
 Hyperactivity outside GI tract
 Infection:tissue sensitization persists after the
infection has healed

Symptoms and characteristics


 Alteration in stool frequency
 Alteration in stool consistency
 Both diarrhea and constipation
 Flatulence and bloating
 Distention
 Abdominal pain may occur shortly after a meal
and be revealed by defecation

Goals of Nutrition Therapy


 Elimination of FoodMap
 Ensure adequate nutrient intake
 Explain the role of food in the management of
therapy

 Identify food intolerances: fructose, caffeine,


sorbitol, lactose, and alcoholic beverages

Implementation and steps


 The patient should slowly increase fiber intake
to 25-35 g/day
 The patient should understand the rationale for
pre probiotics
 Avoid foods that increase gas and flatulence
 Use bulking agents as needed

Medical Management
 Anti diarrheal agents
 Anti cholinergic agents
 Antidepressants
 Laxatives

Diverticular disease

Diverticolosis
A situation of saclike herminations
(diverticula) of the colonic wall that results
from long term constipation and increased
colonic pressure
MNT for Diverticulosis
 Treatment if symptoms develop focusing on
reducing pain and alleviate constipation
 Increase fiber intake (26-35 g/day) of 6-
10 g beyond the standard recommendation
(insoluble fiber)
 Intake of fiber supplements if dietary
intake is not sufficient
 Avoid seeds like nuts ,pumpkin ,popcorn
hulls ,sunflower ,sesame seeds
Diverticulitis
It is an inflammation infection in the are
around diverticulum

MNT of Diverticulitis
 Antibiotics are given to treat infection
 NPO until bleeding and diarrhea resolved
 Begin oral intake with clear liquid
 Slowly begin restricted fiber - low residue
diet
 Progress to low fiber diet (10 g/day)
 Decrease inflammation(increase 5 g of
fiber/week)
Lower GIT (part 2)
Inflammatory Bowel Disease

Inflammatory bowel Disease (15-30 years of age).

Chronic inflammatory disease of the GIT includes:


Crohn’s disease and Ulcerative Colitis(colon)

Crohn’s disease:lower portion of the small


intestine and colon
Both conditions share a characteristic of
inflammation that result from excessive immune
response in intestinal tissue

Symptoms
 Diarrhea
 Abdominal pain
 Weight loss

Crohn’s Ulcerative colitis


disease
Location Ileum,cecum,30% It begins in rectum and
of are in small spreads into colon
inflammati intestine or colon
on
Pattern of Discrete areas (skin Continuous inflammation
inflammati lesions)separated by that begins at rectum and
on normal tissues ends at colon
Depth of Damage throughout Damage in mucosa and
damage all the layers of submucosa
tissues
Fistulas Common Usually do not occur
Cancer risk Increased Greatly increased
 If ileum is affected there will be deficiency in
B12 (site of absorption) and bile acid may
become depleted

Potential Nutrition Related Problems with


IBD
 Anemia leads to blood loss and poor food
intake
 GIT narrowing and strictures leads to bloating
,nausea, bacterial overgrowth, and diarrhea
 Increased GIT secretion with inflammation,and
decreased transit time which leads to diarrhea
and malabsorption
 Malabsorption related to diarrhea ,nausea
,vomoiting, bloating
 Food aversion
 Growth failure ,weight loss ,protein calorie
malnutrition
 Increased homocysteine levels which leads to
depletion of B-complex vitamins especially
folate
Medical Nutrition Therapy

Ulcerative Colitis

Protein:1.3-1.5 g/kg

If colon is present will be better


Ileum:Bile acids,B12,water
Colon:water,electrolytes,short chain fatty acids
Duodenum/Jejunum:simple CHO, A.A,
vitamins ,minerals ,water
Medical Management
 Corticosteroids
 Anti inflammatory agents
 Immunosuppressive agents
 Monoclonal antitumor necrosis factor (anti-

TNF)
Short Bowel Syndrome

Вам также может понравиться