MNT Exam 1- Upper GI
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MNT Exam 1- Upper GI
What are the tansitional diets?
Clear liquid (Juice, tea, broth) >> Full liquid (can add dairy, soy milk, etc)>> Soft (not masticat much)>> regular
can take from 1 to a couple of weeks
if person cant really swallow/chew
What does the clear liquid diet involve?
mono/disaccahrides + electrolytes
easy abs, minimal gut use, small residue
nutritionally inadequate, hydrating
short use only (1-2 days)
What does the full liquid diet invlove?
liquid/semi-solid at rt
need more GI funct
more nutrient mix, low fiber
not adequate, except protein, ca, vit c, riboflavin
watch lactose intolerance
What are the dysphagia diets?
: pureed = oral/esopha. tenderness due to surgery, ulceration, etc.
: mechanical altered/soft= texture ease of mastication
: advanced "soft"= transitional for acute illness
What are the consistencies of the liquids for the dysphagia?
Thin (water, ice, milk, juice coffee)
Nectar-like (smotthie, some juice, ensure)
Spoon-thick (yogurt, pudding)
What parts does the upper GI consist of?
mouth, pharynx, esopahgus, stomach, digestion secretions (water, enz, bile salt, mucus)
What is digestion and what does it break down?
Complex molecules convert to simple molecules
CHO= polysach to glucose/fruc/galac
PRO= polypep to aa/di/tripeptides
FAT= lipid to ffa and monogly
guided by auto NS, parasym +sym
What are the phases of swallowing?
1. oral prep:aroma of food, bile secretions
2. oral phase:bite + chew (vol)
3. pharayngeal phase
: swallow reflex (invol)
4. esophageal phase
: food move from esophagus to stomach (invol)
What is the gastric function(gas tank)?
to store, mix, release food into sm intestine
mucosa have gastic glands to protect lining
parietal cells secrete HCL and intrinsic facotr (B12)
acid denautres proteins
What is the pathiophys of the mouth?
peridontal dz (teeth caries, gingavitis, stomatis, glottitis)
xerostomia (dry mouth)
dysguenia/ageusia (taste loss)
What is the intervention of pathophys of mouth?
modify texture, consistency, temp
eval kcal/food diary
What are some important things about dysphagia?
: drool, food in mouth, cough/choke, change in voice
can come from conditions, neurological
: alzheimers, etc.
require speech therapist eval.
What is the Tx for dysphagia?
barium swallowed to study severity
prescribed diet varies (sm. meals, cold food better, consistent food)
may need nutrition support
What is GERD?
reflux of gastric contents into the esophagus
LES control the entrance
cause burning in chest and throat
What is the nutrition therapy for GERD?
improve LES pressure
: avoid high fat, alcohol spearamint,
coffee, tea, chocolate, stop smoking
decrease esophagus irritation
: aviod citrus, cofffee, spicy
food, co2 drink, tomatoe
What are the levels of modified solids?
: dysphagia puree(pudding like)
: dysphagia mechanical/altered(moist, semi-solid)
: dysphagia advanced (soft solid, more chew)
: reguler (any solid)
What are the eating strategies for GERD?
decrease frequency/vol of reflux:
upright for 3-4 hrs
sm. frequent meals
liquid betwen meals
find out food/activity that cause pain
: record log
what is the pharmalogical Tx for GERD?
*proton pump inibitors
: decrease acid production by parietal cells (secrete HCL in stomach, will decrease)
: decrease ph
histamin H2 receptor antagonists
: decrease HCL secretion (change tummy envirn.)
: increase motility/ gastric emptying and LES tone( more mechanical)
what is the surgical intervention for GERD?
nissen fundoplication: fund wrap around LES to limit reflux
What is a hiatal hernia?
thin muscle layer that come up over stomach
need surgery to remove
what is pud?
peptic ulcer dz
ulceration of mucosal lining (duodenal, gastric, esphagus)
H.pylori cause 95%
stressors can cause it too
gastritis, aspirin, etc can also cause
what is medical mgmt of PUD?
use antibio, antacids, hist h2 beta blockers
what are dietary recommendations for pud?
milk diets work, but no strong evidence
different for everyone
: alcohol, coffee, capcacian, reduce food before sleep, big/ frequent meals
what surgery is required for pud?
gastric surgery, when ulcer is linked to hemorrhage
upper GI trauma, cancer
gastrectomy (remove tummy)
what is important regarding dumping syndrme?
happens post gastrectomy or gastrojejunostomy
because of quick entry of stomach content into intestine
increase osmolar load
what are the two onsets on dumping syndrome?
: 30 min after meal, more common
: 2 hrs after meal
What is involved in early onset dumping syn.?
fulless/nasaue followed by cramping/pain 15 min after meal
flushing, rapid HR, sweating, faintness
because of distention of sm. liquid bowels from food
less peripheral resistance and pool of blood happen
what happens in late dumping?
1-3 hrs after meal
quick digestion + abs of sugar >> increase BG >> too much insulin made >> hypoglycemia(weak, anxious, shaky, hun.)
what is important regarding malnutrition in post-gastrectomy patients?
malabsorption due to inadequate secretions of pancreatic enzymes
what is the diet mgmt of dumping syndrom?
limit simple CHO
limit lactose (replace w ca, vit D)
more complex CHO, fat 30-40%, pro 20%
sm meals frequent
avoid temp extreme
lie down hr after meal
take supplements for pancreatic enzymes
what is the ANT for Tx of upper GI issues?
brewers yeast, chamomile, ginger, nutmeg, peppermint, probiotics, tumeric, aloe vera