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What is inflammatory bowel disease?
a chronic disease characterized by inflammation of the intestines
what are the two major inflammatory bowel diseases?
- -crohn's disease (CD)
- -ulcerative colitis (UC)
Where does the major digstive of food and absorption of nutrients take place?
What is the compostition of intestinal juice?
water, salt, mucus, and digestive enzymes
Beneficial bacteria that colonize in the ileum produce?
Vitamin B12 is absorbed bound to what?
a crater-like lesion on the skin or at the surface of the mucous membrane of an organ due to superficial loss of tissue.
How much dietary fiber is included in a fiber-restricted diet and a high-fiber diet?
restricted: less than 10 g total fiber per day, especially lowered in insoluble fiber
high: women: 25 g men: 38 g
or at least 14 g total fiber per 1000 calories
a chronic disease causing the formation of ulcers on the mucosa of the large intestine and rectum, and induces episodes of abdominal pain and blood diarrhea
an autoimmune chronic regional enteritis characterized by transmural mucosal inflammatiion, which can affect any part of the gasrtointestinal tract but most often occurs in the terminal ileum and can cause fistulas
Irritable bowel syndrome
a condition characterized by inefficient and uncoordinated contraction of the colon. Symptoms may include abdominal pain, diarrhea, gas, bloating, and constipation, in the absense of pathology.
a cytologic and chemical reaction in affected blood vessels and tissues in response to an injury or an abnormal stimulation due to a chemical, physical, or biological agent.
an abnormal passage or connection between one epithelium and another, such as between an organ and an an adjacent structure like the skin, vessel, or another organ.
the establishment by surgery of an artificial cutaneous opening into the colon, possibly after removal of the rectum and anus
an endoscopic examination of the colon
a disease with rapid onset, which is usually of high intensity
a persistent or long-term disease, which is usually of low intensity
how does ulcerative colitis present clinically? Give the symptoms and signs.
- -abdominal pain and cramping, which reduce after bowel movements
- -diarrhea, blood diarrhea
- -abdominal sounds
- -rectal bleeding
- -possibly: nausea and vomiting, weight loss, anemia, joint pain, lack of growth
complications of ulcerative colitis
- -loss of blood
- -hyponatremia (low blood sodium)
- -failure to grow
- -electrolyte imbalance
- -liver disease
how is ulcerative colitis diagnosed?
- -barium enema
- -CBC, C-reactive protein
How does Crohn's disease present clinically? Give signs and symptoms
- -chronic abdominal pain
- -chronic diarrhea
- -abdominal sounds
- -weight loss
- and possibly:
- -bloody stool, rectal bleeding
- -gas and bloating
- -abdominal mass
- -intestinal obstruction
- -joint pain
- -anal incontinence
What are the complications of chron's disease?
- -inflammation of white part of the eye
- -skin rash
- -mouth sores
- -maldigestion and absorption
- -renal stones
What tests assist in the diagnosis of Chron's disease?
- -barium enema
- -upper gastrointestinal endoscopy
- -stool culture
- -fecal fat
- -C-reactive protein
- -liver function test
What is the purpose of nutrition therapy for clients with inflammatory bowel disease?
- -prevent malnutrition
- -correct malnutrition
- -individualized, foods they can tolerate
- -increase calories, increase protein, increase vitamins and minerals
- -use supplements
- -enteral feedings
- -enough fluid and electrolytes
what are dietary recommendations for clients with inflammatory bowel disease?
- a client at risk for malnutrition
- a client with an acute episode
- a client is in remission or the disease is under control
- a) small frequent feedings
- b) supplementation with vitamins and minerals needed
- c) nutrition support if needed
- a) bowel rest: clear liquid diet, nutrition support, parenteral nutrition
- b) maintenance of fluid and electrolyte balance
- c) management of symptoms and reduction of discomfort
- d) when tolerance increases sufficiently, a low fiber diet
- a) increase fiber as tolerated
- b) control lactose as needed
- c) limit fat if signs of intolerance
- d)limit alcohol intake
- e) eat regular meals and snacks, eat slowly and chew well
- f) ingest coffee and caffeine as tolerated
- g) take oral supplements as needed to increase the nutritional status of the client
Clinical signs and symptoms of the irritable bowel syndrome
- -abdominal pain and cramping
- -gas, flatulence
- - diarrhea
- -bloating, abdominal distention
- -sensation of only partial evacuation
- -gastrointestinal upset
- -abdominal tenderness
Why are individuals with inflammatory bowel disease at high risk of malnutrition?
- -nutrients are not being absorbed and digested
- -increased losses
- -increased needs for nutrients
- -medications interfere with nutrient absorption, ex: folate
Give 4 main differences between Crohn's disease and ulcerative colitis
- 1. With crohns disease, patches of inflammation anywhere in GI and can create fistula
- 2. Crohn's can affect the entire GI tract
- 3. Ulcerative colitis is confined to the colon with one are of inflammation, it is less likely to cause a fistula
- 4. Ulcerative colitis is more superficial
Give four similarities between crohn's disease and ulcerative colitis
- 1. cause cramps, bloating, and diarrhea
- 2. more frequent in young adult female, and more common in jewish decent
- 3. increased incidence than in years past
- 4. they are both classes of inflammatory bowel disease
What are some of the theories used to explain the etiology of inflammatory bowel disease?
- -psychological characteristics
- -lack of fiber???