CSIBSFODMAPSstu07142017.docx - Nutrition Therapy for Irritable Bowel Syndrome Learning Objectives 1 Describe the pathophysiology of the FODMAP diet in

CSIBSFODMAPSstu07142017.docx - Nutrition Therapy for...

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Nutrition Therapy for Irritable Bowel Syndrome Learning Objectives 1. Describe the pathophysiology of the FODMAP diet in irritable bowel syndrome treatment. 2. Analyze dietary data for FODMAP sources. 3. Articulate to a patient the FODMAP diet plan. 4. Plan nutrition therapy goals for a patient with IBS through the restriction phase of the FODMAP diet. 5. Construct a long-term plan, conducive to a patient’s lifestyle, through the re-challenge process of the FODMAP diet. Introduction The gastro-intestinal (GI) tract has an important role in overall health maintenance. Unfortunately, there are multitudes of disorders that affect the proper functioning of the GI tract, including irritable bowel syndrome (IBS). IBS is a common functional GI disorder (FGID) affecting one in seven adults. Because IBS effects the way nerves and muscles in the digestive tract work, this can lead to a cluster of symptoms that, as a whole, increase sensitivity in the bowel (Lee & Park, 2015). These symptoms—including bloating, flatulence, diarrhea, and constipation—can significantly alter a patient’s quality of life. It is important that other serious GI disorders and gynecological conditions be ruled out, as the clinical presentation of IBS can be non-distinct (Clayton, 2013; Staudacher, 2017). Diagnosis of IBS and all other FGIDs involves the Rome criteria. This criteria states that patients may be diagnosed with IBS after experiencing a set of symptoms for a period of 3, or in some cases 6, months. The key symptoms assessed are the presence and persistence of abdominal pain or discomfort, bloating, and changes in bowel habits, motility, or stool appearances. Management of IBS involves nutrition therapy in which foods that have been shown to trigger the symptoms of IBS are reduced. For many years, patients have related their symptoms to ingestion of fatty foods, alcohol, gluten, and coffee (Clayton, 2013). More recently, research has focused on a large group of dietary sugars called FODMAPs (Fermentable Oligo-saccharides, Di-saccharides, Mono-saccharides and Polyols). These sugars can be poorly absorbed in the small intestine and fermented by bacteria to produce gas (Staudacher, 2017). FODMAPs are digested rapidly by the bacteria in the bowel, leading to heightened GI discomfort and relative symptoms in those with IBS. Important areas of education for patients embarking on the low FODMAP diet is to ensure the overall diet is restricted in FODMAPs, nutritionally balanced and adequate, and of high diet quality. Case Description Lauri is a 48-year old stay-at-home mom of four school-age children. Due to the international travel demands of her husband’s work, Lauri is the sole caregiver of the children on week days, week nights, and about two weekends a month. Lauri’s children are involved in a number of after school activities, so she feels that her car is always in motion. In addition to her hectic schedule, Lauri enjoys staying physically active. However, she has a lingering back injury caused by a car accident. Lauri had been
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