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Unformatted text preview: Ulcerative Colitis: inflammation of rectum extents to colon mucosal damage ONLY Signs and Symptoms: bloody diarrhea: key symptom abdominal pain tenesmus: urgency to go to bathroom fever negative N balance edema dehydration anemia anorexia weight loss non-GI tract lesions toxic megacolon inflammatory marker remission/exacerbation Medications: antibiotics anti-inflammatory immunomodulators corticosteroids newer drugs: colazol and keratinocyte growth factor Nutritional Management: depends on: severity of symptoms nutritional status medical/surgical management objectives: provide adequate nutrition support for repair decreases stool frequency increase pt comfort general recommendations: kcals: ~BEE*1.5 protein: 1 to 1.5 g/kg BW fiber: symptomatic pt: as tolerated asymptomatic pt: no restriction vitamins/minerals: ensure adequate intake fluids/electrolytes: supplement as indicated lactose: symptomatic pt: as tolerated asymptomatic pt: no restriction severe cases initial restriction of oral intake parental nutrition (intractable diarrhea) peripheral or central PN progress to enteral feedings as tolerated oral/tube fiber content per pt tolerance lactose-containing foods as tolerated elemental diet/PN may be necessary in preparation for surgery potential treatments: probiotics: microbial foods or supplements alter microflora; promote acidic pH 1 omega 3 FA: increase intake-anti-inflammatory Surgery: protocolectomy w/: ileostomy ileoanal pouch anal anastomies Diverticular Disease: Diverticulosis: herniation of the mucous membrane through the muscular layer of the colonic wall risk factors (contribute to its development): hx constipation low fiber diet obesity decreased physical activity proposed disease process: increased intracolonic pressure due to abnormalities in motility exacerbated by low fiber diet symptoms: usually symptom free mild cramps, bloating alternating diarrhea constipation nutritional management: high fiber intake increase fiber intake gradually Diverticulitis: acute inflammation of diverticular pockets; may cause ulceration proposed etiology: fecal matter trapped in dierticula? Changes in colonic mucosal immune response? Abrasion of mucosal lining by hardened/impacted fecal matter?...
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This note was uploaded on 10/25/2009 for the course HUN 4446 taught by Professor Mathews during the Spring '09 term at University of Florida.
- Spring '09