A_B+2010+MouthEsophStomach

A_B+2010+MouthEsophStomach - Clinical Nutrition &...

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Clinical Nutrition & Clinical Nutrition & Gastrointestinal Disease Gastrointestinal Disease Objectives: Understand how the process of nutrient digestion & absorption is impaired in specific GI diseases Understand the causes of under-nutrition in various GI conditions and diseases Know the appropriate dietary recommendations in various GI conditions and diseases » TEXT: Chapters 16 & 17
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Under-nutrition in GI Diseases: Defects Associated with Malabsorption Under-nutrition in patients with GI diseases can occur as a consequence of: Decreased dietary intake Increased nutrient losses Increased nutrient requirements Major causes of malabsorption: Impairment of mechanical digestion Impairment of chemical digestion Impairment of solubilization Anatomic or pathologic impairment of absorption
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Mouth Problems Mouth Problems Dental Caries, tooth loss, infections Gingivitis Stomatitis Periodontal disease Glossitis Cheilosis
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Effects of nutrient deficiencies on the mouth Many non-specific symptoms, can be due to malnutrition but possibly other causes Symptom Deficiency Gingivitis Ascorbic acid Stomatitis and glossitis B-2, B-6, B-12, folic, niacin, iron Cheilosis B-2, niacin Cheilosis
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Effects of systemic diseases & treatments on mouth Side effects of chemo- or radiation therapy for oral/esophogeal cancers mouth blindness; xerostomia HIV candidiasis + other infections Altered taste and dry mouth from many drugs, including protease inhibitors Anorexia Nervosa/Bulimia Nervosa repeated vomiting can result in damage to lingual surface of teeth & oral/esophageal irritation TREATMENT – avoid acid, hot, salty, spicy, dry foods. Candida on tongue caused by AIDS
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Salivary gland problems Salivary gland problems Salivary glands produce lubrication and amylase Condition: Xerostomia (dry mouth) Cause: Poorly controlled diabetes Sjogren’s syndrome Oral surgery Chemotherapy, radiation Mouth-breathing Problems: Hard to swallow, lack of taste, more infections and dental caries Caries caused by xerostomia
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Salivary gland problems Salivary gland problems Treatments for xerostomia (palliative): Avoid sticky, crumbly foods Ice chips Carbohydrate: stimulates salivation Artificial saliva solutions Sugar-free gum or candies Sip fluids with meals & as needed
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Edentulous Patient Masticatory Insufficiency: No teeth, or inadequate number and location of teeth, often poorly-fitting dentures Chewing difficulties Nutritional Implications: May choose soft, low-fiber foods ( At risk of nutrient deficiencies, weight loss **Need to teach acceptable food prep methods; instruct on good nutrient dense foods
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Upper GI Tract -- Upper GI Tract -- Review Tables in text for Upper GI Disorders, Causes, Common Symptoms & Nutritional Consequences; Understanding of normal physiology important
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This note was uploaded on 04/21/2010 for the course NUT 116B taught by Professor Andrewclifford,phd during the Winter '10 term at UC Davis.

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A_B+2010+MouthEsophStomach - Clinical Nutrition &...

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