NS 4410_GI_2011 part II

NS 4410_GI_2011 part II - GI Diseases and Nutrition...

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GI Diseases and Nutrition Learning Objectives Broadly identify genetic, environment and causative factors that contribute to the development of Inflammatory Bowel Disease Describe the role of T helper cells in immunity and IBD Appreciate the differences in T helper cell phenotype between CD and UC Identify treatments for IBD and recognize their putative mechanisms Appreciate the utility of probiotics in the treatment of IBD Discuss medical nutrition therapy (MNT) for the IBD patient
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Use of nonsteroidal anti inflammatory drugs Examples: aspirin and ibuprofen Lead to disease flares possibly by altering mucosal barrier function and increasing permeability of the intestinal wall to bacteria Smoking (opposite true for UC) Early appendectomy (opposite true for UC) Not being breastfed (opposite true for UC) There are many studies in small cohorts of patients that observed a positive relationship with fat and refined sugar, and inverse relationship with fruits, vegetables and fiber (These are often compromised by insufficient data or methodological limitations and do not provide unequivocal evidence to incriminate any particular dietary factor) Environmental Triggers
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NSAIDs (salicylic acid, ibuprofen, motrin) inhibit COX enzymes and contribute to GI mucosa damage
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E. Coli Ineffective innate -> Overactive acquired Commensal Bacteria: Antigens and Adjuvants Causative Agents
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IBD is characterized by an overly aggressive T-cell response to a subset of commensal enteric bacteria
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Helper T cells (TH) are important in directing the immune response
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This note was uploaded on 01/28/2012 for the course NS 441 taught by Professor Caudill during the Spring '11 term at Cornell.

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NS 4410_GI_2011 part II - GI Diseases and Nutrition...

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