UPPER GASTROINTESTINAL DISEASE Nutrition and Gastrointestinal Disorders Nutrition

UPPER GASTROINTESTINAL DISEASE

Nutrition and Gastrointestinal Disorders • Nutrition and intestinal function are intimately interrelated. • The chief purpose of the gut is to digest and absorb nutrients in order to maintain life. • Consequently, chronic gastrointestinal (GI) disease commonly results in malnutrition and increased morbidity and mortality.

Causes of Upper Gastrointestinal Diseases Stress Obesity H. Pylori infection gastritis Repeated vomiting • Anorexia • Bulimia Aspirin and other NSAIDs pregnancy smoking

• Use antibiotics, sucralfate, antacids. • Small, frequent meals of well-balanced diet. • Stop eating 2 to 3 hours before bedtime. • Stay upright for 3 hours after meals. • sleep on a slight angle. • Quit smoking. • Omitting rapid eating, chewing gum to reduce bloating and stomach gas. • Wear loose-fitting clothing around your abdomen. Sucralfate a drug used in the treatment of gastric and duodenal ulcers. It is a complex of aluminium hydroxide and a sulphate derivative of sucrose. Nutrition Management • Reduce or withdraw use of NSAIDs. Behavioral Management Medical Management • Decrease consumption of greasy and spicy foods and alcoholic drinks. • Avoid carbonated beverages, citrus fruits and juices. • Decrease consumption of caffeine. • Increase intake of n-3 and n-6 fatty acids. • Good chewing of food. • Stop overeating. • losing weight if you’re overweight or obese.

Recommendation • Protein: • Receive no less than 0. 8 gram of low-fat protein per kilogram of body weight. • If there has been blood loss, protein may be increased to 1 or 1. 5 grams per kilogram of body weight. • Fat: Fat-free or low-fat diet. • Carbohydrates have little effect on gastric acid secretion. • Vitamin and mineral: iron if there has been hemorrhage, may be prescribed. • People who avoid citrus juices because of their acidity should be encouraged to eat other sources of vitamin C. •

Dietary recommendations for Upper Gastrointestinal Diseases Food Classification Suggested Daily Servings Milk And milk products 2 -3 Meats and protein alternatives 2 servings (2 -3 oz portions) Vegetables 1 -4 cups (4 -6 servings) Recommended choices Limit or Avoid Milk (fresh, dried or evaporated), cream, yogurt, Limit high fat dairy cheese and cottage cheese. Fresh or frozen meat, poultry and fish, canned meats (tuna and salmon), eggs, nuts, seeds, dry beans Limit high fat, fried meats, or peas. Most meat & or large amounts of gravies. poultry choices should be lean or very lean. Fresh, canned or frozen vegetables served in any Limit fried, augratin or form. 100% vegetable juices. cream sauces on veg.

Dietary recommendations for Upper Gastrointestinal Diseases Food Classification Suggested Daily Servings Fruits 1 -2 ½ cups (2 -5 servings) Grains and grain products 3 -10 Nuts, seeds, and beans 4 -5 a week Recommended choices Limit or Avoid Fresh, frozen or canned fruits and 100% juices of all Limit Avocados kinds. Use whole-grain or enriched breads, pasta, oatmeal, breakfast cereals, tortillas, grits, white, brown or wild rice, popcorn, cornbread, Go easy on high fat breads, crackers, pretzels, buns, muffins, biscuits, etc. rolls, English muffins. It is recommended to use at least 3 servings of whole-grain cereals daily. All varieties of nuts, seeds and beans.

Dietary recommendations for Upper Gastrointestinal Diseases Food Classification Fats and Oils Sweets Fluids Seasonings/ Condiments/ Sauces Suggested Daily Servings Recommended choices Limit or Avoid Margarine, butter, mayonnaise, butter, salad dressing, gravies, cream Use sparingly not generously sauces, sour cream. Make Limit portions. 2 -3 times a day most of your fats sources from fish, nuts & vegetable oils (Olive & canola esp. ) All sweets and desserts in 1 or <1 per day limited portions and amounts. Limit high fat choices. Water and other fluids, such 6 -8 cups as fruit juice, vegetable juice, lemonade, or soups. Encourage limited quantities Limit black pepper, garlic, As desired of all that are high in salt for cloves, and chili powder normal healthy diet.

Case study • Noor is a 20 -years-old female; 166 cm height and 49 kg weight. She lost her weight lately, as she does not have the desire to eat. Since a year and half, she has been drinking about 2 -3 cups of black coffee daily and her eating is not very well as she was anxious about her grades and accepting her as a freshman at KAU. Recently, she has been felt a burn and noisy pain in her stomach, which after seeing a doctor, it appeared to be at risk of advanced stage of ulcer.

Case study Answer the following: • 1_ Identify this patient’s risk factors for ulcer disease. • 2_ Make the assessments you need to plan appropriate meals for Noor. • 3_ What education and advices would you gave it to Noor?