Mouth Pharynx Esophagus Stomach Small Intestine Large Intestine Rectum.
Large Intestine Working knowledge of physiological changes during disease processes & the effects of...
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Large Intestine
• Working knowledge of physiological changes during disease processes & the effects of these on nutrition care.
Large Intestine
• Calculate & interpret nutrient composition of foods appropriate for diets used in MNT.
• Calculate & define diets for common conditions.
Large Intestine
• Parts of the colon– haustra - sacculations in wall of colon,
due to the circular muscle fibers & tenia coli
Large Intestine
• Parts of the colon– tenia coli - three thickened bands of soft
tissue 1/4” wide & 1/6 shorter than the colon, longitudinal fibers that go from appendix to rectum
Constipation
• Infrequent and difficult passage of stool
• Fewer than 3 stools/week while eating high residue diet
Constipation Etiology
• Not defecating when the urge happens
• Failure to establish a regular time to defecate
• Lack of fiber in the diet
Constipation Etiology
• Insufficient fluid intake
• Loss of muscle tone in intestinal tract
• Side effects of medications
• Lack of exercise
• Pregnancy
Laxatives - Stimulants
• Senna (natural)
• Bisacodyl – stimulates nerve endings to increase
peristalsis
• Dulcolax - active ingredient is bisacodyl
Irritable Bowel Syndrome
• Cause unknown
• Exaggerated gastrocolic reflex
• Abnormal colonic sensitivity to stretching
• Anxiety & stress
IBS
• Contributing causes– excessive use laxatives– excessive use caffeine– antibiotic therapy– irregular sleep, rest, fluid intake, bowel
movements
IBS
• Abnormal stooling pattern associated with symptoms of intestinal dysfunction that persists
• May be some inflammation
IBS Symptoms
• Diarrhea & constipation
• Excessive flatulence
• Sensation of incomplete evacuation
• Rectal pain
• Mucus in stools
IBS Nutritional Care
• Get over fear of eating
• Gain or maintain wt
• Acute phase– elemental food products– advance DAT
IBS Nutritional Care
• Chronic phase– high fiber diet– avoid gas forming foods– DAT– exclusion of caffeine & chocolate
Diverticular Disease
• Diverticulitis– accumulation of fecal matter in the
diverticular pockets with infection & inflammation
Diverticular Disease
• Outpouchings results from segmentation due to high intracolonic pressures
• Low fiber diet
• Colon muscle weakens
• Common elderly
Diverticular Monitoring
• Body wt & change
• H & H
• Alb
• Transferrin, TIBC
• Stool number & frequency
Nutritional Care
• Diverticulitis– bowel rest to prevent perforation– low fiber & residue– No nuts, seeds, fibrous veg– DAT
Nutritional Care
• Diverticulosis– increase stool caliber & vol– lessen intraluminal pressure– high fluid & fiber
Colostomy
• Surgical formation of an artificial anus on the abdominal wall by incising the colon & bringing to the surface
Ileostomy & Colostomy
• Consistency of material in colon next
• Next slides of openings and where in the intestinal tract
Nutritional Care
• Avoid foods that cause odor– corn– dried beans– onions– cabbage– highly spiced foods
Nutritional Care
• Avoid foods that cause odor– fish– antibiotics– some vitamin & mineral supplements
Nutritional Care
• Avoid foods that produce flatulence
• Avoid very fibrous veg
• Chew food well
• More fluid
• More salt
• Crohn’s Disease Case study #40 - 3, 4, 5
• Diverticulosis Case study #17 - 2, 3, 4, 5, 6, 7, 8, 10, 11, 12
• Select menu high in fiber from reg menu
• Write SOAP note