Lecture 7 10/8/08

CREATEDATE 10/5/08 3:49 PM NUTR 300 10/8/08 Nutrition for Today Digestion and Absorption II Reading: Chapter 3 of textbook (not p 108-110 ?How does the body coordinate and regulate digestion?) Learning Objectives: Describe the gastrointestinal disorders addressed in lecture: their causes, their effects on nutritional health, and any nutritional or other interventions that are commonly used as treatments. Discuss potential use of probiotics in digestive disorders Heartburn and gastroesophageal reflux disease (GERD) Causes HCl in esophagus Hiatal hernia Smoking, alcohol use, overweight, pregnancy, large high fat meals, lying down within 1-2 hours after a meal, certain foods Effect on nutritional health Changes in health of esophagus How to treat? Eat small meals, don?t lay down right away after eating, elevate head of bed, stop smoking, lose weight, antacids Antacids ? neutralize HCl, inhibit pepsin production H2 receptor blockers ? block acid production Proton pump inhibitors - block acid production Ulcers (peptic ulcers) Erosion of an area of the stomach or part of duodenum due to exposure to HCl and pepsin Burning pain~1-3 hours after a meal Can lead to loss of blood and subsequent anemia Causes ? H. pylori Non-steroidal anti-inflammatories Effect on nutritional health ? Potential for blood loss leading to anemia How to treat? Antibiotics Antacids, H2 receptor blockers, proton pump blockers Food allergies and intolerances Causes ? Allergy ? allergic reaction mediated by cells of the immune system Common allergenic foods ? eggs, seafood, wheat, milk, soy, nuts Intolerance ? gastrointestinal discomfort caused by foods (lactose intolerance) Common intolerances - wheat, milk, and soy Lactose intolerance ? Approximately 75% of the world?s population is affected by lactose intolerance. ~15% of people with Northern European descent, ~80% of blacks and Latinos, and up to 100% of Asians and American Indians. Effect on nutritional health ? Concern is for calcium intake Other sources of calcium - canned salmon with bones, sardines, collard greens, turnip greens, broccoli, tofu How to treat? Allergies - Avoid offending foods Intolerances - Avoid offending foods HYPERLINK "http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance_ez/" http://digestive.niddk.nih.gov/ddiseases/pubs/lactoseintolerance_ez/ HYPERLINK "http://www.faqs.org/nutrition/A-Ap/Allergies-and-Intolerances.html" \t "_parent" http://www.faqs.org/nutrition/A-Ap/Allergies-and- HYPERLINK "http://www.faqs.org/nutrition/A-Ap/Allergies-and-Intolerances.html" \t "_parent" Intolerances.html Celiac Disease Causes ? Genetic disorder ? inability to absorb a component of gluten Exposure results in local inflammation in small intestine, leads to erosion unless treated Symptoms ? fatty stools, diarrhea or constipation, cramping, anemia, weight loss, fatigue, irritability abdominal cramping, intestinal gas, distention and bloating, anemia Effect on nutritional health ? Can lead to malabsorption if small intestine becomes too damaged Iron deficiency anemia Osteoporosis Vitamin and mineral deficiencies Central and peripheral nervous system disorders -- usually due to unsuspected nutrient deficiencies Intestinal Lymphomas and other GI cancers Lactose intolerance ( HYPERLINK "http://www.celiac.org/cd-what.php" http://www.celiac.org/cd-what.php ) How to treat? Avoid gluten and gluten containing foods (wheat, rye, barley) unidentified starch modified food starch hydrolyzed vegetable protein - HVP hydrolyzed plant protein - HPP texturized vegetable protein - TVP binders and fillers malt ( HYPERLINK "http://www.celiac.org/cd-what.php" http://www.celiac.org/cd-what.php ) Alternate carbohydrate sources ? corn, rice, millet, quinoa, tapioca, potato, arrowroot, cassava Crohn?s Disease Causes ? An inflammatory disease of the gastrointestinal tract of unknown etiology. Can occur anywhere along the GI tract Symptoms ? diarrhea, abdominal pain, rectal bleeding, weight loss, fever Effect on nutritional health ? Can lead to deficiencies in protein, energy, and vitamins Associated with kidney stones, gallstones, liver disease, and arthritis How to treat? Medications, nutritional supplements, surgery Ulcerative Colitis Causes ? Inflammatory disease of the large intestine of unknown etiology. Symptoms ? diarrhea, abdominal pain, weight loss, anemia, nausea, fever Effect on nutritional health ? May result in dehydration, bleeding, nutritional deficiencies How to treat? Anti-inflammatory medications Surgery Diarrhea and Constipation Causes ? 1 - Acute ? 3 weeks ? infection 2 ? Chronic > 3 weeks ? allergies (cow?s milk), irritable bowel syndrome, lactose intolerance, celiac disease, Crohn?s disease, ulcerative colitis 3 ? Travelers ? results from viral or bacterial infection Symptoms ? Frequent passage of loose watery stools (? 3 per day), abdominal pain, fever Effect on nutritional health ? Potential for loss of important nutrients. Dehydration. How to treat? Treat cause Constipation Causes ? Commonly seen in people with neurological disorders Absence of bowel movements for a longer time than usual How to treat? Increase fluid and fiber intake Irritable Bowel Syndrome (IBS) A disorder that interferes with normal colon finction More common in women than in men Associated with stress, caffeine, large meals, chocolate, alcohol, dairy, wheat, certain medications Causes ? Disorder of the large intestine of unknown etiology. Normal function is impaired. Symptoms ? abdominal cramping and pain, diarrhea or constipation. How to treat? Medications Stress management, regular physical activity Eating smaller meals High fiber diet with plenty of water Probiotics Selected live microorganisms Lactobacillus and bifidobacterium Used for treatment of diarrhea, IBS, H. pylori associated ulcers, food allergies Vocabulary: GERD Hiatal hernia Peptic ulcer Food allergy Food intolerance Celiac disease Gluten Crohn?s disease Ulcerative colitis Diarrhea Constipation Irritable bowel syndrome (IBS) Probiotics E. Kirk Phd, RD PAGE 6