Mnt For Upper Gi Tract Disorders

Front 1

T or F: The entire esophagus functions as one tissue during swallowing?

Back 1

True

Front 2

Movement of a bolus of food into the stomach.

Back 2

Mouth - Pharynx - (upper sphincter relaxes) - esophagus - (peristaltic waves and LES relaxes) - stomach.

Front 3

Definition of dysphagia:

Back 3

Difficulty in swallowing

Front 4

Definition of GastroEsophageal Reflux Disease (GERD):

Back 4

The backward flow of the stomach of duodenal contents into the esophagus; may occur normally or as a chronic pathologic condition

Front 5

Common symptoms of GERD:

Back 5

Reflux of gastric secretions, heartburn with episodes of substernal pain, belching, esophageal spasm. Children's symptoms may also include refusal to eat, vomiting, dysphagia, or c/o abdominal pain.

Front 6

Prolong erosive disease (GERD) can result in:

Back 6

esophagitis, esophageal erosions, ulceration, scarring, stricture, and even dysphagia.

Front 7

What is Barret's esophagus (BE)?

Back 7

A condition in which cells lining the distal esophagus become abnormal, even premalignant.

Front 8

Acute esophagitis may be caused by:

Back 8

ingestion of a corrosive agent, viral inflammation, or intubation.

Front 9

Risk of reflux is increased with:

Back 9

hiatal hernia, reduced LES pressure, tobacco use, increased abdominal pressure (as in obstructive lung disease), delayed gastric emptying, recurrent vomiting, pregnancy, or other factors.

Front 10

GERD can cause esophagitis. The severity of esophagitis is influenced by:

Back 10

the composition, frequency, and volume of the gastric reflux; the health of the mucosal barrier; rate of clearance from the esophagus; rate of gastric emptying.

Front 11

T or F: Erosive and nighttime GERD are considered to be associated with more severe and prolonged symptoms.

Back 11

True. Nighttime GERD is R/t altered phsyiology and anatomy during sleep from decreased salivary secretions and swallowing, decreased GI motility, prolonged exposure to acid, and the supine position.

Front 12

Esophagitis, although mainly R/t GERD, can also be R/t:

Back 12

Viral/Bacterial infection, reduced LES pressure, Hiatal hernia, intubation, ingestion of corrosive agents, radiation, smoking, large doses/chronic use of asprin or other nonsteroidal antiinflammatory drugs (NSAIDs) or other medications.

Front 13

Proton pump inhibitors are considered most effective to treate GERD. How do they work?

Back 13

Proton pump inhibitors decrease acid production by the gastric parietal cell.

Front 14

Prokinetic agents may be used in person who

Back 14

have delyaed gastric emptying.

Front 15

Rather than using proton pump inhibitors for all cases of GERD, milder forms of reflux can be managed with what types of medications?

Back 15

H2 receptor antagonists
antacids

Front 16

What behavioral modifications are used to manage esophagitis?

Back 16

Avoiding lying down after meals and eating within 3 hrs of retiring, wearing loose fitting clothing, avoiding cigarette smoking.

Front 17

What is the nutrition management goals for esophagitis and how can they be achieved?

Back 17

1 Decrease exposure to gastric contents by: avoiding large meals, dietary fat and alcohol.
2 Decrease acidity of gastric secretions by: avoiding coffee and fermented alcholic beverages.
3 Prevent pain and irritation by: avoiding acid pH foods and spices.

Front 18

Definition of fundoplication:

Back 18

A procedure in which the fundus of the stomach is wrapped around the lower esophagus to limit reflux.

Front 19

For a person with severe esophagitis, what diet may be best tolerated initially?

Back 19

Low-fat, liquid diet because it doesn't increase esophageal distention and it may pass more easily through any strictured areas.

Front 20

LES pressure is lowered by:

Back 20

carminatives (peppermint and spearmint), coffee, pregnancy, taking pregesterone-based birth control, .

Front 21

Risk factors for esophageal cancer includes:

Back 21

obesity, alcohol and its degradation into acetaldehyde, nitrities, a diet low in selenium/fruits/vegs/cereal fiber.

Front 22

T or F: The presence of hiatal hernia is synonymous with reflux

Back 22

False. It does prolong exposure to acid and increase risk of serious esophagitis. It also causes epigastric discomfort after large, energy-dense meals, laying down, or bending over.

Front 23

What is the most common type of hiatal hernia?

Back 23

The sliding hernia. The less common is the paraesophageal hernia.

Front 24

MNT for hiatal hernias include:

Back 24

weight reduction, decreasing meal sizes, omitting high-fat, high-kcal meals before reclining, minimizing alcohol consumption.

Front 25

Why are tonsils removed?

Back 25

To reduce the number and frequency of ear infections, tonsillitis, and sinusitis. Tonsils are considered lymphatic tissue and are therefore part of the immune system.

Front 26

The best foods to eat after a tonsilectomy include:

Back 26

cold, mild-flavored, soft, moist foods. The first day after surgery, chilled/frozen dairy or fruit slurries and noncitrus juices are tolerated. By day two the diet can be expanded to include warm fluids and soft foods. Within 3-5 days the a normal diet can be consumed.

Front 27

MNT for oral cancer:

Back 27

Nutrition support by tube feeding or gastrostomy if needed for total or supplemental support. If oral is possible - liquid/soft foods; moist foods for easy mastication and swallowing; small, frequent meals of high caloric density; complex carbs rather than simple carbs.
Use of artificial saliva, frequent consumption of fluids, and normal saline rinses may help the eating process.

Front 28

What is functional dyspepsia (aka nonunlcer dyspepsia)?

Back 28

unexpelained persistent or recurrent upper GI discomfort

Front 29

What are symptoms of functional dyspepsia?

Back 29

vague abdominal discomfort, bloating, early satiety, nausea, belching.

Front 30

What is the dietary MNT for dyspepsia?

Back 30

Reduce dietary fat intake, smaller meals, diets of low caloric density, and limiting alcohol. Non dietary MNT includes mild exercise and lowering stress levels.