Diet in GIT disorders

18/6/2015
 Objectives
Learning outcomes:
• Describe the diet in different GIT disorders>
 Dyspepsia
• This is the term used to describe a range of
GIT symptoms, the occurrence of which is
associated with the ingestion of food
• This symptoms include nausea, heartburn,
discomfort and gastric pain
• These symptoms have different causes
 Causes of dyspepsia
• Food intolerance
• Psychological factor
• General disease e.g. Heart failure and chronic
renal disease
• Ulceration or inflammation of the gut mucosa
as in peptic ulcers
• Peptic ulcers may be either in the stomach
(gastric) or in the duodenum (duodenal)
 Causes of peptic ulcers
• Helicobacter pylori infection
• Intake of non steroidal anti-inflammatory
drugs (NSAIDs) e.g. Aspirin, Ibuprofen
• Gastric ulcers are less common than duodenal
ulcer, can be acute or chronic
• The pain occurs shortly after eating
• Duodenal ulcers, pain and dyspeptic
symptoms occur when the stomach is empty
• Stress and irregular meals frequency may
contribute to development of duodenal ulcer
• Sometimes symptoms are relieved by regular
and small meals
Principles for dietary treatment for dyspepsia

• Take a snack at bed time and between meals

• Eat small but frequent meals
• Avoid foods that upset you e.g. raw
vegetables, coffee e.t.c.
• Alcohol, nicotine, aspirin and highly spiced
foods are gastric irritants and should be
avoided
 Constipation
• Delay and difficulty in evacuation of faeces
• In most cases due lack of roughage in the diet
• Causes discomfort i.e. Headache, nausea,
abdominal distension, loss of appetite and
vomiting in extreme cases
• Chronic constipation can lead to
haemorrhoids
• Cereals, vegetables, fruits and increased
intake of fluids will prevent constipation
 Constipation Cont’
• Fiber, also known as roughage, is the part of
plant-based foods (grains, fruits, vegetables,
nuts, and beans) that the body can't break
down.
• It passes through the body undigested,
keeping your digestive system clean and
healthy, easing bowel movements, and
flushing cholesterol and harmful carcinogens
out of the body.
• Insoluble fiber does not dissolve in water. It is
the bulky fiber that helps to prevent
constipation, and is found in whole grains,
wheat cereals, and vegetables such as carrots,
celery, and tomatoes.
• Soluble fiber dissolves in water and helps
control blood sugar levels and reduce
cholesterol.
• Good sources include barley, oatmeal, beans,
nuts, and fruits such as apples, berries, citrus
fruits, and pears.
 Diarrhoea
• Diarrhoea of passage of watery stools usually more
than 200 mls/day (more than 4 times)
• Diarrhoeal diseases are a major public health
problems in developing countries
• They are caused by inadequate water supplies, poor
quality of water, poor sanitation and malnutrition
• Diet in diarrhoea includes generous fluid, with
replacement of electrolytes
• Diet is light bland with no spices, not strongly
flavoured
 Liver and biliary disorders
1. Functions of the liver includes metabolism of
protein as amino acids used for synthesis of
blood proteins, enzymes e.t.c.
• Urea is an end product of protein and excreted
via the kidneys and the remainder of the amino
acids are used for glycogenesis to produce
energy
2. Fat metabolism produces cholesterol, lecithin
and many others are produced by the liver
3. CHO metabolism produces glucose and stored as
glycogen in the liver
4. Detoxification of harmful substances
- The liver destroys hormones produced by the body,
so preventing circulating levels from becoming too
high
- It detoxifies some drugs e.g. Barbiturates
5.Production of bile
- Normal secretes 500-1000 ml of bile /day of which
90-97% is water
- The liver stores fat soluble vitamins, Vit B12 and Iron
- Energy is stored in the form of glycogen which can
rapidly be mobilized a source of energy
 Hepatic cirrhosis
• Because the liver glycogen stores are reduced
- Provide frequent small meals and late night snacks
of food containing high CHO
- This frequent meals will help to prevent the
metabolism of body fat and protein stores and also
prevent hypoglycaemia
- Both protein and energy requirements are
increased
- The diet should provide 75KJ/Kg and protein 1 gm/
kg
 Jaundice
Three Basic Tips for the Jaundice patient.
1. Most important is not to take oily and spicy
food.
2. Take rest as much as possibble
3. Drink water at least 3 liters a day.
4. Eat abundance of green leafy vegetables and
juice.
• Tomatoes- Fresh juice of tomato with a little
addition salt and pepper to taste in the early
morning is helpful.
• Lemon- Lemon protects the damaged liver
cells and it should be taken 20 ml with water..
• Sugarcane- A glass of sugarcane is very
effective but one has to make sure that it has
to be properly cleaned.
• Orange Juice- Patient should take orange juice
as it keeps the bowel movement normal.
• Turmeric- A pinch of Turmeric powder to be
added with a glass of warm water and can be
take three to four times day.
• Grapes, Sweet Potatoes and soya beans are
helpful
 General diet for mild cases
• Portions are small, well presented and appetising
• Snacks such as milk drinks and biscuits are
available to maintain nutrient intake
• Likes and dislikes are considered
• Provide nutrition supplements for those who
require them
• Vitamin supplements are very essential
• Iron supplements
• Low sodium
• Low fat diet
 Gastro-enteritis
• Diarrhea
• Nausea and vomiting
• Abdominal cramps
• Fever
• Muscle aches
• Headache
 G.E Cont’
• The goal of a gastroenteritis diet is to prevent
dehydration.
• It is also important to maintain a proper
balance of electrolytes
• In gastroenteritis, choose a diet that is
nutritious and prevents dehydration.
• For most people of all ages, that diet is your
normal food intake, perhaps modified slightly
by limiting sugars and fatty or spicy foods
• Electrolytes, like sodium and potassium, are
minerals your body needs to work properly.
• Vomiting and diarrhea can take too many
electrolytes out of your body.
• Choose foods that will help you to rehydrate,
regulate the balance of electrolytes in your
body, and maintain nutrition.
• Bananas
• Brown rice
• Chicken or other lean meats
• Whole grains
• Potatoes
• Apple sauce
• Vegetables
• Oral rehydration solutions
 Guidelines for children
• Give small amounts of fluid frequently.
• Avoid sugary drinks, like fruit juices, fruit
drinks, soft drinks, or sports drinks.
• Offer the child the foods they normally eats.
• Avoid foods that may upset their stomach or
make symptoms worse
• Smaller, more frequent meals may be helpful.
• Give an ORS to your child if the doctor advises
it.
• Remember that these solutions do not cure
diarrhea.
• They also do not cut down on the length of
time children are sick with diarrhea.
• But, giving an ORS may help to prevent
dehydration
• Do not withhold food.
• Do not dilute (water down) food or formula
Thank you