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FSHN 450-2 Lower gi

Two types of IBD Crohn’s and ulcerative colitis
IBD irritable bowel disease
Crohn’s disease aka regional ileitis
Crohn’s is inflammation of the small intestine
Crohn’s can also involve uterus or right side of colon
Stenosis narrowing of lumen
Fistula tunnel from abnormal adherence of mucosal surface to another epithelial tissue
Crohn’s malabsorption blockage results in overgrowth of bacteria , deamination of bile acids and protein -> malabsorption
Steatorrhea fatty diarrhea
Tenesmus sudden need to use the bathroom
___ affects ___% of people w/ Crohn’s malnutrition, 25-85%
oxalate kidney stones and why w/ Crohn’s undigested FAs bind to Ca so Ca unavailable and can’t bind oxalate
methotrexate immunosuppressant for IBD that inhibits folic acid metabolism and affects bone marrow
antidiarrheal drug side effect anti-coloneric= dry mouth, dry eye
methotrexate side effects megaloblastic anemia
immunosuppressant side effects antibodies against TNF-a, abdominal sx, increase risk of infection
sulfasalazine side effects (anti-inflammatory) allergic reactions, gastritis, better/new forms
what’s lost w/ diarrhea? magnesium, potassium, sodium
B12 deficiency is often involved when terminal ileum is involved
How to get folic acid? must receive via injection
What foods are high in oxalate? dark greens and whole wheat
Omega 3s and IBD inconclusive but may prolong remission w/ 3-5g/day
Ileostomy MNT fluid and sodium balance, B12
IBS medical treatment loperimide/narcotics= slow transit time, somatostatin/GLP antisecretory
IBS is a ___ not a ___ functional disorder, disease
IBS aka spastic colon
IBS symptoms bloating, gas, cramping, pain, diarrhea, constipation, mucous in stool, tenesmus
Diagnosis of exclusion IBS, if barium enema, CT scans, endoscopic exam all negative
Rome II criteria for Dx of IBS relieved by defecation, onset associated w/ change in form of stool, onset associated w/ change in frequency of stool
Fodmaps fermentable oligo, di, mono saccharides and polyols
Diverticulosis diet adequate fiber and fluid intake
Created by: melaniebeale



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