Pancreatic and Gastrointestinal, Case Study Example

You are caring for a patient who is suffering from a severe attack of Acute Pancreatitis.  Please describe the progression of nutrition care that you would recommend.

The nutrition focus in treating patients with pancreatitis begins with limiting the amounts of fat in the diet. Recommended food groups include grains, vegetables; fruits; meat and beans; skimmed milk and 8 tea spoon of fats and oils daily. Grains that are highly useful in pancreatitis nutrition include whole wheat bread; brown and wild rice. All vegetables should be consumed one the patient can tolerate them. Avocado should be avoided when fruits are eaten, but all others are valuable. Meat must be lean and beans cooked without oil (American Dietetic Association, 2014).

Foods not recommended include grained processed with added fat; breaded and fried vegetables containing oil bases sauces; fatty meats such as beef; pork and lamb; luncheon meats; poultry containing high fat content, especially, ducks; deserts pies, eggs and foods processed with added fat ( American Dietetic Association, 2014).

A patient presents with classic constipation symptoms.  After reviewing their personal history, you can see that their diet could best be described as “Meat and Potatoes”.  What would you recommend in order to alleviate their discomfort?

This individual should immediately increase roughage/ fiber and water in the diet. These could be obtained from fruits; raw vegetables; salads and sprouts.  To facilitate regular bowel movement more oil could be added to the diet that will naturally soften the stool. A minimum of six 8 ounce glasses of water daily between meals is also recommended.

You are caring for a patient who has just had a gastrectomy for treatment of stomach cancer.  So far the patient is doing fine, but you are starting to notice signs of fat malabsorption and dumping syndrome.  What can be done from a nutrition standpoint to help this patient?

These are manifestations related to the side effectives of gastrectomy. The first line of treatment is a nutritional intervention since gastric consistency of the stomach has been altered and a malabsorption of Vitamin B 12 is evident. Therefore, meals have to be considerably smaller being 5 -6 times per day instead of three. Also, reduction in fatty foods is imperative. Foods such as butter, cheese, processed meats/vegetables containing large amounts of oil have to be significantly limited.

You find out that you have GERD.  What is that, why is it important to treat it, and what foods would you avoid? 

Gastroesophageal reflux disease (GERD) is also classified as gastro-esophageal reflux disease (GORD), acid reflux and gastric reflux disease. Importantly, it occurs in response to chronic mucosal damage when stomach acids travel to the esophagus. However for this reflux to take place changes in the passage separating the stomach and esophagus had to have occurred. These changes are muscular in context. For example there is abnormal relaxation of sphincter muscles separating the stomach from esophagus, which serves as a natural barrier.

When this barrier is dysfunctional acid flows in from the stomach and eventually damages the esophagus. Therefore, treatment is imperative before symptoms escalate and damage becomes irreversible. Besides, patients experience heart burn; regurgitation; increased salivation; chest pain and coughing. Ultimately, strictures in the esophagus occur along with the development of Barrette esophagus, which alters cell division to create neoplasms in that region.

You are trying to explain what Celiac Disease is to your family.  Describe the principles of a gluten-free diet and list five specific foods to include in your diet and five foods to avoid.

Celiac Disease is considered an autoimmune disorder occurring in the lower intestines. The immune system reacts to gliadin which is a gluten protein. As such, a gluten free diet is essential in relieving symptoms.  Due to the presence of gluten in the body it creates a predisposition of the body attacking the gut; a self-destructive mechanism. The gut is perpetually inflamed and patients experience symptoms such as frequent pale greasy stools and severe weight loss(Schuppan, Junker & Barisani, 2009).

No medication presently can treat this disease. Consequently patients must be on a gluten free diet all their lives. Gluten free products can be obtained with a prescription and some are   even reimbursed by insurance companies. While products are advertised as gluten free ususally the gluten content are reduced and not eliminated entirely (Schuppan et.al, 2009).

Works cited

American Dietetic Association. Pancreatitis Nutrition Therapy. Web http://www.nutritioncaremanual.org/vault/editor/Docs/Pancreatitis%20Nutrition%20Therapy.pdf

Schuppan, D. Junker, Y. Barisani D. Celiac disease: from pathogenesis to novel therapies. Gastroenterology 137 (6); 2009;1912–33. Print