Nutrition for Gastrointestinal Health The human gastrointestinal (GI) system is very complex, and disruptions to this homeostatic environment can lead to inflammation, pain and multiple other GI symptoms. Nutrition significantly impacts your GI health, and some GI disorders may have serious nutritional implications. Almost everyone has had some form of episodic GI symptoms ranging from indigestion, gas, nausea, vomiting, abdominal pain, diarrhea and constipation. Others may have more complicated disorders, such as dysphagia. Evaluation of a client with gastrointestinal symptoms is holistic and takes a multidisciplinary approach to help separate GI symptoms associated with dietary practices from those related to GI disease or dysfunction. In this module, we will discuss an overview of nutrition and its impact on GI health, and examples of different nutritional therapies utilized in the management of general gastrointestinal (GI) symptoms. This module will guide you to identify the nutritional needs of individuals with GI disorders and the impact nutrition can have on their overall health.
Anti-Inflammatory Diets Anti-inflammatory diets have been proven to reduce inflammation and identified as having protective qualities. An anti-inflammatory diet consists of which of the following foods? Select all that apply.
Fresh herbs and spices Fruits and vegetables Plant-based proteins (like beans and nuts) Processed grains Non-fatty fish Anti-inflammatory diets contain foods such as fruits and vegetables, whole grains, plant-based proteins (like beans and nuts), fatty fish, and fresh herbs and spices.
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Homeostasis Homeostasis is achieved when there are healthy interactions between gut microbes and their host. When this balance is altered, it can contribute to which of the following disorders?
Probiotic Inflammatory Regulatory Hereditary Healthy interactions between gut microbes and their host are needed to maintain homeostasis. Changes in microbiome structure lead to dysbiosis, which contributes to inflammation.
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Dehydration Dehydration is a concern when vomiting is continual. Vomiting causes a loss of fluid and electrolytes, stressing body functions. Which of the following electrolytes can be depleted? Select all that apply.
Iron Magnesium Sodium Potassium Dehydration is a concern when vomiting is continual. Vomiting causes a loss of fluid and electrolytes (magnesium, potassium, sodium), stressing
body functions. Infants are at high risk for dehydration because their bodies contain a high percentage of fluids.
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Nutrition for GI Health
Food is our main source of energy, and vitamins and trace minerals are essential components of our diet for nutritional health. Without these essential components dietary deficiencies can develop, cause gastrointestinal (GI) symptoms, and complicate GI diseases/disorders. Common GI symptoms, such as vomiting and diarrhea, disrupts the homeostatic environment of the GI system and can lead to fluid/electrolyte and nutritional deficiencies. Dehydration is a concern with uncontrolled vomiting and diarrhea. The loss of fluid and electrolytes stresses body functions. Infants are at high risk for dehydration because their bodies contain a high percentage of fluids. Malnutrition is very common in hospitalized clients and has been associated with prolonged hospitalization, longer intensive care unit (ICU) stay, higher hospital costs, and adverse health outcomes (Ukleja, 2018). Therefore, identifying clients at risk by conducting a nutritional assessment, close monitoring, and prioritizing nutrition interventions have been associated with improved clinical outcomes.
Dimensions of Health Clients can be significantly affected by disruptions in gastrointestinal (GI) health and impacts various dimensions of health.
Physical Health Intellectual Health Emotional Health Social Health Spiritual Health Environmental Health
General Screening for GI Disorders
W hile caring for a client with gastrointestinal (GI) symptoms, the health care provider will conduct a thorough nutritional assessment to determine priority actions and overall plan of care. During the assessment, questions asked include, but are not limited to: Dietary practices; foods they typically eat and any cultural considerations If they are taking any medications Allergies to medications or foods Changes in appetite or diet Changes in weight Difficulty chewing or swallowing, and Changes in bowel habit such as constipation, diarrhea, rectal bleeding, or dark stools. Changes in weight can be a key indicator in nutritional health. Assess usual body weight, ideal body weight and present body weight. GI symptoms and disorders will often influence nutritional intake and can lead to malnutrition.
Some medications such as anti-inflammatory medications, aspirin, antibiotics, and opioids can cause nausea, vomiting, diarrhea, constipation, and other GI symptoms. Client's that use laxatives over an extended period of time may start to develop constipation. Inquire about the client's home environment, such as if they are exposed to any GI symptoms in the home, food and exercise habits, oral hygiene, recent life changes and stress levels, and alcohol, caffeine, and tobacco use Another part of the health history is asking about family history of GI disorders. Has anyone in the family has had any type of GI disorder such as ulcerative colitis, colorectal or gastric cancer, gastroesophageal reflex disease (GERD), peptic ulcers, alcoholism, Crohn’s disease, or celiac disease.
Cultural Considerations Culture can have an impact on gastrointestinal (GI) health. You will explore cultural considerations as part of the dietary assessment. Certain GI disorders are associated more with various ethnic groups. Culture
Associated GI Disorders
African American
Alcoholism, colorectal cancer, diabetes, helicobacter pylori infection, hepatitis C, obesity
Hispanic
Diabetes, helicobacter pylori infection, hepatitis C, obesity
Japanese
Gastric cancer
Jewish American
Lactose intolerance
Native American
Alcoholism, gallstones, gallbladder cancer
Mexican American
Diabetes, gallstones, gallbladder cancer
Risk for Malnutrition
When assessing an adult client with GI disorders, the healthcare provider recognizes that the client is at risk for malnutrition. To assess the client for malnutrition, which of the following would apply? Select all that apply.
Weight from childhood Usual body weight Ideal body weight Present body weight When reviewing the client's health, it is important to assess the client’s usual body weight, ideal body weight and present body weight. Stomach and intestinal disorders will often influence nutritional intake and impact a client's weight and health status, leading to malnutrition. The childhood weight would not be important at this time.
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General Diagnostics of Gastrointestinal Disorders When clients report various symptoms of a gastrointestinal (GI) disorder, those reported symptoms with be closely evaluated to help determine if it is an upper or lower GI problem. When a health care professional suspects a client is suffering from GI disease or disorder, or if a patient reports unexplained symptoms in their GI tract, technology offers valuable tools. Diagnostic tests and procedures can range from invasive to noninvasive, simple to more complex, and can help health care professionals learn more about the causes, symptoms, and severity of different health conditions.
Nutritional Therapy
Diet is the cornerstone of therapy for gastrointestinal (GI) health, regardless of the symptoms or disorder. Unusual dietary practices, nutritional inadequacies, or food intolerances can lead to GI symptoms or disorders. Common diets that reduce inflammation in the GI system and are often recommended for individuals experiencing GI symptoms or disorders includes: Mediterranean DASH diets These diets offer antioxidant –rich foods which play an essential role to reducing inflammation in the GI system . They also focus on the prevention of various health alterations, to include GI health. The goal is having well-balanced food choices, weight management, and maintaining healthy eating. The DASH diet has a special focus on controlling hypertension, as well.
Why the DASH Diet Works Review the information below on the DASH diet.
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