![]() Symptoms resulting from chronic malabsorption in Coeliac Gradually introduce foods while maintaining remission/symptoms Symptomatic foods reported >5% Crohns pt. Less time consuming than elimination diet smokersĪchieve & maintain good nutritional status during active disease & remissionĪlleviate clinical symptoms in combination with med/surgical txĪchieve remission when EN used as primary or combination tx Smoking - 65% reduction relapse risk in cessation vs cont. ![]() Genetic predisposition - 10 fold in 1st degree relitives Considerations for symptoms: enteric infection, abscess, bacterial overgrowth,īile salt malabsorption, dysmotility (IBS), gall stones Not enough evidence for n-3 FA, probiotics, Enteral nutrition for txĬrohn's disease than ulcerative colitis, since symptoms (suchĪs pain or diarrhoea) may be due to causes other than activeĭisease. Nutrient dense non-bulky foods (milk, dairy, meat, eggs)Ĩ0% unresectable at diagnosis - 3% survival rate at 5yrs - disease usually diagnosed too late stage Iron Deficiency Anaemia (IDA) - Poor Fe intakes & absorption Radical - Surgery (partial/total gastrectomy) + chemo (neoadjuvant & adjuvant) EN can be used but in common practice it is used more for dysphagic patients.ĭiet - ↑salt, nitrates and ↓fruit and vegetables Nutritional support required due to dysphagia, or appetite loss, leading to reduced oral intake and weight loss.ĭecreased appetite- small frequent meals, avoid fluids pre/with meals, avoid fizzy drinks, make the most of best times of day and foods that do fancy, small amount of alcohol to increase appetite, steroids may be appropriate, advice for weight loss may need to be considered.ĭecreased weight- small frequent meals, food fortification, high kcal/protein foods and drinks, full fat products, ONS if not meeting nut. how dysphagic the patient is.ĭysphagia- modified texture diet, ensure adequate nutrition, may require ONS or EN, if total dysphagia would require EN (PN in mean time if unable to place quickly or get NGT down) or stent. Whether they are having surgery (with neoadjuvant chemo) or chemoRT or palliative RT. loss from radiotherapyĭependant on whether they are for radical or palliative care. ![]() loss prior to radiotherapy & additional 10% body wt. Surgery: oral nutrition (taste & smell changes, aspiration, fistulae) Tx can have permanent effects on organs of head & neck eg. Stents mainly used as a palliative measure although occasionally a biodegradable stent may be used whilst patient is having radical treatment. Palliative: 4-6 cycles of chemo, scan at 4 cycles. If small tumour with no nodal disease can go straight for surgery. Chemo doses dependant on BMI - if malnourished, optimal dose not given! Radical: 2 cycles of chemo then surgery (oesophagectomy, possibly with partial gastrectomy) or radiotherapy with further chemo (chemoradiotherapy seen as gold standard in advanced cancers. Stage III & IV - Multimodality therapy (Surgery, radiotherapy & chemo) Stage I & II - Single modality treatment (Surgery or radiotherapy) (1998) - 50-75% experience moderate-severe malnutritionĭependent on type and location of cancer, stage of the disease (I, II, III, IV), fitness of patient, and patient choice ↓BMIĪlso, acid reflux, coughing up blood, hoarseness or chronic cough Smoking, ↑ BMI, ↓fresh fruit and vegetables, GORD Survival rate at 1 year is 42% and at 10 years is 12%. adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids).Ĩ,332 new cases diagnosed each year in the UK squamous cell carcinoma (SCC) (cancer that begins in flat cells lining the esophagus)Ģ.
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