Nutrition Nuggets

Inflammatory Bowel Diseases

August 2010—Inflammatory bowel disease (IBD) covers some emerging intestinal disorders, the primary ones being Crohn’s disease (CD) and ulcerative colitis (UC). These pose major health complications for as many as 1 million people in the United States. A number of factors are thought to play a part in their rapid increase during the current era.

Cultural Food Practices After a Death

June 2010—A funeral meal is not just a bite to eat; it’s a way of easing the transition from death to life. Traditional food and beverages serve important cultural roles. Ethnic backgrounds and religions have a great impact on the components, quantities, preparation and presentation of post-burial repasts.

Perspectives on Tube Feeding

April 2010—Over the centuries, there have been many attempts to administer nutritional fluids to those unable to swallow. The ancient Egyptians used reeds and animal bladders to feed patients with a mixture of wine, broth, and raw eggs.

Nutrition for Pressure Sores & Muscle Wasting

February 2010—Proper nutrition is critical for maintaining skin health and preserving lean body tissue. Both of these are common problems at the end of life, but much can be done to minimize the damage that can easily develop when a patient is bedbound and not taking in sufficient nutrients.

Irritable Bowel Syndrome

December 2009—Irritable bowel syndrome (IBS) is a complex disorder that affects the large intestine and is experienced by as much as 20 percent of the adult population. It occurs more often in women than men and frequently begins in adolescence or early adulthood.

Acid Reflux or Gastroesophageal Reflux Disease (GERD)

October 2009—Almost everyone experiences a little acid reflux occasionally, particularly after a heavy meal. Up to 36 percent of otherwise healthy Americans experience heartburn, also called acid indigestion, at least once a month. After a meal, the valve between the esophagus and stomach usually remains closed. When it relaxes at an inappropriate time, this allows a portion of stomach contents to travel backwards into the esophagus, resulting in a burning sensation.

Bowel Retraining

July 2009—More than 5.5 million Americans have fecal incontinence which can range from occasionally leaking a small amount of stool while passing gas to serious loss of control. Bowel training helps people relearn how to control their bowels. Frequently, within a few weeks of beginning a bowel program, individuals who were formerly incontinent can have regular bowel movements.

Gastroparesis – the Slow Stomach

June 2009—Gastro = stomach and paresis = paralysis. Gastroparesis, (GP), is a condition in which the stomach muscle doesn’t work properly, due to weakness and/or nerve damage. Instead of grinding the food and gradually injecting it, one muscular contraction at a time, into the small intestines, the GP stomach depends mainly on acid and digestive enzymes to break food down and on gravity to empty the contents. This results in delayed emptying and poor digestion.

Probiotics - the Friendly Bacteria

April 2009—Did you know that over 400 species of microorganisms call your digestive system home and the majority are not only beneficial, but are absolutely essential for good health? These helpful bacteria are called probiotics− which means “for life” − and they have numerous functions, the majority of which have yet to be identified.

Nutritional Care for COPD

February 2009—Most adults with Chronic Obstructive Pulmonary Disorder (COPD) have some degree of both chronic bronchitis and emphysema. Airflow obstruction due to excess mucus causes shortness of breath and chronic cough. A highly nutritious diet increases immune response and can result in less infections and improved quality of life.

Delicious Shakes for the Holidays -- Anytime!

December 2008—Shakes and smoothies are an easy way to consume a lot of calories, protein, and other important nutrients when eating enough food can be challenging. They can be made in many different flavors so that food remains interesting and appealing to patients. Here is a selection of tasty recipes that you can whip up in a flash!

Promoting Enjoyment and Safety in Patient Feeding

October 2008 — At end-of-life when the pleasurable aspects of living become limited, meal and snack times can become some of a patient’s few remaining pleasures. A primary factor in our ability to avoid discouragement and depression is the amount of positive experiences we have on a daily basis.

Constipation - Don't Be Stuck Up!

August 2008 —Constipation is very prevalent at end-of-life and is a common side effect of narcotic pain medications such as codeine, morphine, and other opioids. Being inactive and consuming insufficient fluids also contributes to reduced intestinal motility.

Diarrhea - When You're Losin' It

July 2008 —Problems with loose bowels are very common in cancer patients during chemotherapy as well as many persons at end of life. This can rapidly cause electrolyte imbalance and dehydration if provision is not made to replace lost fluids and minerals.

Nausea and Vomiting

June 2008 —Problems with queasy and upset stomach are very common in palliative care
and there exist numerous interventions that can reduce the occurrence of nausea. The timing, amounts, and types of food and drink consumed can have a major effect. In addition, various forms of herbal, pharmacological, and psychological treatments are available and often highly effective.

Dry and Sore Mouth

May 2008 —These are two conditions that are very prevalent at end of life and in those undergoing chemotherapy. A sore mouth and throat and a lack of saliva can make many foods difficult to chew and swallow. Care must be taken to ensure the patient is getting an dequate
diet.

Dysphagia - When Eating Is A Trial

April 2008 —Dysphagia is defined as difficulty or discomfort when swallowing. Problems arise due to medications, cancer treatment, and loss of control over the swallowing reflex caused by various other diseases.

Hiccups - Minor Annoyance or Life-Controlling Problem?

March 2008 —Persistent hiccups frequently occur in the palliative care population. This is a concern for 10 to 20 percent of cancer patients and it afflicts children more often than adults. Prolonged hiccups can be extremely distressing and have a significant impact on quality of life.
Pharmacological approaches are often the most rational therapies when physical measures fail to disrupt the hiccup reflex.

Artificial Hydration and Nutrition

February 2008—When the diagnosis of a life-limiting illness has been made, it is necessary to
consider the treatment options and the possibility that artificial hydration and/or nutrition will increase the quality of life.