Tag Archives: dietary intake

C. difficile infections With Challenging Nutritional Intake Imbalances; Malnutrition

NurseCadeceus

A C. difficile infection effects the gastrointestinal system.

What Is the Gastrointestinal System?
The human gastrointestinal system or GI tract, is an organ system responsible for consuming and digesting food, absorbing nutrients, and expelling waste (fecal matter).  The whole digestive tract is about nine meters (30 feet) in length. (1)

  1. Food enters through the mouth and is broken down by saliva and the act of chewing. It passes through the esophagus until it reaches the stomach.
  2. The stomach uses acids and enzymes to convert food into a semi-liquid state called chyme. The stomach then expels the chyme into the small intestine.
  3. The small intestine is the portal for all nutrients to enter into the bloodstream. Crucial digestive enzymes and hormones secreted from the pancreas, liver, and gallbladder break down the semi-liquid chyme into molecules small enough to be absorbed into the bloodstream.
  4. Any leftover food goes into the large intestine, where it is converted into solid waste with the help of bacteria. Water and salts are extracted from any undigested food. The end-product (fecal matter) is expelled through the rectum and anus.

Malnutrition may be broadly defined as nutritional imbalance.

More specifically, it has been defined by the American Academy of Nutrition and Dietetics as consisting of any two or more of the following:

  • Insufficient  intake
  • Weight loss
  • Loss of muscle mass
  • Loss of subcutaneous fat
  • Localized or generalized fluid accumulation that may mask weight loss
  • Diminished functional status as measured by hand-grip strength

(1) http://naturopathconnect.com

Patients who are nutritionally challenged and have subsequently restrict their diets to an excessive degree are at higher risk for micro-nutrient and macro-nutrient deficiency. Deficiencies can arise from altered nutrition and poor intake from many illnesses.

A Zinc deficiency may present with a rash that can resemble contact dermatitis or seborrheic dermatitis and can be best described as eczematous pink scaly plaques that may evolve into vesicular, bullous, pustular, or desquamative lesions. Patients with severe zinc deficiency will experience growth delay, mental slowing, poor wound healing, anemia, photophobia, hypogeusia, and anorexia. Zinc is an essential mineral required by the body for maintaining a sense of smell, keeping a healthy immune system, building proteins, triggering enzymes, and creating DNA. Zinc also helps the cells in your body communicate by functioning as a neurotransmitter. A deficiency in zinc can lead to stunted growth, diarrhea, impotence, hair loss, eye and skin lesions, impaired appetite, and depressed immunity. Conversely, consuming too much zinc can lead to nausea, vomiting, loss of appetite, abdominal cramps, diarrhea, and headaches in the short term, and can disrupt absorption of copper and iron in the long term. If you have a zinc deficiency, then animal foods are better sources of zinc than plant foods.  Main foods high in Zinc:  Lamb, Wheat-germ, Spinach, Pork, Chicken, Beans.

Vitamin C plays an important role in maintaining connective tissue by virtue of its effect on the hydroxylation of proline and lysine. Patients with scurvy are prone to easy bruising, hemorrhage, fatigue, weakness, and gingivitis. Treatment consists of oral repletion of vitamin C. Foods high in Vitamin C include bell peppers (yellow), dark leafy greens, kiwis, broccoli, berries, citrus fruits, tomatoes, peas, and papayas.

The elderly patients, and patients nutritionally challenged (e.g. C. diff. infections, IBS, Crohn’s, etc.) are at higher risks for developing protein engery malnutrition (PEM) as a consequence of several factors. One is from the inability to maintain adequate nutrition due to the symptoms created by  a C. difficile infection and other GI diagnosis.  Secondary is related to the loss of employment and wages resulting in the inability to acquire food and food products/supplements. Long-term poor nutrition can also result in poor oral health and dental problems which can also lead to difficulty in chewing.  There are many factors that can lead to malnutrition. * Discussing dietary challenges with a healthcare provider is important and asking for a dietary consult with a Registered Dietician is always helpful *  Protein is also essential for the healing of wounds. Accordingly, increasing this patient’s protein intake is a priority. A deficiency in protein leads to muscle atrophy, and impaired functioning of the human body in general. High protein foods include meat, fish, cheese, tofu, beans, eggs, lentils, yogurt, Not everybody needs the same amount of protein. (2) Protein servings of meat, poultry, or fish, should be the size and thickness of the palm of your hand, That’s about a 3-ounce portion. Meat eaters eat no more than two palm-sized servings of meat a day to get enough — but not too much — protein.  Patients with decreased kidney functions need to discuss dietary needs with their healthcare professional and referral/consult with a Registered Dietician for guidance.  To look at it another way, protein should take up no more than one-third of your plate at meals, whether it’s in a form you can drink or chew, Include small amounts of protein foods at every meal to spread your intake evenly throughout the day. (2)

(2) Wedmd.com

Malnutrition can also be diagnosed with a CT scan: A patient can be diagnosed with malnutrition from inflammatory bowel disease (IBD), with significant weight changes and altered bowel habits. In addition, the albumin level, if checked, will be low = malnutrition.

Physical findings that are associated with PEM (Protein – energy Malnutrition) include the following:

  • Decreased subcutaneous tissue: Areas that are most affected are the legs, arms, buttocks, and face
  • Edema: Areas that are most affected are the distal extremities and anasarca (generalized edema)
  • Oral changes: Cheilosis, angular stomatitis, and papillar atrophy
  • Abdominal findings: Abdominal distention secondary to poor abdominal musculature and hepatomegaly secondary to fatty infiltration
  • Skin changes: Dry, peeling skin with raw, exposed areas; hyperpigmented plaques over areas of trauma
  • Nail changes: Fissured or ridged nails
  • Hair changes: Thin, sparse, brittle hair that is easily pulled out

Protein Studies include:  Measures of protein nutritional status include levels of the following:

  • Serum albumin
  • Retinol-binding protein
  • Prealbumin
  • Transferrin
  • Creatinine
  • Blood urea nitrogen

* If a loved one or if you are nutritionally challenged at any time, from any illness, contact your healthcare provider as soon as possible and discuss the symptoms and complications associated with maintaining an adequate nutritional diet or hydration.  Clear liquid diets are ONLY for three days and Full Liquid diets are ONLY to be used during the direct healthcare provider supervision and frequent monitoring.

 

* The information provided on the website is for educational use only and not for physical or mental health assessment, diagnosis, or treatment for any illness or symptoms.  Please see disclaimer.  Always seek medical care and contact healthcare providers as soon as possible for full medical exams, diagnosis, and treatments. Thank you.

C. difficile infection; Maintaining Nutrition

matzo-ball-soup

 

 

 

As we know those combating a C-Diff Infection deal with the major symptom; diarrhea. This can cause a person to lose large amounts of water, alter electrolytes, and loose minerals.  However, certain foods can help one to overcome the symptoms of diarrhea. It is important to drink clear liquids such as juices, decaffeinated tea, or sports drinks, gelatin, frozen ices, and water. Bland foods are also appropriate such as applesauce, bananas, canned soft fruits, crackers, eggs, mashed potatoes, pretzels, smooth nut butters, toast, white rice and especially soups.

* Please Note:  If an individual is unable to maintain adequate hydration and nutrition, contact the Physician and seek medical attention as soon as possible.  Dehydration can be life threatening *

Soups provide fluid, sodium, calories and vitamins. One soup that provides fluid replacement, protein, maintains nutrition, and is relatively easy to prepare is a simple matzoh ball soup.

Recipe: Matzoh Ball soup

2 quarts of salted water
3 eggs,
¼ cup of oil
Large dash each salt and pepper
1 cup of matzoh meal(approx)

Bring water to a boil. While you are waiting for water to heat combine eggs, oil, salt and pepper. Then mix in matzoh meal, a little at a time, until the mixture is thickened but still sticky. Matzoh meal absorbs lots of water, so wait 10 minutes or so to see if you need more. Aim for your batter to feel like modeling clay.

Wet your hands and roll batter into balls; for large balls, roll them into the size of a small egg. For smaller balls, aim for walnut-sized. Drop balls into the boiling water, then reduce heat and simmer for at least 30 minutes.

Makes approx 12 small matzoh balls.

 

April 2014: K. Factor, R.D., MS – Chairperson of Nutrition Wellness

Maintaining Hydration + Nourishment during a Clostridium Difficile infection

soupchicken3Our bodies depend on water and every cell, tissue and organ depends upon water to operate efficiently. The body uses water to maintain temperature, remove waste, and lubricate joints and water makes up for more than half of our body weight.  When it comes to hydration water is the best option. There are other fluids and foods that can aid in providing water needed. Fruit and vegetable juices, broths, milk, sports drinks can contribute to the amount of water you should get each day. Limiting caffeinated beverages is recommended as caffeine may cause fluid shifts from body tissue to intestines promoting elimination and some to urinate more frequently, create anxious or jittery symptoms. A moderate amount of caffeine, 200 to 300 milligrams, equivalent to 2 to 4 eight-ounce cups of a caffeinated beverage per day. Water rich foods such as watermelon, tomatoes and lettuce can aid in warding off dehydration.

Is your body low on water?

You lose water each day when you go to the bathroom, sweat, and even when you breathe. Water is lost from the body even faster when combating an infection or being out in the hot weather. Individuals exercising in hot weather, ill with a fever,or vomiting and having bouts of diarrhea are at a higher risk of dehydration. The elderly are also at a higher risk of dehydration due to decreased senses that contribute signaling the body of the feeling of thirst.  When the lost fluids are not replaced, dehydrated occurs.  Offering fluids frequently to older individuals will aid in maintaining hydration.  Monitoring urine color during the day is another way to know if the body is well hydrated: When the urine is colorless to a light yellow in color hydration is being maintained.  If the urine is dark yellow in color, the body is in need of additional fluids.  How much is enough?  The average daily intake required for a healthy body is 8 eight ounce glasses of fluids a day.  There are various circumstances for each individual.  Individuals diagnosed with heart conditions (i.e., Congested Heart Failure, etc.) may be instructed by their health care providers to limit fluids in their daily diet. Patients diagnosed with altered kidney functions will also be placed on their own daily fluid intake program.  Discussing your daily fluid intake, with your physician or professional health care provider, is suggested.

What are some symptoms of dehydration? Little or no urine, with a urine color that is of dark yellow, Dry mouth, Sleepiness or fatigue, Extreme thirst, Headache, Confusion, Feeling dizzy or lightheaded, No tears when crying

It can be very difficult to recognize dehydrated, especially in the elderly. Preventing dehydration by drinking plenty of water, and following your health care providers recommendations,  can prevent dehydration.

If you are unable to maintain hydration for any reason, seek medical attention as soon as possible.

Contact your Primary care physician to report symptoms and/or visit a local clinic/hospital for medical care.

A quick and easy recipe for Chicken, Zucchini, and Spinach Soup to maintain hydration and help stay nourished.

Total prep time: 60 minutes

Ingredients:  2 Chicken breasts, 4 cups broth of choice (Vegetable, Chicken, Beef), 4 cups water, 1 large zucchini, 1 yellow onion, 1 Tomato diced, 1 bag of fresh or frozen spinach, 2 cloves minced garlic, 3/4 cup Tomato sauce.

In a large stock pot add the water, broth, and the two chicken pieces. Bring to a boil then reduce to a simmer allowing the chicken to cook thoroughly (approx. twenty minutes).  After twenty minutes remove the chicken from the broth and cut the chicken into cubes.  While broth is simmering add chicken cubes back into the stock pot and continue to cook on medium/low heat.  Chop the zucchini, onion, and tomato into small cubes and add them into the stock pot, stir in the spinach, garlic, and tomato sauce. Cover and cook for fifteen to twenty minutes for vegetables to cook.  *Options: In a separate pot boil water for pasta egg noodles, or rice, or orzo to be served with the vegetable soup.  This is a low fat recipe. Sodium content can be controlled by choosing a low-sodium broth. Salt and Pepper to taste.  Buon appetito.