Terry Page is a 42 year old male who presents to an outpatient GI clinic with stomach pain and intestinal complaints. Terry has had both diarrhea and constipation for many years. Ht: 5â8â Wt: 294lbs. Medical History: GERD, obesity, Colonoscopy was negative Diagnosis: IBS Medications: Omeprazole 5o mg BID (proton pump inhibitor) ; Vitamin D 600 IU; 800 mg calcium; Lomotil PRN (for diarrhea), Metamucil 1 Tbsp in 8 oz liquid BID Labs: Negative for stool cultures (bacteria). Significant labs from CBS, CMP: FBG = 115; Cholesterol = 201; LDL- C = 155; HDL-C = 32; Triglycerides = 181; HbA1c = 6.1; Diet History: Terry has a good appetite even with abdominal pain and diarrhea. He has gained 20 pounds in the past 5 years. He does not seem to find any foods that trigger diarrhea more than others but notices increased gas with broccoli or cauliflower. AM: Yogurt smoothie with 1 cup fresh fruit (peaches and cherries) with 8 oz low fat yogurt or dry cereal with dried fruit, nuts mixed with yogurt and 2-3 cups of coffee with half & half and artificial sweetener. Mid-morning: Diet Pepsi, ½ cup dried fruit and nuts Lunch: Salad with kidney beans or lentils, cheese, tomatoes, carrots, asparagus with Italian dressing (1/4 cup) and 12-15 wheat crackers and Diet Pepsi or Sandwich with lunchmeat, cheese and chips PM: Some type of meat with pasta or potatoes and a variety of vegetables and some type of bread or roll with butter. Snacks: Ice cream, cake or cookies, usually each night but lately has been trying sugar free cookies to help with weight loss. Drinks wine or beer 2-3 times per week.
1- What is inflammatory bowel disease? What does your textbook indicate regarding its etiology? (use page numbers from textbook as reference and as part of your answer) (4)
2. Before Terryâs IBS diagnosis, Terry searched his symptoms on Google and he thought he had ulcerative colitis or Crohnâs. How could this happen? What are the similarities and differences between IBS, Crohnâs disease and ulcerative colitis? Use textbook page references with your answer(4)
3. Which of Terryâs laboratory values indicate the presence of inflammation? (4)
4. What would be the primary nutrition concerns for Mr. Page? (3)
5. Prepare a food plan that may help with Terryâs IBS symptoms (6)
6. What is standard treatment for Terryâs diarrhea & abdominal pain with IBS? (4)
Terry Page is a 42 year old male who presents to an outpatient GI clinic with stomach pain and intestinal complaints. Terry has had both diarrhea and constipation for many years. Ht: 5â8â Wt: 294lbs. Medical History: GERD, obesity, Colonoscopy was negative Diagnosis: IBS Medications: Omeprazole 5o mg BID (proton pump inhibitor) ; Vitamin D 600 IU; 800 mg calcium; Lomotil PRN (for diarrhea), Metamucil 1 Tbsp in 8 oz liquid BID Labs: Negative for stool cultures (bacteria). Significant labs from CBS, CMP: FBG = 115; Cholesterol = 201; LDL- C = 155; HDL-C = 32; Triglycerides = 181; HbA1c = 6.1; Diet History: Terry has a good appetite even with abdominal pain and diarrhea. He has gained 20 pounds in the past 5 years. He does not seem to find any foods that trigger diarrhea more than others but notices increased gas with broccoli or cauliflower. AM: Yogurt smoothie with 1 cup fresh fruit (peaches and cherries) with 8 oz low fat yogurt or dry cereal with dried fruit, nuts mixed with yogurt and 2-3 cups of coffee with half & half and artificial sweetener. Mid-morning: Diet Pepsi, ½ cup dried fruit and nuts Lunch: Salad with kidney beans or lentils, cheese, tomatoes, carrots, asparagus with Italian dressing (1/4 cup) and 12-15 wheat crackers and Diet Pepsi or Sandwich with lunchmeat, cheese and chips PM: Some type of meat with pasta or potatoes and a variety of vegetables and some type of bread or roll with butter. Snacks: Ice cream, cake or cookies, usually each night but lately has been trying sugar free cookies to help with weight loss. Drinks wine or beer 2-3 times per week.
1- What is inflammatory bowel disease? What does your textbook indicate regarding its etiology? (use page numbers from textbook as reference and as part of your answer) (4)
2. Before Terryâs IBS diagnosis, Terry searched his symptoms on Google and he thought he had ulcerative colitis or Crohnâs. How could this happen? What are the similarities and differences between IBS, Crohnâs disease and ulcerative colitis? Use textbook page references with your answer(4)
3. Which of Terryâs laboratory values indicate the presence of inflammation? (4)
4. What would be the primary nutrition concerns for Mr. Page? (3)
5. Prepare a food plan that may help with Terryâs IBS symptoms (6)
6. What is standard treatment for Terryâs diarrhea & abdominal pain with IBS? (4)
