Irritable Bowel Syndrome (IBS)

The proposed case will discuss irritable bowel syndrome. Individualized medical nutrition therapy is critical in the disease management. In this case, the learner will be provided with details to conceptualize the case and will be able to conduct a comprehensive nutrition assessment to evaluate the nutritional status. After identifying and prioritizing nutrition problems, the learner will determine the nutrition diagnoses and write proper statements. Based on the collected data, the learner will develop a nutrition care plan with appropriate goals, interventions, and strategies for monitoring and evaluation. Unspecified-IBS encounter challenges with food as it triggers the symptoms. Thus, the learner will evaluate the nutrient composition of dietary history and provide a substitute considering individual tolerance and severity of the symptoms. In addition, FODMAP will be applied. It also teaches patients what foods or eating patterns would be best (or best to avoid) for their day-to-day activities through self-awareness of symptoms and dietary food log.

Lactose Intolerance

This chapter presents a case scenario of lactose intolerance. Lactose intolerance is the inability to digest and absorb lactose, which is the sugar in milk, due to deficiency of the enzyme lactase. This condition commonly occurs after weaning, and it results in various gastrointestinal symptoms such as diarrhea. In addition, it may result in nutritional deficiencies. Management of lactose intolerance requires diet manipulations. This case study provides the needed information to implement the appropriate intervention such as patient's details and case history. Moreover, the case analysis section discusses in detail the disease pathophysiology and the medical nutrition therapy goals. This comprehensive analysis will allow the dietetic professional to follow the nutrition care process (NCP) framework (assessment, diagnosis, intervention, and monitoring and evaluation) to properly intervene and deal with the case. This case study will show the importance of the medical nutrition therapy for the management of lactose intolerance.

Celiac Disease

This chapter reveals and discusses a case involving celiac disease (CD). CD is a common, lifelong, genetically-based autoimmune disorder that causes inflammation of the proximal small intestine. This disease is triggered by eating foods containing gluten, which causes intestinal discomfort. Gluten is a protein that is found naturally in wheat, barley, and rye and is common in foods such as bread, pasta, cookies, and cakes. Many pre-packaged foods, lip balms and lipsticks, hair and skin products, toothpaste and vitamin and nutrient supplements contain gluten, although it is rarely found in medicine. The key to living with CD is to follow a gluten-free diet. This case shows the role of medical nutrition therapy in managing and preventing the undesirable symptoms of CD. Moreover, it allows dietetic professionals to assess celiac patients' conditions and provide them with relief from undesirable symptoms, while also establishing an effective follow-up plan with each patient.

Diarrhea/Constipation

This chapter will discuss a case of diarrhea/constipation. Diarrhea and constipation are functional bowel disorders (FBDs) of the mid or lower gastrointestinal (GI) tract. These FBDs result from intestinal motility dysfunction and/or changes in intestinal fluid absorption, which in turn leads to bloating, discomfort, and occasionally, abdominal pain. Certain dietary choices aggravate these conditions, leading to serious complications. Management of diarrhea/constipation usually requires the use of medications and/or lifestyle modifications. The presently discussed case involved factors that exacerbated the conditions of diarrhea/constipation. This case serves as an example of the role of medical nutrition therapy in managing FBDs (particularly diarrhea and constipation). Moreover, this case will allow the dietetic professional to assess the causes of diarrhea/constipation in order to plan for the nutrition intervention and educate the patient about the dietary manipulations required to reduce their symptoms.

Peptic Ulcer Disease

This chapter will discuss a peptic ulcer disease (PUD) case. PUD is a common gastrointestinal tract disease (GIT) that affects the stomach and duodenum. It is characterized by deep lesions into the mucosal thickness. Various dietary and behavioral choices could aggravate the epigastric pain associated with PUD and interfere with the healing process leading to complications. Management of PUD includes medical treatment with medications along with behavioral and nutritional changes. This case presents a complication of PUD, and choices exacerbating the condition. It will also discuss the role of medical nutrition therapy in minimizing the symptoms and promoting ulcer healing. Additionally, it will allow the dietetic professional to methodically assess the elements in the case that are relevant for planning the nutrition intervention; in addition to, educating the patient about dietary modifications to improve the patient's quality of life.

Inflammatory Bowel Diseases (Crohn's Disease)

The case study presented in this chapter is related to Crohn's disease (CD). CD is a type of inflammatory bowel diseases (IBD) affecting both small and large bowels. Several factors are involved in the aetiopathogenesis of CD. Individuals diagnosed with CD will typically experience periods of relapse and remission. Therefore, the main aim of medical therapy in CD is to induce and maintain remission. The case presented in this chapter will demonstrate the role of medical nutrition therapy in a recently diagnosed patient with CD who was admitted with abdominal pain for 6 weeks and acute flare for the disease, which is complicated by weight loss. Overall, the case study will assist the practice of clinical dietitians who are dealing with IBD patients. Mainly, it will allow them to assess the symptoms and associated nutritional complications of CD, and develop a nutrition support intervention plan. Also, it will support the process of patient's education for dietary modification to help alleviate the symptoms in CD.

Pediatric Ulcerative Colitis With Extra Intestinal Manifestations

Pediatric gastroenterology practitioners adopted different guidelines that focus on high-quality nutrition care for rare disorders such as inflammatory bowel disease in its two main forms: Crohn's disease and ulcerative colitis. This chapter presents a case report of ulcerative colitis with extra intestinal manifestations in the form of right knee arthritis and hypo-chromic microcytic anemia in a 13 years old Egyptian boy who presented to the outpatient services with complains of frequent attacks of right knee pain and swelling, nausea, decreased appetite and food intake, along with significant weight loss. Attacks of diarrhea associated with abdominal cramping and progressive fatigue was reported at the first visit. The authors of this case chapter aimed to share their experience in diagnosing, managing and systematically follow up a pediatric ulcerative colitis patient. The chapter refers to a comprehensive management of the patient's disease who was effectively managed by an integrated multidisciplinary approach.

Dysphagia and Considerations for Nutritional Intervention

This chapter discusses a clinical case from the interdisciplinary practice of dysphagia and the collaboration between speech-language pathology clinicians and dietetics professionals from the perspective of the speech-language pathologist. The discussion begins with an introduction to the normal swallowing process to better understand disordered swallowing and the role of therapeutic and compensatory interventions. Changes in swallowing that occur with normal aging and their impact are identified and reviewed. Common interventions and considerations in the clinical management of dysphagia from the perspective of the speech-language pathologist are included with rationale based on the current literature. Swallowing motor functions and factors in dysphagia decision making are discussed in relationship to clinical problem solving with a sample case and nutritional interventions. The chapter closes with general recommendations and conclusions to assist in learning and understanding of the concepts discussed.

The Positive Impact of Weight Management on Liver Cirrhosis

Weight management offers patients with liver cirrhosis significant health benefits. This case study describes the treatment of liver cirrhosis through dietary interventions. A 48-year-old male presented at Doctor Soliman Fakeeh Hospital in Saudi Arabia, Jeddah. The patient was suffering from morbid obesity (BMI= 43.76 kg/m2), non-alcoholic steatohepatitis, and chronic hepatitis B viral infection. Sleeve gastrectomy surgery was not possible due to the patient having liver fibrosis (stage 4). Alternatively, he was offered a healthy lifestyle intervention involving advisement regarding dietary habits and the initiation of a regular exercise routine. FibroScan was repeated seven months after the dietary intervention, where it was observed that the liver fibrosis improved from stage 4 to stage 3 post-treatment. Additionally, the patient lost almost 29% of his original body weight. In this case, weight management through following a healthy, balanced diet and increasing physical activity for one year produced remarkable improvement in the patient's liver cirrhosis related to non-alcoholic steatohepatitis.

Gastroesophageal Reflux Disease

This chapter discusses a gastroesophageal reflux disease (GERD) case. GERD is a common disorder affecting the gastrointestinal tract. It results from the relaxation of the lower esophageal sphincter, which leads to stomach acid reflux, which in turn causes heartburn and discomfort. Certain lifestyle factors and dietary choices aggravate this condition, leading to serious tissue damage. Management of GERD usually requires medications and lifestyle and dietary modifications. This case involves the symptoms and aggravating factors of GERD. It also shows the role of medical nutrition therapy in managing GERD symptoms. Moreover, it will allow dietetic professionals to assess GERD symptoms to plan for nutrition interventions and educate patients about the dietary manipulation required to reduce gastric acid secretions and relieve pain.