Nutrition & Foodservice Edge Magazine - March/April 2024 - 14

DEEP DIVE: DISEASES OF THE
DIGESTIVE SYSTEM
enzymes, insulin, or certain
medications that will take
effect by the time the food
enters the stomach, so meal
and medication timing is
critical.
WE HAVE LIBERALIZED
AND SIMPLIFIED OUR
DIET ORDERS,
chyme (chemical digestion).
The stomach also churns
(mechanical digestion) at this
stage, moving the chyme down
into the small intestine. It is
important to note that the
chicken (protein) and mayo
& dressing (fat) stay in the
stomach the longest, as the bun
(carbohydrate) digestion has
already begun in the mouth.
The fibers in the carrots,
tomato, lettuce, and apple are
still moving down the tract.
but our clients' nutrition
habits have become more
sophisticated. Knowing
and honoring each one of
their diet preferences is an
important task!
Accessory organs including
the liver, pancreas, and
gallbladder are important
team members of the GI
system. When our lunch
makes it to the stomach and
leaves to the small intestine,
the pancreas gets a phone
call to release insulin to
assist the glucose into our cells. Let's say
we skipped this delicious lunch and our
body needed some energy. In this case,
our liver gets a call to release glycogen.
The pancreas also releases enzymes and
other hormones necessary for metabolic
processes. Diseases in these accessory
organs include gallbladder disease (or
no gallbladder after a cholecystectomy),
pancreatitis, type 1 diabetes, cirrhosis
of the liver, and fatty liver. Nutrition
therapy is critical and individualized for
these disease states.
Disease states that can impact the digestive function of the
stomach include gastroparesis (delayed gastric emptying
sometimes caused by uncontrolled diabetes), stomach
ulcers, food intolerances, and irritable bowel syndrome
(IBS) to name just a few. Nutrition therapy and therapeutic
diets for the aforementioned disease states are to be
individualized and consistent. You have probably witnessed
an anxious person with IBS eating a meal in public worried
about the food causing them an emergency trip to the
restroom. It is an important part of our job to provide foods
that will not trigger their bowel problems, even if they do not
have a diet order related to it. Thankfully, with the evolution
of culture change due to CMS mandates, we have liberalized
and simplified our diet orders, but our clients' nutrition
habits have become more sophisticated. Knowing and
honoring each one of their diet preferences is an important
task! If your client has gastroparesis, or delayed gastric
emptying, offer small meals more often that are low-fat and
low-fiber (Zikmund). Your client may also be on digestive
By the time your food leaves the stomach, your
macronutrients (carbohydrate, protein, fat) have been
broken down into elemental (tiny) components of glucose,
amino acids, and lipids. Vitamins, minerals, and water
continue on down the line as well into the small intestine.
The small intestine measures in at a whopping 22 feet long
(Zikmund). In my community college nutrition class, a
favorite lesson is 'building the GI tract.' The small intestine
group gets to cut a thick piece of fuzzy yarn and show
how long it is. The class is amazed that it spans the entire
classroom! The inner lining of the small intestine has
fingerlike projections called villi. This is when I encourage
people to hold up their hands, turn their fingers towards
each other, and wiggle them around. Those wiggly fingers
are like the villi, " sucking " the tiny nutrients into the
bloodstream for absorption. A disease state that affects
these villi is celiac disease, an autoimmune disorder that
14 NUTRITION & FOODSERVICE EDGE | MARCH-APRIL 2024
Nutrition & Foodservice Edge Magazine - March/April 2024

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