Question

Case Study #4 – GI Disorders

Patient History

Lisa A. is a 45 year old working in pharmaceutical sales who has been suffering from frequent and severe heartburn, especially at night when trying to sleep. She has been recently diagnosed with GERD. She is 5’4” and currently weighs 185 lbs. Her job requires her to travel frequently and to regularly entertain clients at dinner. When on the road, she relies on restaurants and fast food for her meals. The following represents a “usual” diet recall for Lisa:

7:00am           20oz. coffee with cream and sugar; Chocolate chip muffin with 1 pat butter

9:30am           12oz. coffee with cream and sugar

1:00pm           double bacon cheeseburger; small French fries with ketchup; medium coke

3:00pm           Snickers bar; 12oz. coffee with cream and sugar

9:00pm           12 oz. steak; 1 cup creamed spinach; French fries; 2 glasses (7oz.) red wine

11:00pm         8 oz. peppermint tea

Assignment

1. Calculate Lisa’s BMI and discuss how this might relate to her diagnosis of GERD.

2. List specific dietary/behavioral issues that may be exacerbating Lisa’s frequent heartburn.

3. Discuss specific strategies you would recommend to Lisa to reduce or eliminate her frequent heartburn.

4. Modify her usual diet recall to reflect your dietary strategies which address her frequent heartburn.

Answer 1

Lisa's BMI - 32.0 - Obese. Obesity is one of the contributing factor GERD.

The causes for Lisa's frequent heart burn are her dietary pattern includes the coffee, chocolate, fatty products such as butter, cheese burger, fried items, peppermint tea - these all items induces the GERD symptoms.

Strategies to reduce or eliminate frequent heart burn

• Maintain healthy weight
• Avoid symptoms triggering food items such as beverages, chocolates, fatty food items, fried items, Peppermint, citrus fruits
• Elevate head end of the bed while lying down.
• Wait atleast 3 hours after taking food, for go to bed.
• Avoid overeat at a time.
• A walk for a little time after taking food may helpful reduce the symptoms.
• Eat slowly.
• Avoid restaurant food as much as possible. Eat home made food items.
• Maintenance proper sleep. avoidance of stress.
• If have smoking habit, quit it.

Model Meal plan

Breakfast - 2 slices whole wheat bread, 1/2 cup low fat milk, 1/2 apple or any fruit, 1 cup cereals.

Morning snack- Grape juice or papaya juice or any fruit juice except symptoms triggering fruits- 1cup

Lunch- 1/2 cup cooked pasta, 1 cup raw carrot slices or cucumber slices, 1 egg, 1- slice bread

Afternoon snacks- Fat free milk - 1cup, 2 cups popcorn

Dinner- 5 cups cooked legumes, 1 banana