Question

Case Study #7

Mr. Max is a 38-year-old male who has been diagnosed with GERD. Testing revealed he has a narrowing of his esophagus from the GERD. His symptoms consisted of food (even though chewed thoroughly) getting caught in his throat, and frequent and severe heartburn about 1 hour after eating. He also complained of some pain in and around his jaw and neck. Mr. Max is 5 feet 8 inches tall and weighs 215 lbs. Mr. Max has been started on a proton pump inhibitor per his physician

1. What are some appropriate nutritional recommendations for Mr. Max?

2. When Mr. Max had his colonoscopy, it was noted that he has diverticulosis. What nutritional recommendations would be appropriate for him? What recommendations should he be given to avoid constipation?

Answer 1

1.

• Avoid High fat foods, Caffeine, Chocolate, Onions, Peppermint, Carbonated beverages, Alcohol, Citrus and tomato products.
• Add non-citrus fruits such as bananas, melons, apples, and pears among others.
• Choose lean meats that are grilled, poached, broiled, or baked and egg whites
• Oatmeal, whole grain bread, rice, and couscous are good sources of healthy complex carbs. Whole grains and brown rice add fiber to your diet.
• Replace saturated fats with unsaturated ones like oils of olive, sesame, canola, and sunflower; avocados; peanuts and peanut butter; and many nuts and seeds; soybeans and tofu; and fatty fish such as salmon and trout.
• Potatoes and other root vegetables are great sources of healthy carbs and digestible fiber. and avoid adding onion and garlic during preparation.

• Sit up while eating and avoid lying flat for a minimum of two hours after eating a meal. Standing up and walking around after a meal helps encourage gastric juices to flow in the right direction.

• Avoid eating just before the bed time. Have dinner 2 hours before bedtime.

2. Diverticulosis is formation of small, bulging pouches (diverticuli) form inside the lower part of the intestine, usually in the colon. Constipation and straining during bowel movements can worsen the condition.

To prevent constipation and soften the stool a diet rich in fiber can help.

High-fiber foods include:

• Beans and legumes
• Bran, whole wheat bread and whole grain cereals such as oatmeal
• Brown and wild rice
• Fruits such as apples, bananas and pears
• Vegetables such as broccoli, carrots, corn and squash
• Whole wheat pasta

Eat 25 to 30 grams of fiber daily.

If the foods are not enough for sufficient fiber, add fiber supplements to the diet.

Drink at least 8 cups of fluid daily. Fluid will help soften your stool.

Exercise also promotes bowel movement and helps prevent constipation.