Ann Checker Is A 42 Year Old Female Who Presented To An Outpatient Gastroenterology Clinic Today With Stomach And Intest 1 (589.13 KiB) Viewed 38 times
Ann Checker is a 42 year old female who presented to an outpatient gastroenterology clinic today with stomach and intestinal complaints. She has had diarrhea and constipation for many years. Reports diarrhea is much worse now and it is interfering with her life. . • Present Medical History: Obesity, GERD • Medications: Omeprazole 50 mg BID, Vitamin D 60010 daily, Calcium 800 mg, Lomotil PRN • Alcohol Use: 1 drink, 2 to 3 times per week. Not a smoker. Family History: Father- hypertension, atherosclerosis. Mother/ sister: hypothyroidism, type 2 diabetes • Pertinent Labs: Glucose 115 mg/dl. Hemoglobin A1c 6.4%. Cholesterol 200 mg/dl. • Social History: Patient is divorced, has 2 kids (ages 12 and 14). Kindergarten teacher. Caucasian. Anthropometrics: Height: 5'5" Weight: 191# • Blood Pressure: 120/72 Nutrition history: Patient reports good appetite even with abdominal pain and diarrhea for years. She has gained more than 20 pounds since her last pregnancy. She likes most foods-cooks mostly at home. Reports she has been trying to follow a high fiber diet do that it might help with her symptoms. She asks if yogurt intake will provide enough probiotics as she heard she needs to balance the bacteria in her intestines. She admits that she is not sure what that means. She says doctor has referred her for dietary modifications for IBS. Usual intake: Ann shared the following typical intake: . . Morning: Homemade yogurt smoothie with 1C fresh fruit (peaches and cherries) + 8 ounces yogurt or dry cereal with dried fruit, mixed nuts, and yogurt; 2-3C coffee with half and half and artificial sweetener Mid-morning: diet pepsi, 1/2 C fruit and nuts. • Lunch: Salad with kidney beans or lentils, cheese, tomatoes, carrots, asparagus, wheat crackers- ~12-15, diet pepsi • Dinner: Some type of meat-mostly chicken; pasta or potatoes, variety of vegetables, bread/roll with butter. • Snacks: ice cream, cakes, cookies- usually each night but has been trying to eat sugar free candies to help with weight loss. One glass of wine or beer 2 to 3 times per week.
In addition to identifying food intolerances, medical nutrition therapy for IBS includes small frequent meals. Select one: O True O False
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