0 stringlengths 12 494 | embeddings listlengths 384 384 |
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measures\tto\tbe\taccomplished\tin\tthe\tsmall\tbowel\tvia\tcapsule\tendoscopy.\nThe\tincidence\tand\tnumber\tof\tsurgical\tprocedures\trelated\tto\tpeptic\tulcers\thas\tdecreased\tmarkedly\nin\tthe\tpast\t3\tdecades\tbecause\tof\trecognition\tof\tsymptoms\tand\trisk\tfactors,\tand\tearlier\tscreening\tfor\nH.\tpylori | [
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H.\tpylori\n.\tUncomplicated\tpeptic\tulcers\tin\teither\tthe\tgastric\tor\tduodenal\tregion\tmay\tpresent\twith\nsigns\tsimilar\tto\tthose\tassociated\twith\tdyspepsia\tand\tgastritis.\nAbdominal\tdiscomfort\tis\tthe\tmost\tcommon\tsymptom\tof\tpeptic\tulcers\tand\tcan\tbe\tfelt\tanywhere | [
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between\tthe\tnavel\tand\tthe\tbreastbone.\tThis\tdiscomfort\tis\tusually\tdescribed\tas\ta\tdull\tor\tburning\tpain\nthat\toccurs\twhen\tthe\tstomach\tis\tempty\t(between\tmeals\tor\tduring\tthe\tnight),\tand\tmay\tbe\tbriefly\nrelieved\tby\teating\tfood,\tin\tthe\tcase\tof\tduodenal\n\tulcers,\tor\tby\ttaking\tantaci... | [
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ulcers,\tor\tby\ttaking\tantacids.\tIn\tboth\ttypes\tof\tpeptic\nulcers,\tthe\tsymptoms\tlast\tfor\tminutes\tto\thours\tand\tcome\tand\tgo\tfor\tseveral\tdays\tor\tweeks.\tOther\nsymptoms\tinclude\tbloating,\tburping,\tnausea,\tvomiting,\tpoor\tappetite,\tand\tweight\tloss.\tSome\tpeople\nexperience\tonly\tmild\tsympto... | [
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0.00837501... |
experience\tonly\tmild\tsymptoms\tor\tnone\tat\tall.\nPeptic\tulcers\talso\tmay\thave\t“emergency\tsymptoms,”\tin\twhich\tmedical\tassistance\tshould\tbe\tsought\nimmediately.\n\tThese\tinclude\tsharp,\tsudden,\tpersistent,\tand\tsevere\tstomach\tpain,\tbloody\tor\tblack\nstools\t(\nmelena\n),\tbloody\tvomit\t(hemateme... | [
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symptoms\tcould\tbe\tsigns\tof\ta\tserious\tproblem,\tsuch\tas:\n•\t\nAcute\tor\tchronic\tGI\tbleed:\twhen\tacid\tor\ta\tpeptic\tulcer\tbreaks\ta\tblood\tvessel.\n•\t\nGI\tperforation:\twhen\ta\tpeptic\tulcer\tburrows\tcompletely\tthrough\tthe\tstomach\tor\tduodenal\nwall,\tpotentially\tpenetrating\tan\tadjacent\torgan... | [
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0.05786766111... |
wall,\tpotentially\tpenetrating\tan\tadjacent\torgan\t(e.g.,\tpancreas)\n•\t\nGI\tobstruction:\twhen\ta\tpeptic\tulcer\tblocks\tthe\tpath\tof\tfood\ttrying\tto\tleave\tthe\tstomach. | [
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If\tor\twhen\tthese\tproblems\toccur,\timmediate\tmedical\tattention\tis\tnecessary,\tas\tcomplications\tof\nhemorrhage\tand\tperforation\tcontribute\tsignificantly\tto\tthe\tmorbidity\tand\tmortality\tof\tpeptic\tulcers.\nGastric\tversus\tduodenal\tulcers\nPathophysiology\nAlthough\tgastric\tulcers\tcan\toccur\tanywhe... | [
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(\nFig.\t26.5\n).\t\nGastric\tulcers\n\ttypically\tare\tassociated\n\twith\twidespread\tgastritis,\tinflammatory\ninvolvement\tof\tparietal\tcells,\tand\tatrophy\tof\tacid-\tand\tpepsin-producing\tcells\toccurring\twith\nadvancing\tage.\tIn\tsome\tcases,\tgastric\tulceration\tdevelops\tdespite\trelatively\tlow\tacid\to... | [
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0.026... |
hypomotility,\tgastric\tstasis,\tand\tincreased\tduodenal\treflux\tare\tassociated\tcommonly\twith\tgastric\nulcers,\tand\twhen\tpresent,\tmay\tincrease\tthe\tseverity\tof\tthe\tgastric\n\tinjury.\tThe\tincidence\tof\nhemorrhage\tand\toverall\tmortality\tis\thigher\twith\ta\tgastric\tulcer\tthan\ta\tduodenal\tulcer. | [
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FIG.\t26.5\nA,\n\tDiagram\tshowing\ta\tnormal\tstomach\tand\tduodenum;\t\nB,\n\ta\tgastric\tulcer;\t\nC,\n\ta\tduodenal\tulcer.\nA\t\nduodenal\tulcer\n\tis\tcharacterized\tby\tincreased\tacid\tsecretion\tthroughout\tthe\tentire\tday\naccompanied\twith\tdecreased\tbicarbonate\tsecretion.\tMost\tduodenal\tulcers\toccur\t... | [
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0.011... |
centimeters\tof\tthe\tduodenal\tbulb,\tin\tan\tarea\timmediately\tbelow\tthe\tpylorus.\tGastric\toutlet\nobstruction\toccurs\n\tmore\tcommonly\twith\tduodenal\tulcers\tthan\twith\tgastric\tulcers,\tand\tgastric\nmetaplasia\t(e.g.,\treplacement\tof\tduodenal\tvillous\tcells\twith\tgastric-type\tmucosal\tcells)\tmay\tocc... | [
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0.01563165... |
with\tduodenal\tulcer\trelated\tto\t\nH.\tpylori\n.\nMedical\tand\tsurgical\tmanagement\tof\tulcers\nRegardless\tof\tthe\ttype\tof\tulcer,\tthe\tfirst\tintervention\tis\tto\tevaluate\tthe\tpatient\tendoscopically\tand\nresuscitate\tas\tneeded.\tControl\tacute\n\tbleeding\tif\tpresent.\nPeptic\tulcers.\nH.\tpylori | [
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bleeding\tif\tpresent.\nPeptic\tulcers.\nH.\tpylori\n\tis\tthe\tprimary\tcause\tof\tgastritis\tand\tpeptic\tulcers,\tthus\tits\tdiagnosis\tif\tpresent,\tand\ntreatment,\tshould\tbe\tthe\tfirst\tmedical\tintervention.\tAt\tthe\tfirst\tendoscopy,\tdiagnostic\tbiopsies\tshould\nbe\ttaken\tfor\t\nH.\tpylori\n.\tTreatment\t... | [
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H.\tpylori\n\tinfection\tentails\teradication\tof\tthis\torganism\twith\tthe\nappropriate\tantibiotic\tand\tacid-suppressive\tregimen.\n\tAlthough\tsurgical\tintervention\tis\tless\nprevalent,\temergent\tand\telective\tprocedures\tand\tsurgeries\tare\tstill\trequired\tfor\tpeptic\tulcer | [
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complications.\tInterventions\tcan\trange\tfrom\tendoscopic,\topen,\tand\tlaparoscopic\tprocedures\tto\ttreat\nindividual\tlesions,\tto\tpartial\tgastrectomy\tand\toccasionally\tselective\tvagotomies.\nStress\tulcers.\nStress\tulcers\n\tmay\toccur\tas\ta\tcomplication\tof\tmetabolic\tstress\tcaused\n\tby\ttrauma,\tburn... | [
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by\ttrauma,\tburns,\tsurgery,\nshock,\trenal\tfailure,\tor\tradiation\ttherapy.\tA\tprimary\tconcern\twith\tstress\tulceration\tis\tthe\tpotential\nfor\tsignificant\tGI\themorrhage.\tGastric\tischemia\tassociated\twith\tGI\thypoperfusion,\toxidative\tinjury,\nreflux\tof\tbile\tsalts\tand\tpancreatic\tenzymes,\tmicrobia... | [
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have\tbeen\timplicated.\tAlthough\tstress\tulcerations\tusually\toccur\n\tin\tthe\tfundus\tand\tbody\tof\tthe\nstomach,\tthey\talso\tmay\tdevelop\tin\tthe\tantrum,\tduodenum,\tor\tdistal\tesophagus.\tTypically\tshallow,\nand\tcausing\toozing\tof\tblood\tfrom\tsuperficial\tcapillary\tbeds,\tstress\tulcer\tlesions\talso\... | [
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deeper,\teroding\tinto\tthe\tsubmucosa,\tcausing\tmassive\themorrhage\tor\tperforation.\nStress\tulcers\tthat\tbleed\tcan\tbe\ta\tsignificant\tcause\tof\tmorbidity\tin\tthe\tcritically\till\tpatient\n\t(see\nChapter\t37\n).\tAlthough\tcurrent\tprevention\tand\ttreatment\tinclude\tsucralfate,\tacid\tsuppressants,\tand | [
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antibiotics\tas\tneeded,\thigh-quality\tevidence\tto\tguide\tclinical\tpractice\tin\teffective\ttreatments\tis\nlimited.\tEfforts\tto\tprevent\tgastric\tulcers\tin\tstressed\tpatients\thave\tfocused\ton\tpreventing\tor\tlimiting\nconditions\tleading\tto\thypotension\tand\tischemia\tand\tcoagulopathies.\tAvoiding\tNSAID... | [
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doses\tof\tcorticosteroids\tis\talso\tbeneficial.\nProviding\toral\tor\tenteral\tfeeding,\twhen\tpossible,\tincreases\tGI\tvascular\tperfusion\tand\tstimulates\nsecretion\tand\tmotility.\tA\tmeta-analysis\tof\tstudies\tin\tcritically\till\tpatients\tthat\treceived\tan\tH\n2\n-receptor | [
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2\n-receptor\nantagonist\tfor\tstress\tulcer\tprevention\tfound\tthis\ttherapy\tto\tbe\tpreventative\tonly\tin\tpatients\twho\tdid\nnot\treceive\tenteral\tfeeding.\tIn\tfact,\tfor\tpatients\n\treceiving\tenteral\tfeeding,\tH\n2\n-receptor\tantagonist\ntherapy\tmay\tincrease\tthe\trisk\tof\tpneumonia\tand\tdeath\t(\nCha... | [
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Chanpura\tand\tYende,\t2012\n).\tFurther\nresearch\tis\tneeded\tto\tprospectively\ttest\tthe\teffect\tof\tenteral\tfeeding\ton\tthe\trisk\tof\tstress\tulcer | [
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prophylaxis.\nMedical\tnutrition\ttherapy\nIn\tpersons\twith\tatrophic\tgastritis,\tvitamin\tB\n12\n\tstatus\tshould\tbe\tevaluated\tbecause\tlack\tof\tintrinsic\nfactor\tand\tgastric\n\tacid\tresults\tin\tmalabsorption\tof\tthis\tvitamin\t(see\t\nChapter\t31\n).\tLow\tacid\tstates\tmay\ninfluence\tabsorption\tof\tiron... | [
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bioavailability.\tIn\tthe\tcase\tof\trefractory\tiron\tdeficiency\tanemia,\tother\tcauses\tmay\tbe\tthe\tpresence\tof\nH.\tpylori\n\tand\tgastritis.\tEradication\tof\t\nH.\tpylori\n\thas\tresulted\tin\timproved\tabsorption\tof\tiron\tand\nincreased\tferritin\tlevels\n\t(\nHershko\tand\tCamaschella,\t2014\n). | [
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increased\tferritin\tlevels\n\t(\nHershko\tand\tCamaschella,\t2014\n).\nFor\tseveral\tdecades\tdietary\tfactors\thave\tgained\tor\tlost\tfavor\tas\ta\tsignificant\tcomponent\tin\tthe\ncause\tand\ttreatment\tof\tdyspepsia,\tgastritis,\tand\tpeptic\tulcer\tdisease.\tThere\tis\tlittle\tevidence\tthat | [
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0.0088882... |
specific\tdietary\tfactors\tcause\tor\texacerbate\tgastritis\tor\tpeptic\tulcer\tdisease.\tProtein\tfoods\ntemporarily\tbuffer\tgastric\tsecretions,\tbut\tthey\talso\tstimulate\tsecretion\n\tof\tgastrin,\tacid,\tand\tpepsin.\nMilk\tor\tcream,\twhich\tin\tthe\tearly\tdays\tof\tpeptic\tulcer\tmanagement\twas\tconsidered\... | [
0.030307939276099205,
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0.04831116646528244,
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0.0416472... |
coating\tthe\tstomach,\tis\tno\tlonger\tconsidered\tmedicinal.\nThe\tpH\tof\ta\tfood\thas\tlittle\ttherapeutic\timportance,\texcept\tfor\tpatients\twith\texisting\tlesions\tof\tthe\nmouth\tor\tthe\tesophagus.\tMost\tfoods\tare\tconsiderably\tless\tacidic\tthan\tthe\tnormal\tgastric\tpH\tof\t1\tto\n3.\tThe\tpH\tof\toran... | [
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3.\tThe\tpH\tof\torange\n\tjuice\tand\tgrapefruit\tis\t3.2\tto\t3.6,\tand\tthe\tpH\tof\tcommonly\tused\tsoft\tdrinks\nranges\tfrom\tapproximately\t2.8\tto\t3.5.\tOn\tthe\tbasis\tof\ttheir\tintrinsic\tacidity\tand\tthe\tamount\nconsumed,\tfruit\tjuices\tand\tsoft\tdrinks\tare\tnot\tlikely\tto\tcause\tpeptic\tulcers\tor\... | [
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with\thealing.\tSome\tpatients\texpress\tdiscomfort\twith\tingestion\tof\tacidic\tfoods,\tbut\tthe\tresponse\tis\tnot\nconsistent\tamong\tpatients,\n\tand\tin\tsome,\tsymptoms\tmay\tbe\trelated\tto\theartburn.\tThe\tdietary\ninclusion\tof\t“acidic\tfoods”\tshould\tbe\tindividualized\tbased\ton\tthe\tpatient’s\tpercepti... | [
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0.006229673977941275,
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0.... |
Consumption\tof\tlarge\tamounts\tof\talcohol\tmay\tcause\tat\tleast\tsuperficial\tmucosal\tdamage\tand\tmay\nworsen\texisting\tdisease\tor\tinterfere\twith\ttreatment\tof\tthe\tpeptic\tulcer.\tModest\tconsumption\tof\nalcohol\tdoes\tnot\tappear\tto\tbe\tpathogenic\n\tfor\tpeptic\tulcers\tunless\tcoexisting\trisk\tfacto... | [
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0.03582684323191643,
0.1121586486697197,
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0.020898815244436264,
0.01646213... |
for\tpeptic\tulcers\tunless\tcoexisting\trisk\tfactors\tare\talso\npresent.\tOn\tthe\tother\thand,\tbeers\tand\twines\tsignificantly\tincrease\tgastric\tsecretions\tand\tshould\tbe\navoided\tin\tsymptomatic\tdisease.\nCoffee\tand\tcaffeine\tstimulate\tacid\tsecretion\tand\talso\tmay\tdecrease\tLES\tpressure;\thowever,\... | [
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0.07925469428300858,
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0.07566852867603302,
0.09879925847053528,
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0.0174700990319252,
0.009823... |
has\tbeen\tstrongly\timplicated\tas\ta\tcause\tof\tpeptic\tulcers\toutside\tof\tthe\tincreased\tacid\tsecretion\tand\ndiscomfort\n\tassociated\twith\ttheir\tconsumption.\nWhen\tvery\tlarge\tdoses\tof\tcertain\tspices\tare\tfed\torally\tor\tplaced\tintragastrically\twithout\tother\nfoods,\tthey\tincrease\tacid\tsecretio... | [
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0.0188299... |
the\tmucosal\tlining,\tand\taltered\tGI\tpermeability\tor\tmotility.\tSmall\tamounts\tof\tchili\tpepper\tor\tits\nactive\tcomponent,\tcapsaicin,\tmay\tincrease\tmucosal\tprotection\tby\tincreasing\n\tproduction\tof\tmucus.\nThe\tburning\tsensation\tin\tthe\tgut\twhen\tcapsaicin\tis\tconsumed\tis\tdue\tto\ttransient\tre... | [
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0.0939278453... |
vanilloid-1\t(TRPV1)\treceptors\tthroughout\tthe\tGI\ttract,\tand\trepeated\texposure\tcan\tdesensitize\tthe\nreceptor.\tLarger\tamounts\tof\tcapsaicin\tmay\tnot\tbe\tas\twell\ttolerated\tand\tcould\tcause\tsuperficial\nmucosal\tdamage,\tespecially\twhen\tconsumed\twith\talcohol,\tas\tTRPV1\treceptors\tcan\n\talso\tbe\... | [
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0.12279501557350159,
-0.007157417945563793,
0.07035178691148758,
-0.... |
by\tethanol\t(\nPatcharatrakul\tand\tGonlachanvit,\t2016\n).\tAnother\tspice,\tcurcumin,\tthrough\tits\nantiinflammatory\tactivity\tthat\tinhibits\tthe\tNF-κB\tpathway\tactivation\tmay\tbe\ta\tchemopreventive\ncandidate\tagainst\t\nH.\tpylori\n–related\tcancer\t(\nSarkar\tet\tal,\t2016\n)\t(see\t\nChapter\t12\n). | [
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0.080... |
H.\tpylori\n–related\tcancer\t(\nSarkar\tet\tal,\t2016\n)\t(see\t\nChapter\t12\n).\nOverall,\ta\thigh-quality\tdiet\twithout\tnutrient\tdeficiencies\tmay\toffer\tsome\tprotection\tand\tmay\npromote\thealing.\tPersons\n\tbeing\ttreated\tfor\tgastritis\tand\tpeptic\tulcer\tdisease\tshould\tbe\tadvised\tto | [
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avoid\tfoods\tthat\texacerbate\ttheir\tsymptoms\tand\tto\tconsume\ta\tnutritionally\tcomplete\tdiet\twith\nadequate\tdietary\tfiber\tfrom\tfruits\tand\tvegetables.\nCarcinoma\tof\tthe\tstomach\nAlthough\tthe\tincidence\tand\tmortality\thave\tfallen\tdramatically\tover\tthe\tlast\t50\tyears\tin\tmany\tregions,\ngastric\... | [
0.028387868776917458,
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0.06887881457805634,
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gastric\tcancer\tis\tstill\tthe\tsecond\tmost\tcommon\n\tcause\tof\tcancer\tdeath\tworldwide,\twith\tvarying\nincidence\tin\tdifferent\tparts\tof\tthe\tworld\tand\tamong\tvarious\tethnic\tgroups\t(\nNagini,\t2012\n).\tDespite\nadvances\tin\tdiagnosis\tand\ttreatment,\tthe\t5-year\tsurvival\trate\tof\tstomach\tcancer\ti... | [
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0.0... |
Etiology\nThe\tcause\tof\tgastric\tcancer\tis\tmultifactorial,\tbut\tmore\tthan\t80%\tof\tcases\thave\tbeen\tattributed\tto\t\nH.\npylori\n\tinfection.\tIn\taddition,\tdiet,\tlifestyle,\n\tgenetic,\tsocioeconomic,\tand\tother\tfactors\tcontribute\tto\ngastric\tcarcinogenesis.\tA\tWestern\tdiet,\thigh\tin\tprocessed\tme... | [
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0.02158... |
associated\twith\tan\tincreased\trisk\tof\tgastric\tcancer\tcompared\twith\ta\tdiet\thigh\tin\tfruits\tand\nvegetables\t(\nBertuccio\tet\tal,\t2013\n).\tOther\tfactors\tthat\tmay\tincrease\tthe\trisk\tof\tgastric\tcancer\tinclude\nalcohol\tconsumption,\texcess\tbody\tweight,\tsmoking,\n\tintake\tof\thighly\tsalted\tor\... | [
0.008712098002433777,
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0.03200877085328102,
0.010371... |
intake\tof\thighly\tsalted\tor\tpickled\tfoods,\tor\ninadequate\tamounts\tof\tmicronutrients.\tCertain\tcooking\tpractices\talso\tare\tassociated\twith\tincreased\nrisk\tof\tgastric\tcancer,\tincluding\tbroiling\tof\tmeats,\troasting,\tgrilling,\tbaking,\tand\tdeep\tfrying\tin\topen\nfurnaces,\tsun\tdrying,\tsalting,\t... | [
0.020017752423882484,
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0.07642924785614014,
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0.05586408078670502,
-0.026... |
carcinogenic\tN-nitroso\tcompounds.\tPolycyclic\taromatic\n\thydrocarbons\tsuch\tas\tbenzo[a]pyrene\nformed\tin\tsmoked\tfood\thave\tbeen\tincriminated\tin\tmany\tareas\tof\tthe\tworld\t(\nNagini,\t2012\n).\nPathophysiology\nStomach\tcancer\trefers\tto\tany\tmalignant\tneoplasm\tthat\tarises\tfrom\tthe\tregion\textendi... | [
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0.07381236553192139,
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0.01379... |
gastroesophageal\tjunction\tand\tthe\tpylorus.\tBecause\tsymptoms\tare\tslow\tto\tmanifest\tthemselves\tand\nthe\tgrowth\tof\tthe\ttumor\tis\trapid,\tcarcinoma\tof\tthe\tstomach\n\tfrequently\tis\toverlooked\tuntil\tit\tis\ttoo\nlate\tfor\ta\tcure.\tLoss\tof\tappetite,\tstrength,\tand\tweight\tfrequently\tprecede\tothe... | [
0.052168507128953934,
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0.06555195897817612,
0.06468422710895538,
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0.03792186826467514,
0.00876... |
cases,\t\nachylia\tgastrica\n\t(absence\tof\tHCl\tand\tpepsin)\tor\t\nachlorhydria\n\t(absence\tof\tHCl\tin\tgastric\nsecretions)\tmay\texist\tfor\tyears\tbefore\tthe\tonset\tof\tgastric\tcarcinoma.\tMalignant\tgastric\tneoplasms\ncan\tlead\tto\tmalnutrition\tas\ta\tresult\tof\texcessive\tblood\tand\tprotein\n\tlosses\... | [
0.03395755961537361,
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0.04459835961461067,
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0.047751534730196,
0.03555... |
because\tof\tobstruction\tand\tmechanical\tinterference\twith\tfood\tintake.\nMedical\tand\tsurgical\tmanagement\nMost\tcancers\tof\tthe\tstomach\tare\ttreated\tby\tsurgical\tresection;\tthus,\tpart\tof\tthe\tnutritional\nconsiderations\tincludes\tpartial\tor\ttotal\t\ngastrectomy\n,\ta\tresection\tor\tremoval\tof\tthe... | [
0.019576136022806168,
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0.08324286341667175,
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0.08592279255390167,
0.08961668610572815,
0.08726809173822403,
0.015107289887964725,
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0.0242... |
gastrectomy\n,\ta\tresection\tor\tremoval\tof\tthe\tstomach.\tSome\npatients\tmay\texperience\tdifficulties\twith\tnutrition\tafter\tsurgery.\nMedical\n\tnutrition\ttherapy\nThe\tdietary\tregimen\tfor\tcarcinoma\tof\tthe\tstomach\tis\tdetermined\tby\tthe\tlocation\tof\tthe\tcancer,\tthe\nnature\tof\tthe\tfunctional\tdi... | [
0.03018982894718647,
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0.05153489112854004,
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0.04907519742846489,
0.03302736580371857,
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0.015591281466186047,
0.08865881711244583,
0.05122090503573418,
0.04219672083854675,
0.032830... |
inoperable\tcancer\tshould\treceive\ta\tdiet\tthat\tis\tadjusted\taccording\tto\ttolerance,\tpreference,\tand\ncomfort.\tAnorexia\tis\talmost\talways\tpresent\tfrom\tthe\tearly\tstages\tof\tdisease.\tIn\tthe\tlater\n\tstages\tof\tthe\ndisease,\tthe\tpatient\tmay\ttolerate\tonly\ta\tliquid\tdiet.\tIf\ta\tpatient\tis\tun... | [
0.037373024970293045,
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0.058685917407274246,
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0.0709942877292633,
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0.012429472990334034,
0.10205990821123123,
0.028886396437883377,
0.024074967950582504,
0.036... |
consideration\tshould\tbe\tgiven\tto\tusing\tan\talternate\troute,\tsuch\tas\ta\tgastric\tor\tintestinal\tenteral\ttube\nfeeding,\tor\tif\tthis\tis\tnot\ttolerated\tor\tfeasible,\tparenteral\tfeeding.\tThe\tnutritional\tsupport\tfor\tthe\npatient\tshould\tbe\tin\taccordance\twith\tthe\tpatient’s\tgoals\tof\tcare\t(see\... | [
0.025628676638007164,
0.009204891510307789,
0.05836081504821777,
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0.03230505436658859,
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0.005240472499281168,
0.1014527678489685,
0.004273468162864447,
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0.069... |
Chapter\t12\n).\nGastric\tsurgeries\nBecause\tof\tincreased\trecognition\tand\ttreatment\tfor\t\nH.\tpylori\n\tand\tacid\tsecretion,\tgastric\tsurgeries\nare\tperformed\tless\tfrequently.\tHowever,\tpartial\tor\ttotal\tgastrectomy\tmay\tstill\tbe\tnecessary\tfor\npatients\twith\tulcer\tdisease\tthat\tdoes\tnot\trespond... | [
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0.04110289737582207,
0.12540075182914734,
0.019339818507432938,
0.02745175175368786,
-0.01360... |
surgeries\tperformed\tfor\tweight\tloss\tor\tbariatric\tsurgeries\tare\tmore\tcommon.\n\tThese\tsurgeries,\tsuch\nas\tRoux-en-Y\tgastric\tbypass,\tgastric\tbanding,\tsleeve\tgastrectomy,\tvertical\tbanding\tgastroplasty,\tand\njejunoileal\tbypass\tare\tdesigned\tto\tinduce\tweight\tloss\tthough\tvolume\trestriction,\tm... | [
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0.07911930978298187,
0.030393404886126518,
0.02521221712231636,
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both\t(see\t\nChapter\t20\n).\nTypes\tof\tsurgeries\nA\ttotal\tgastrectomy\tinvolves\tremoval\tof\tthe\tentire\tstomach,\twhereas\tonly\ta\tportion\tof\tthe\tstomach\tis\nremoved\twith\ta\tsubtotal\tor\n\tpartial\tgastrectomy.\tA\tgastrectomy\tis\taccompanied\tby\ta\treconstructive\nprocedure.\tA\ttotal\tgastrectomy\ti... | [
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stomach.\tThe\ttotal\tstomach\tis\tremoved,\tand\ta\tRoux-en-Y\treconstruction\tis\tperformed\tto\tmaintain\tGI\ntract\tcontinuity.\tWith\ta\t\nRoux-en-Y\n,\tthe\tjejunum\tis\tpulled\tup\tand\tanastomosed\tto\tthe\tesophagus.\tThe\nduodenum\tis\tthen\tconnected\tto\tthe\tsmall\n\tbowel\tso\tthat\tbile\tand\tpancreatic\... | [
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the\tintestine.\t\nBillroth\tI\t(gastroduodenostomy)\n\tinvolves\tremoval\tof\tthe\tpylorus\tand/or\tantrum,\tand\nan\tanastomosis\tof\tthe\tproximal\tend\tof\tthe\tduodenum\tto\tthe\tdistal\tend\tof\tthe\tremnant\tstomach.\tA\nBillroth\tII\t(gastrojejunostomy)\n\tinvolves\tremoval\tof\tthe\tstomach\tantrum\tand\tan\ta... | [
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remnant\tstomach\tto\tthe\tside\tof\tthe\tjejunum,\twhich\n\tcreates\ta\tblind\tduodenal\tloop\t(\nFig.\t26.6\n).\nFIG.\t26.6\nGastric\tsurgical\tprocedures\t[Billroth\tI\t(A:\tpreoperative\tand\tB:\tpostoperative),\tBillroth\tII,\tRoux\ten\tY,\npylorplasty,\tvagotomy].\nThe\t\nvagus\tnerve\n\tis\tresponsible\tfor\tnot... | [
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proximal\tstomach,\ttherefore\ta\t\nvagotomy\n\toften\tis\tperformed\tto\teliminate\tgastric\tacid\tsecretion.\nTruncal\tvagotomy\n,\tcomplete\tsevering\tof\tthe\tvagus\tnerve\ton\n\tthe\tdistal\tesophagus,\tdecreases\tacid\nsecretion\tby\tparietal\tcells\tin\tthe\tstomach\tand\tdecreases\ttheir\tresponse\tto\tthe\thor... | [
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parietal\tcell\tvagotomy\n\t(partial\tor\tselective)\tdivides\tand\tsevers\tonly\tthe\tvagus\tnerve\tbranches\tthat\naffect\tthe\tproximal\tstomach\twhere\tgastric\tacid\tsecretion\toccurs,\twhereas\tthe\tantrum\tand\tpylorus\nremain\tinnervated.\tVagotomy\tat\tcertain\tlevels\tcan\talter\tthe\tnormal\n\tphysiologic\tf... | [
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physiologic\tfunction\tof\tthe\nstomach,\tsmall\tintestine,\tpancreas,\tand\tbiliary\tsystem.\tVagotomy\tprocedures\tcommonly\tare\naccompanied\tby\ta\tdrainage\tprocedure\t(antrectomy\tor\t\npyloroplasty\n)\tthat\taids\twith\tgastric\temptying.\nPostoperative\tmedical\tnutrition\ttherapy | [
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Oral\tintake\tof\tfluids\tand\tfoods\tis\tinitiated\tas\tsoon\tas\tGI\ttract\tfunction\treturns\t(typically\t24\tto\t72\nhours\tpostoperatively).\tSmall\tfrequent\n\tfeedings\tof\tice\tor\twater\tare\tnormally\tinitiated,\tfollowed\tby\nliquids\tand\teasily\tdigested\tsolid\tfoods,\tafter\twhich\tthe\tpatient\tcan\tpro... | [
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Although\tthis\tis\tthe\tcommon\tpostoperative\tdiet\tintervention,\tthere\tis\tlimited\tevidence\tsupporting\nthis\tpractice.\tIn\tfact,\tsome\tstudies\tsuggest\tbeginning\ta\tregular\tdiet\tof\ttolerated\tfoods\tas\tthe\tfirst\ndiet\tto\timprove\tpatient\ttolerance\t(\nWarren\tet\tal,\t2011\n).\tIf\tthe\tpatient\tis\... | [
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).\tIf\tthe\tpatient\tis\tunable\tto\ttolerate\tan\toral\tdiet\nfor\tan\textended\tperiod\tof\ttime\t(e.g.,\t5\tto\t7\tdays),\tthen\tenteral\tfeeding\tshould\tbe\tconsidered\tif\nappropriate\tfeeding\taccess\tis\tavailable,\tand\tif\tnot,\tPN\tshould\tbe\tconsidered.\nUnderstanding\tthe\tsurgery\tperformed\tand\tthe\tp... | [
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0.05... |
providing\tproper\tnutritional\tcare.\tNutritional\tcomplications\tafter\tgastric\tsurgeries\n\tare\tvaried\t(\nTable\n26.4\n).\tComplications\tsuch\tas\tobstruction,\tdumping,\tabdominal\tdiscomfort,\tdiarrhea,\tand\tweight\tloss\nmay\toccur,\tdepending\ton\tthe\tnature\tand\textent\tof\tthe\tdisease\tand\tsurgical\ti... | [
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0.03467804938554764,
0.07162699848413467,
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0.02... |
Fig.\n26.6\n).\tPatients\tmay\thave\tdifficulty\tregaining\tnormal\tpreoperative\tweight\tbecause\tof\tinadequate\tfood\nintake\trelated\tto\t(1)\tearly\tsatiety,\t(2)\tsymptoms\tof\tdumping\tsyndrome\t(see\tlater\n\tin\tthis\tchapter),\tor\n(3)\tnutrient\tmalabsorption.\nTABLE\t26.4\nGastric\tSurgery–Related\tNutritio... | [
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0.03... |
Surgical\tProcedure\nPotential\tComplications\nVagotomy\nTotal\tgastric\tand\ttruncal\nvagotomy\nImpairs\tmotor\tfunction\tof\tstomach\nGastric\tstasis\tand\tpoor\tgastric\temptying\nTotal\tgastrectomy\nEarly\tsatiety,\tnausea,\tvomiting\nWeight\tloss\nInadequate\tbile\tacids\tand\tpancreatic\tenzymes\tavailable\n\tbec... | [
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0.06141119822859764,
0.09125437587499619,
0.010849692858755589,
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0.050649... |
because\tof\nanastomotic\tchanges\nMalabsorption\nProtein-energy\tmalnutrition\nAnemia\nDumping\tsyndrome\nBezoar\tformation\nVitamin\tB\n12\n\tdeficiency\nMetabolic\tbone\tdisease\nSubtotal\tgastrectomy\twith\nvagotomy\nEarly\tsatiety\nDelayed\tgastric\temptying\nRapid\temptying\tof\thypertonic\tfluids\nCresci\tG\tet\... | [
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Cresci\tG\tet\tal:\t\nNutrition\tessentials\tof\tgeneral\tsurgery\n,\ted\t5,\tLippincott\tWilliams\t&\tWilkins,\t2013,\tTable\t3–13,\n\tp\t72;\tRollins,\tCJ\t(2015):\tChapter\t23,\nDrug-Nutrient\tInteractions\twith\tGastrointestinal\tDrugs.\tIn\t\nThe\tHealth\tProfessional’s\tGuide\tto\tGastrointestinal\tNutrition\n\t(... | [
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(pp.\t296–311).\tChicago\tIL:\nCathy\tImmartino.\nPatients\twith\tcertain\tgastric\tsurgeries,\tsuch\tas\tBillroth\tII,\tresult\tin\ta\tmismatch\tin\ttiming\tof\tfood\nentry\tinto\tthe\tsmall\tintestine\tand\tthe\trelease\tand\tinteraction\twith\tbile\tand\tpancreatic\tenzymes,\ncontributing\tto\timpaired\tnutrient\tdi... | [
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0.010... |
gastric\tsurgery\tmay\texperience\trelative\tlactase\tdeficiency,\teither\tbecause\tfood\tenters\tthe\tsmall\nintestine\tfurther\tdownstream\tfrom\tadequate\tlactase\tpresence,\tor\tbecause\tthe\trate\tof\ttransit\tthrough\nthe\tproximal\tsmall\tintestine\tis\tincreased.\tBecause\tof\tthe\tcomplications\tof\treflux\tor... | [
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0.0554... |
syndrome\n\tassociated\twith\ttraditional\tgastrectomies,\tother\tprocedures\tare\tused,\tincluding\ttruncal,\nselective,\tor\tparietal\tcell\tvagotomy;\tpyloromyotomy;\tantrectomy;\tRoux-en-Y\tesophagojejunostomy;\nloop\tesophagojejunostomy;\tand\tpouches\tor\treservoirs\tmade\tfrom\tjejunal\tor\tileocecal\tsegments. | [
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Some\tchronic\tnutritional\tcomplications\tthat\tcan\toccur\tafter\tgastric\tsurgery\tinclude\tanemia,\nosteoporosis,\tand\tselect\n\tvitamin\tand\tmineral\tdeficiencies\tresulting\tfrom\tinadequate\tintake\tand\tor\nmalabsorption.\tIron\tdeficiency\tmay\tbe\tattributed\tto\tloss\tof\tacid\tsecretion\tbecause\tgastric\... | [
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normally\tfacilitates\tthe\treduction\tof\tiron\tcompounds,\tallowing\ttheir\tabsorption.\tRapid\ttransit\tand\ndiminished\tcontact\tof\tdietary\tiron\twith\tsites\tof\tiron\tabsorption\tcan\talso\tlead\tto\tiron\tdeficiency.\nVitamin\tB\n12\n\tdeficiency\tmay\tcause\n\ta\tmegaloblastic\tanemia\t(see\t\nChapter\t31\n).... | [
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0.04587... |
a\tmegaloblastic\tanemia\t(see\t\nChapter\t31\n).\tIf\tthe\tamount\tof\ngastric\tmucosa\tis\treduced,\tintrinsic\tfactor\tmay\tnot\tbe\tproduced\tin\tquantities\tadequate\tto\tallow\tfor\ncomplete\tvitamin\tB\n12\n\tabsorption,\tand\tpernicious\tanemia\tmay\tresult.\tBacterial\tovergrowth\tin\tthe\nproximal\tsmall\tbow... | [
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proximal\tsmall\tbowel\tor\tthe\tafferent\tloop\tcontributes\tto\tvitamin\tB\n12\n\tdepletion\tbecause\tbacteria\ncompete\twith\tthe\thost\tfor\tuse\tof\tthe\tvitamin.\tTherefore\n\tafter\tgastrectomy\tpatients\tshould\treceive\nprophylactic\tvitamin\tB\n12\n\tsupplementation\t(injections)\tor\ttake\tsynthetic\toral\ts... | [
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0.07521... |
Dumping\tsyndrome\nEtiology\nThe\t\ndumping\tsyndrome\n\tis\ta\tcomplex\tGI\tand\tvasomotor\tresponse\tto\tthe\tpresence\tof\tlarge\nquantities\tof\thypertonic\tfoods\tand\tliquids\tin\tthe\tproximal\tsmall\tintestine.\tDumping\tsyndrome\tusually\noccurs\tas\ta\tresult\tof\tsurgical\tprocedures\n\tthat\tallow\texcessiv... | [
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that\tallow\texcessive\tamounts\tof\tliquid\tor\tsolid\tfoods\tto\nenter\tthe\tsmall\tintestine\tin\ta\tconcentrated\tform.\tMilder\tforms\tof\tdumping\tmay\toccur\tto\tvarying\ndegrees\tin\tpersons\twithout\tsurgical\tprocedures,\tand\tmost\tof\tthe\tsymptoms\tcan\tbe\treproduced\tin\nnormal\tindividuals\tby\tinfusing... | [
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0.07002230733633041,
-0.00081... |
result\tof\ttotal\tor\tpartial\tgastrectomy,\tmanipulation\tof\n\tthe\tpylorus,\tfundoplication,\tvagotomy,\tand\nsome\tgastric\tbypass\tprocedures\tfor\tobesity.\tAs\ta\tresult\tof\tbetter\tmedical\tmanagement\tof\tpeptic | [
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0.046... |
ulcers,\tuse\tof\tselective\tvagotomies,\tand\tnewer\tsurgical\tprocedures\tto\tavoid\tcomplications,\tclassic\ndumping\tis\tencountered\tless\tfrequently\tin\tclinical\tpractice.\nPathophysiology\nSymptoms\tcan\tbe\tdivided\tinto\ttwo\ttypes\tor\tstages\tof\tdumping\tof\tsolids\tand\tliquids\n\tinto\tthe\tsmall\nintes... | [
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0.05645827576518059,
-0.0021840620320290327,
-0.114713154733181,
-0.018536491319537163,
0.05888577550649643,
0.07022032141685486,
-0.00041062445961870253,
-0.004336694721132517,
0.0764564797282219,
-0.021078752353787422,
0.02895222045481205,
0.039... |
•\t\nEarly\tdumping\t(within\t10\tto\t30\tminutes\tpostprandially)\tis\tcharacterized\tby\tGI\tand\nvasomotor\tsymptoms,\twhich\tinclude\tabdominal\tpain,\tbloating,\tnausea,\tvomiting,\tdiarrhea,\nheadache,\tflushing,\tfatigue,\tand\thypotension.\tThese\tsymptoms\tlikely\toccur\tbecause\tof\tthe\nrapid\tinflux\tof\thy... | [
0.001187736983411014,
-0.04445788636803627,
0.055736128240823746,
-0.04544030502438545,
-0.09852977842092514,
-0.02774222195148468,
0.08896267414093018,
0.04097137227654457,
0.01572769694030285,
0.039595384150743484,
0.07184746116399765,
-0.023854998871684074,
0.07898546010255814,
0.019933... |
rapid\tinflux\tof\thyperosmolar\tcontents\tinto\n\tthe\tduodenum\tor\tsmall\tintestine.\tA\tsubsequent\nfluid\tshift\tfrom\tthe\tintravascular\tcompartment\tto\tthe\tintestinal\tlumen\toccurs,\tresulting\tin\nsmall\tintestine\tdistention,\tpotentially\tcausing\tcramps\tand\tbloating.\n•\t\nLate\tdumping\t(1\tto\t3\thou... | [
0.02410537749528885,
-0.09399271756410599,
0.06919924914836884,
-0.0436079166829586,
-0.12893885374069214,
0.009236023761332035,
0.09879446029663086,
0.004526400938630104,
0.023498427122831345,
0.054871417582035065,
0.08852165192365646,
-0.04401812329888344,
0.033946868032217026,
0.0369765... |
vasomotor\tand\tinclude\tperspiration,\tweakness,\tconfusion,\tshakiness,\thunger,\tand\nhypoglycemia.\tLate\tdumping\n\tis\tlikely\tthe\tresult\tof\treactive\thypoglycemia.\tRapid\tdelivery,\tas\nwell\tas\thydrolysis\tand\tabsorption\tof\tcarbohydrates,\tproduces\tan\texaggerated\trise\tin\tinsulin | [
-0.02030322514474392,
-0.027466673403978348,
0.0660834014415741,
-0.007601253222674131,
-0.05264922231435776,
0.03933532163500786,
0.13521231710910797,
0.030037010088562965,
-0.016559716314077377,
0.05938808247447014,
0.08365587145090103,
-0.030621042475104332,
0.00964395236223936,
0.00249... |
level\tand\ta\tsubsequent\tdecline\tin\tblood\tglucose.\tThe\trapid\tchanges\tin\tblood\tglucose\tand\tthe\nsecretion\tof\tgut\tpeptides,\tglucose\tinsulinotropic\tpolypeptide,\tand\tglucagon-like\tpolypeptide-\n1\tappear\tto\tbe\tat\tleast\tpartly\tresponsible\tfor\tthe\n\tlate\tsymptoms\t(\nDeloose\tet\tal,\t2014\n).... | [
0.024753930047154427,
-0.03400452062487602,
0.03265247866511345,
-0.014322493225336075,
-0.08266466856002808,
-0.015981698408722878,
0.09167361259460449,
0.0339331179857254,
-0.00040299867396242917,
0.027437081560492516,
0.07149198651313782,
-0.03334007412195206,
-0.0076076798141002655,
0.... |
late\tsymptoms\t(\nDeloose\tet\tal,\t2014\n).\nMedical\tmanagement\nMedical\tintervention\ttypically\tinvolves\tdietary\tchanges\tas\tthe\tinitial\ttreatment,\tand\tthey\tare\tusually\neffective.\tHowever,\tin\t3%\tto\t5%\tof\tpatients,\tsevere\tdumping\tpersists\tdespite\tdietary\tchange.\tIn\tthese | [
0.03230736777186394,
-0.011204138398170471,
0.06858392059803009,
0.007352691609412432,
-0.06348466128110886,
0.01636483520269394,
0.10575440526008606,
0.009280997328460217,
0.012264679186046124,
0.0003480814048089087,
0.09469937533140182,
-0.06523283571004868,
0.03790564090013504,
0.017904... |
patients,\tmedications\tmay\tbe\tused\tto\tslow\tgastric\temptying\tand\tdelay\ttransit\tof\tfood\tthrough\tthe\tGI\ntract.\tSome,\tsuch\tas\tacarbose,\n\tinhibit\talpha\tglycoside\thydrolase\tand\tinterfere\twith\tcarbohydrate\nabsorption,\tand\toctreotide,\ta\tsomatostatin\tanalog,\tinhibits\tinsulin\trelease\t(see\t... | [
-0.03034914843738079,
-0.08229470252990723,
-0.012688064016401768,
-0.03486378863453865,
-0.09560658782720566,
-0.019124804064631462,
0.10770946741104126,
0.09878871589899063,
-0.015116256661713123,
0.03192015364766121,
0.07049005478620529,
0.02729802578687668,
-0.012994123622775078,
0.064... |
Table\t26.3\n\tfor\ncommon\tmedications).\tRarely,\tsurgical\tintervention\tis\tused\tto\ttreat\tdumping\tsyndrome.\nMedical\tnutrition\ttherapy\nPatients\twith\tdumping\tsyndrome\tmay\texperience\tweight\tloss\tand\tmalnutrition\tcaused\tby\tinadequate\nintake,\tmalabsorption,\n\tor\ta\tcombination\tof\tboth.\tThe\tpr... | [
0.0528082437813282,
-0.052537575364112854,
0.03380134329199791,
-0.00706756254658103,
-0.08133917301893234,
0.006167389452457428,
0.06560131162405014,
0.007734548766165972,
-0.01874188520014286,
0.07458306103944778,
0.08846616744995117,
-0.027140259742736816,
0.041038818657398224,
0.009681... |
restore\tnutrition\tstatus\tand\tquality\tof\tlife.\tBecause\tthey\tare\tdigested\tmore\tslowly,\tproteins\tand\tfats\nare\tbetter\ttolerated\tthan\tcarbohydrates,\tparticularly\tsimple\tcarbohydrates.\tSimple\tcarbohydrates\nsuch\tas\tlactose,\tsucrose,\tfructose,\tglucose,\tand\tdextrose\tare\thydrolyzed\trapidly\tan... | [
-0.029790831729769707,
-0.069158174097538,
0.05416256934404373,
0.019581109285354614,
-0.008835581131279469,
0.04370388016104698,
0.09659730643033981,
-0.024308381602168083,
-0.034580737352371216,
0.012834942899644375,
0.058530062437057495,
0.005908348597586155,
0.014003831893205643,
-0.03... |
limited,\tbut\tcomplex\tcarbohydrates\n\t(starches)\tcan\tbe\tincluded\tin\tthe\tdiet.\nLiquids\tleave\tthe\tstomach\tand\tenter\tthe\tjejunum\trapidly;\tthus,\tsome\tpatients\thave\ttrouble\ntolerating\tliquids\twith\tmeals.\tPatients\twith\tsevere\tdumping\tmay\tbenefit\tfrom\tlimiting\tthe\tamount\tof | [
0.027789205312728882,
-0.04852497950196266,
0.04696867987513542,
-0.03988821059465408,
-0.07758627831935883,
0.016613537445664406,
0.1189960166811943,
0.02393687143921852,
0.038531601428985596,
0.020482899621129036,
0.08574885874986649,
-0.025218861177563667,
0.04871457815170288,
0.0098973... |
liquids\ttaken\twith\tmeals\tand\tdrinking\tliquids\tbetween\tmeals\twithout\tsolid\tfood.\tReclining\n(approximately\t30\tdegrees)\tafter\tmeals\tmay\talso\tminimize\tseverity\tof\tsymptoms.\nThe\tuse\tof\tsoluble\tfiber\tsupplements,\tparticularly\tpectin\tor\tgums\t(e.g.,\tguar)\tcan\tbe\tbeneficial\tin | [
0.005231659859418869,
-0.09248741716146469,
0.046337127685546875,
-0.03782451152801514,
-0.041177522391080856,
-0.028057651594281197,
0.11719285696744919,
0.01253199577331543,
0.033485960215330124,
0.01611100137233734,
0.08109626919031143,
-0.05095412954688072,
0.04025398567318916,
0.04286... |
managing\tdumping\tsyndrome\tbecause\tof\tfiber’s\tability\tto\tform\tgels\twith\tcarbohydrates\tand\tfluids\nand\tdelay\tGI\ttransit.\tPatients\tmay\tneed\tto\tbe\ttaught\tabout\tportion\tsizes\tof\tfoods,\tespecially\tof\ncarbohydrate\tfoods\tsuch\tas\tjuices,\tsoft\tdrinks,\tdesserts,\tand\tmilk.\tThe\texchange\tlis... | [
-0.007152128964662552,
-0.01148850005120039,
-0.00828345213085413,
-0.018151946365833282,
-0.05602167174220085,
-0.002883373759686947,
0.11909542232751846,
0.030110808089375496,
-0.057789355516433716,
0.028737114742398262,
0.08535321801900864,
-0.00302876066416502,
0.0715724378824234,
0.01... |
Appendix\t18\n\tcan\tbe\tused\tto\tcalculate\tcarbohydrate\tintake\tand\tteach\tabout\tcarbohydrate\tcontrol.\nPostgastrectomy\tpatients\toften\tdo\tnot\ttolerate\tlactose,\tbut\tsmall\tamounts\t(e.g.,\t6\tg\tor\tless\tper\nmeal)\tmay\tbe\ttolerated\tat\tone\ttime.\tPatients\ttypically\tdo\tbetter\twith\tcheeses\tor\tu... | [
0.00880378857254982,
-0.017818152904510498,
0.0537031926214695,
-0.03811715543270111,
-0.11940155178308487,
-0.050809696316719055,
0.04752989858388901,
0.015938851982355118,
0.0005573104717768729,
0.014217182993888855,
0.11700373888015747,
0.06908071786165237,
0.048379361629486084,
0.03439... |
than\twith\tfluid\tmilk.\tNondairy\tmilks\tare\talso\tuseful\twhen\tnecessary.\tVitamin\tD\tand\tcalcium\nsupplements\tmay\tbe\tneeded\n\twhen\tintake\tis\tinadequate.\tCommercial\tlactase-containing\tproducts\tare\navailable\tfor\tthose\twith\tsignificant\tlactose\tmalabsorption\t(see\t\nChapter\t27\n\tfor\tfurther\td... | [
-0.007921227253973484,
-0.03734196349978447,
0.06433390080928802,
-0.04023614525794983,
-0.06760689616203308,
-0.04086051881313324,
0.10623855143785477,
0.011201158165931702,
0.005636474117636681,
0.04701916500926018,
0.09611246734857559,
-0.036300599575042725,
0.0555129274725914,
0.063073... |
for\tfurther\tdiscussion\tof\nlactose\tintolerance\tand\tits\tmanagement).\nWhen\tsteatorrhea\t(greater\tthan\t7%\tof\tdietary\tfat\tin\tthe\tstool)\texists,\treduced-fat\tformulas\tor\npancreatic\tenzymes\tmay\tbe\tbeneficial.\t\nBox\t26.7\n\tprovides\tgeneral\tnutrition\tguidelines\tfor\n\tpatients | [
0.013770620338618755,
-0.06532175838947296,
0.03936681151390076,
0.0208502896130085,
-0.09791254997253418,
-0.0015112640103325248,
0.06719624996185303,
0.05031956359744072,
-0.022248411551117897,
-0.03072083368897438,
0.08263623714447021,
-0.008356336504220963,
-0.02252829633653164,
0.0373... |
Box\t26.7\n\tprovides\tgeneral\tnutrition\tguidelines\tfor\n\tpatients\nwith\tdumping\tsyndrome\tafter\tgastric\tsurgery;\thowever,\teach\tdiet\tmust\tbe\tadjusted\tbased\ton\ta\ncareful\tdietary\tand\tsocial\thistory\tfrom\tthe\tpatient.\nBOX\t26.7\nBasic\tGuidelines\tfor\tDumping\tSyndrome\n1.\t\nEat\tsix\tto\teight\... | [
0.018178150057792664,
-0.038024742156267166,
0.05771084874868393,
-0.04710962250828743,
-0.1061931699514389,
0.014481903053820133,
0.011735529638826847,
0.02636481635272503,
-0.030965236946940422,
-0.009546135552227497,
0.050584111362695694,
0.048173051327466965,
-0.005664530675858259,
0.0... |
1.\t\nEat\tsix\tto\teight\tsmall\tmeals\tthroughout\tthe\tday.\n2.\t\nLimit\tfluids\tto\t4\tounces\t(½\tcup)\tat\ta\tmeal,\tjust\tenough\tto\trinse\tfood\tdown.\n3.\t\nDrink\tremaining\tfluids\tat\tleast\t30\tto\t40\tminutes\n\tbefore\tand\tafter\tmeals.\n4.\t\nEat\tslowly\tand\tchew\tfoods\tthoroughly.\tSome\tmay\tben... | [
-0.03163566812872887,
-0.06576833873987198,
0.04243794083595276,
-0.0698525682091713,
-0.09650326520204544,
-0.03453822806477547,
0.08595065772533417,
0.012145928107202053,
-0.03099116124212742,
0.03544638305902481,
0.10398093611001968,
-0.04655397683382034,
0.04231157898902893,
-0.0151009... |
foods,\tor\tthose\tthat\tare\talready\tbroken\tdown,\tsuch\tas\tground\tmeats.\n5.\t\nAvoid\textreme\ttemperatures\tof\tfoods\t(very\thot\tor\tvery\tcold).\n6.\t\nUse\tseasonings\tand\tspices\tas\ttolerated\t(may\twant\tto\tavoid\tpepper,\thot\tsauce).\n7.\t\nLie\tdown\tor\trecline\tfor\tat\tleast\t30\tminutes\tafter\t... | [
-0.03303482010960579,
-0.07045908272266388,
0.08219317346811295,
0.004379955120384693,
-0.04933551326394081,
0.018935825675725937,
0.08162563294172287,
-0.01623724214732647,
-0.06652428209781647,
0.032227836549282074,
0.10559393465518951,
-0.04948483780026436,
-0.0010601803660392761,
-0.02... |
Lie\tdown\tor\trecline\tfor\tat\tleast\t30\tminutes\tafter\teating.\n8.\t\nLimit\n\tsimple\tcarbohydrate\tfoods\tand\tliquids\twith\tmore\tthan\t12\tgrams\tof\tsugar\tper\tserving.\nExamples:\tfruit\tjuice,\tGatorade,\tPowerade,\tKool\tAid,\tsweet\ttea,\tsucrose,\thoney,\tjelly,\tcorn\nsyrup,\tcookies,\tpie,\tdoughnuts... | [
-0.05211779475212097,
-0.05210946500301361,
0.022867843508720398,
-0.010425439104437828,
-0.06173452362418175,
0.012350828386843204,
0.09894958138465881,
-0.0027645009104162455,
-0.003691636025905609,
0.021843282505869865,
0.1260892003774643,
-0.0224459245800972,
0.07488051056861877,
-0.02... |
and\tfoods\tmade\twith\tthem,\tand\tpotatoes.\n9.\t\nChoose\tfoods\tthat\tare\thigher\tin\tsoluble\tfiber.\tSome\texamples\tof\tthese\tfoods\tinclude\tapples,\noats,\tbeets,\tcarrots,\tand\tbeans. | [
0.010271141305565834,
-0.018583133816719055,
0.026842815801501274,
-0.006579252891242504,
0.009377572685480118,
0.009929773397743702,
0.09543317556381226,
-0.0005602710880339146,
-0.02492392063140869,
0.01237340085208416,
0.12959618866443634,
-0.06552045792341232,
0.015329231508076191,
-0.... |
10.\t\nInclude\ta\tprotein-containing\tfood\tat\teach\tmeal.\n11.\t\nAdd\ta\tserving\tof\tfat\tsuch\tas\tolive\toil,\tnut\tbutter,\tor\tavocado\tto\tmeals\tas\ttolerated\tto\nencourage\tslower\tgastric\temptying.\tMinimize\tfried\tfoods,\tchips,\tcookies,\thot\tdogs,\tand\nother\tgreasy\tfoods.\n12.\t\nMilk\tand\tdairy... | [
-0.0041214521043002605,
-0.0652538388967514,
0.05530742183327675,
-0.021930284798145294,
-0.044692136347293854,
0.05198786035180092,
0.11658716201782227,
0.010474462993443012,
-0.0476432703435421,
0.03425610437989235,
0.13855823874473572,
-0.05456782877445221,
0.050552673637866974,
0.00986... |
slowly\tin\tthe\tdiet\n\tif\tthey\twere\ttolerated\tpreoperatively.\n13.\t\nAvoid\tsugar\talcohols\tsuch\tas\tsorbitol,\txylitol,\tmannitol,\tand\tmaltitol,\tas\tthese\tmay\nexacerbate\tsymptoms.\nUniversity\tof\tVirginia\tHealth\tSystem.\tAnti-Dumping\tDiet,\t\nhttps://uvahealth.com/services/digestive-\nhealth/images-... | [
-0.006720899138599634,
-0.0848369225859642,
0.03537602722644806,
0.01704195700585842,
-0.05896772816777229,
-0.051857948303222656,
0.0984564945101738,
0.05457423999905586,
-0.010264039970934391,
-0.02045845240354538,
0.08058792352676392,
-0.028332538902759552,
0.012318612076342106,
0.04687... |
health/images-and-docs/dumping-syndrome.pdf\n;\tCresci\tGA\t(2015):\tChapter\t14,\tGastrointestinal\tTract\nSurgery.\tIn\t\nThe\tHealth\tProfessional’s\tGuide\tto\tGastrointestinal\n\tNutrition\n\t(pp.168–181).\tChicago\tIL:\tCathy\nImmartino.\nGastroparesis\nEtiology\nGastroparesis\n\tis\ta\tsyndrome\tof\tdelayed\tgas... | [
-0.05971021205186844,
-0.03336172178387642,
0.030059315264225006,
0.06774886697530746,
-0.054727405309677124,
-0.04558677226305008,
0.04905378818511963,
0.11668090522289276,
-0.016698183491826057,
-0.03811477869749069,
-0.01666310243308544,
0.009627764113247395,
0.07191523164510727,
0.0454... |
obstruction\tand\tis\ta\tcomplex\tand\tpotentially\tdebilitating\tcondition.\tThe\tnature\tof\tgastroparesis\tis\ncomplex\tin\tpart\tbecause\tgastric\tmotility\tis\torchestrated\tby\ta\tvariety\tof\tchemical\tand\tneurologic\nfactors.\tViral\tinfection,\n\tdiabetes,\tand\tsurgeries\tare\tthe\tmost\tcommon\tcauses\tfor\... | [
0.008600975386798382,
-0.0573708601295948,
0.05864046514034271,
-0.005181231535971165,
-0.0761151909828186,
0.01692841574549675,
0.07204508036375046,
0.03948218747973442,
0.009661160409450531,
0.07277000695466995,
0.08168294280767441,
-0.020409811288118362,
-0.027938900515437126,
0.0741288... |
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