营养与消化道疾病.ppt

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1、营养与消化道疾病主页目录-Home第一节反流性食管炎一、概述反流性食管炎（refluxesophagitis）是胃食管反流性疾病(gastroesophagealrefluxdisease，GERD)的一种常见形式，它是指由于胃、十二指肠内容物反流入食管引起的一组临床症状和食管的组织损害。主页目录-HomeRefluxesophagitisfallsintothecategoryofrefluxgastroesophagopathy.Itischaracterizedbyinflammation,erosion,ulcerformationandfibrosisoft

2、heesophagealmucousmembraneduetorefluxofthecontentofthestomachandduodenumintotheesophagus.二、发生发展与营养的关系影响LES的食物，如辣椒、酸果、油腻食物、浓茶、酒等目前认为该类食物引起或加重溃疡病情的原因有：①有高的张力，收敛性大，或是酸性强；②引起胃强有力的分泌；③通过释放胃肠道激素，或是刺激神经反射。三、疾病与营养预防1．减少进食量2.改变生活方式3.情绪平稳，忌烟、酒、咖啡4.避免增加腹压Refluxisverycommonandpractiseofsimplemeasur

3、esmaybringenoughrelief.Themorethestomachisstretchedbyfood,thehigherthetendencytoreflux.Eatingfattymealsasfatdelaysgastricemptyingalsoincreasesthetendencytoreflux.Tryto1.Eatsmallmeals2.Eatregularly,thishelpsinreducingthepressureontheupperpartofthestomachcausedbylargemeals.3.Avoidlargeric

4、hmeals,particularlyintheeveningthisreducesthetendencytoreflux.4.Avoideatinglateatnightsoastokeepthestomachrelativelyemptyatbedtime.5.Avoidalcohol,ifitisbeingtaken,itshouldbeinmoderationwithmeals.6.Smokingshouldbeavoided.Tobaccopreventstheesophagealsphincterfromworkingproperly,reducesth

5、erateatwhichthestomachemptiesandincreasesstomachacidproduction.7.Bendingshouldbekepttoaminimum,especiallyaftermeals.四、营养治疗采用低脂肪饮食1.控制总能量2.减少脂肪摄入3.适当增加蛋白质摄入4.食物选择：（1）饮食中应吃些易消化、细软的食品（2）少用刺激性食品（3）戒烟酒5.其他治疗：晚餐不宜多，睡前不加餐，避免餐后即平卧；避免使用减弱食管下括约肌张力的药物。Theloweresophagealmusclecanbeweakenedbyfactor

6、sotherthanfood.Thefollowingrecommendationsmaybehelpfulinreducingsymptoms:Stopusingtobaccoinallforms.Nicotineweakenstheloweresophagealmuscle.Avoidchewinggumandhardcandy.Theyincreasetheamountofswallowedairwhich,inturn,leadstobelchingandreflux.Donotliedownimmediatelyaftereating.Avoidlateev

7、eningsnacks.Avoidtightclothingandbendingoveraftereating.Eatsmall,frequentportionsoffoodandsnackifneeded.Loseweightifoverweight.Obesityleadstoincreasedreflux.Elevatetheheadofthebedsixtoeightinchestopreventrefluxwhensleeping.Extrapillows,bythemselves,arenotveryhelpful.Thefollowin