gastric disorders (such as partial intestinal obstruction
or diverticulitis).
It is also used in certain posto-
perative states that affect any part of the GI tract, e.g., a
hemorrhoidectomy. Low-residue diets are also used in
treating dysenteries of long duration.
The purpose of this diet is to provide non-
stimulating, non-irritating, and easily digested
material that leaves little residue, thus avoiding
mechanical irritation of the GI tract.
Various
commercially prepared low-residue elemental diet
supplements may be given to provide complete
nutrition.
LOW-SODIUM DIET.A low-sodium diet
consists of foods containing a very small percentage of
sodium, with no salt added in preparation or by the
patient.
It is impossible to prepare an absolutely
sodium-free diet.
The low-sodium diet is indicated when edema is
present, in renal diseases, hypertension, and certain
cardiac conditions.
The nephrotic patient is often unable to excrete
sodium in a normal manner because the kidneys
retention of sodium leads to edema. A low-sodium diet
is thus indicated, with no restriction on salt-free
liquids. Such patients should be encouraged to drink
2,000 to 3,000 milliliters (ml) of low-sodium fluids
daily.
The allowance of sodium in a strict low-sodium
diet is 250 to 1,000 mg daily. The allowance of sodium
in a moderate low-sodium diet is 2,000 mg or 2 g.
Regular diets with no salt added contain 2.4 to 4.5 g of
sodium.
Any diet in which the amount of sodium is
drastically reduced has possible side effects. The
patient who is on this diet regimen must be constantly
observedparticularly in warm climatesfor
lassitude, complaints of weakness, anorexia, nausea
and vomiting, mental confusion, abdominal cramps,
and aching skeletal muscles. Electrolyte imbalances
can have serious consequences. If you observe
symptoms such as those described above, notify a
medical officer.
BLAND DIET.A bland diet may be helpful for
gastritis, hyperacidity, hemorrhoids, peptic ulcers, and
other GI disorders. Dietary management of patients
with chronic ulcer disease has been the subject of much
controversy. Bland diets have traditionally been used
for these patients. However, experiments show that
there is no significant difference in the response of
patients with an active duodenal ulcer to a bland diet.
Known irritants to the gastric mucosa include alcohol,
black pepper, caffeine, chili powder, cocoa, coffee,
certain drugs, and tea.
Emphasizing how to eat is as important as
indicating what foods to eat, since there are individual
responses to bland diets. Offer the following
suggestions to the patient:
Avoid worry and emotional upsets at mealtime
Chew food well and eat slowly
Rest before and after meals
Avoid foods of extreme temperatures
If fruits and juices between meals cause distress,
try including them with meals. Meals must be kept
small to reduce gastric acidity and distention. Among
foods to avoid in the bland diet are
fatty meats,
fried foods,
whole-grain breads and cereals,
dried beans and peas,
cabbage-family vegetables,
chocolate,
nuts and seeds, and
carbonated beverages, caffeine, coffee, and tea.
Patients on a bland diet may use spices and
condiments such as allspice, cinnamon, mace, paprika,
sage, thyme, catsup, cranberry or mint jelly, and
extract and flavorings without chocolate or vinegar.
The bland diet allows a more liberal food selection
than other restrictive diets.
This diet reduces the
number of meals to three, and increases the quantity of
foods given. Individualize the diet to the patient.
The Regular-No Stimulants Diet (also called
liberal bland), a type of bland diet, eliminates only
those items that have been shown scientifically to
irritate the gastric mucosa (i.e., alcohol, black pepper,
caffeine, chili powder, cocoa, coffee, certain drugs,
and tea).
Decaffeinated coffee may be restricted in most
types of bland diets. Recent studies show that it causes
increased gastric acid secretion and esophageal
pressure causing gastric acid reflux in the esophagus.
Decaffeinated coffee is only offered on the bland diet
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