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3rd Nutritional Therapeutics 1 Quiz on Pancreatic insufficiency, created by carlymerlo on 31/07/2013.

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Pancreatic insufficiency

Question 1 of 12

1

What are the treatment aims for pancreatic insufficiency?

Select one of the following:

  • Promote optimal digestion by supporting breakdown and absorption of nutrients

  • none

Explanation

Question 2 of 12

1

How do you promote optimal digestion by supporting breakdown and absorption of nutrients

Select one or more of the following:

  • Support production of pancreatic enzymes via nutritional precursors and cofactors

  • Stimulate release of pancreatic enzymes by activating the vagal nerve and CCK via eating habits and bitters

  • Create an environment in the SI lumen which facilitates pancreatic enzyme function - pH 5.9. Increase gastric secretions and bicarbonate

  • Support pancreatic tissue integrity via increasing enzymes for digestion and recycling

  • Increase repair of pancreatic tissue by reducing damaging factors such as oxidative stress and inflammation

Explanation

Question 3 of 12

1

What is another treatment aim for pancreatic deficiency?

Select one of the following:

  • Correct side effects of poor enzyme levels - dysbiosis, food allergies, nutritional insufficiencies (especially fat soluble insufficiencies).

  • none

Explanation

Question 4 of 12

1

What are the holistic considerations for pancreatic insufficiency?

Select one of the following:

  • Nervous system activity - manage stress levels
    Impact on liver function - decrease nutritional status and increased workload from the GIT

  • None

Explanation

Question 5 of 12

1

What are pancreatic enzymes?

Select one or more of the following:

  • Pancreatic enzymes are natural chemicals that help break down fats, proteins and carbohydrates. A normally functioning pancreas secretes about 8 cups of fluid, called pancreatic juice, daily into the duodenum, the portion of the small intestine that connects with the stomach. This fluid contains pancreatic enzymes and helps neutralize stomach acid as it enters the small intestine

  • Lipase: Lipase works with bile from the liver to break down fat molecules so they can be absorbed and used by the body.
    A shortage of Lipase may cause; Lack of needed fats and fat-soluble vitamins.
    Diarrhea and/or fatty stools.

  • Proteases: Proteases break down proteins. They help keep the intestine free of parasites such as bacteria, yeast and protozoa
    A shortage of protease may cause; Allergies or the formation of toxic substances due to incomplete digestion of proteins.
    Increased risk for intestinal infections.

  • Amylase: Amylase breaks down carbohydrates (starch) into sugars which are more easily absorbed by the body. This enzyme is also found in saliva.
    A shortage in Amylase may cause: Diarrhea due to the effects of undigested starch in the colon.

Explanation

Question 6 of 12

1

What type of digestive enzyme supplements can we use to treat pancreatic insufficiency?

Select one of the following:

  • Vegetable enzymes: These are microbe derived enzymes and contain a mixture of lipase, amylase, protease, and lactase which are used in the breakdown of each macro nutrient
    They are effective over a wider pH range

  • Bromelain: Bromelain is derived from pineapple from the fruit and the stem.
    It is a protelytic enzyme which hydrolyzes proteins to oliopeptides and amino acids.
    Take with food to aid protein digestion.
    It operates in a broad pH range
    It is also antioxidant and anti-inflammatory

  • Papain: Derived from papaya fruit
    It is also a proteolytic enzyme

Explanation

Question 7 of 12

1

How can Zinc help with pancreatic insufficiency?

Select one of the following:

  • Zinc is an anti-oxidant which reduces oxidative stress which contributes to pancreatic damage. Zinc is needed for pancreatic tissue and enzyme production. Deficiency is associated with impaired exocrine function. Pancreatic enzyme insufficiency decreases the absorption of zinc, creating a vicious cycle.

  • none

Explanation

Question 8 of 12

1

What anti-oxidants can be used to treat pancreatic insufficiency?

Select one or more of the following:

  • Selenium

  • Vitamin C

  • Vitamin E

  • beta carotene

Explanation

Question 9 of 12

1

Do fat soluble vitamins need to be replenished if there is pancreatic insufficiency?

Select one of the following:

  • Yes, they need to be replenished due to malabsorption

  • none

Explanation

Question 10 of 12

1

Would you treat pancreatic insufficiency with bicarbonate?

Select one of the following:

  • yes - if production is decreased and or reduced stimulus for release

  • none

Explanation

Question 11 of 12

1

Should a person with pancreatic insufficiency avoid high fat fried foods and high fat foods?

Select one of the following:

  • Yes- In exocrine pancreatic insufficiency, undigested fat is passed in the stool, causing greasy, foul-smelling, loose stools. A low fat diet can also reduce pain associated with pancreatitis.

  • none

Explanation

Question 12 of 12

1

How would you advise a patient with pancreatic insufficiency to eat?

Select one or more of the following:

  • Chew food thoroughly in order to stimulate the cephalic phase of digestion (secretion release) and don't over eat.

  • Include protein in each meal and bitters in diet

Explanation

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