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Adime

1. The patient is a 31-year-old female with a history of IBS and weight gain who experiences frequent GI discomfort. 2. She has been diagnosed with altered GI function likely due to carbohydrate intolerance based on her history and routine consumption of FODMAP foods. 3. The intervention plan is to educate the patient on the low-FODMAP diet, develop a 6-week elimination diet plan and goals for food tracking and meal preparation, then slowly reintroduce FODMAP foods while monitoring symptoms.

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819 views4 pages

Adime

1. The patient is a 31-year-old female with a history of IBS and weight gain who experiences frequent GI discomfort. 2. She has been diagnosed with altered GI function likely due to carbohydrate intolerance based on her history and routine consumption of FODMAP foods. 3. The intervention plan is to educate the patient on the low-FODMAP diet, develop a 6-week elimination diet plan and goals for food tracking and meal preparation, then slowly reintroduce FODMAP foods while monitoring symptoms.

Uploaded by

api-294212644
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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ADIME

1. Nutrition Assessment:

Age: 31 years old

Gender: Female

Height: 57

Weight: 180

Race: White

BMI: 28.2

Weight change: gained 60 lbs in 10 years

Nutrition Relevant Labs:

Tested negative for celiac disease on 1/3/2013 (tTG-


IgA test)

Sm intestine biopsy confirmed negative celiac disease


diagnosis on 3/12/14.

IBS diagnosis 13 years ago (March 2000)

Estimated from 24 hour recall energy intake:

2,000 2,500 kcal/day

Recommended total energy intake 1,800 kcal / day

Estimated from 24 hour recall:

Reveals routine consumption of fermentable, Oligo, Di,


Mono-saccharides, and Polyols (FODMAPs)

Physical activity:

1 time per week for 1.5 hrs (volleyball)


GI symptoms:

Client complains of frequent GI discomfort including


bloating, wind, diarrhea, constipation and pain >10 days
per month

Client indicates occasional GI symptom relief when


following a Gluten-free diet, but not always

2. Nutrition Diagnosis

Altered GI function related to possible dietary carbohydrate


intolerance as evidence by a +10-year history of IBS, negative
tTG-IgA test/ negative celiac disease diagnosis; patient reports
daily abdominal pain including wind, pain, constipation, diarrhea
and bloating; diet reveals routine consumption of Fermentable,
Oligo, Di, Mono-saccharides, and Polyols (FODMAPs).

3. Intervention

Provide client with educational materials related to the low-


FODMAP diet and elicit feelings, concerns, and ideas for
adherence.

Collaborate to develop a plan regarding the suitable food


alternatives based on patient feedback during the 6-week
elimination phase of the diet to ensure adherence and adequate
RDI intakes.

Collaborate to develop a plan for reintroduction of individual


foods high in FODMAPs one by one and discuss the techniques
used to assess client reported GI symptoms after 6-week period.

Before starting treatment, ask patients to rank the severity of


their GI symptoms and fecal consistency/number of stools per
day on a standardized scale.
Counseling Goals

1. Hold collaborative education counseling session with client to:

a. Elicit patient feelings, concerns and ideas for adherence


to the diet.

b. Explain the role of diet in IBS and FODMAP concept

c. Outline which foods high in FODMAPs / low in FODMAPs

d. Discuss the process and purpose of temporary


elimination diet

e. Describe difference between low FODMAP and gluten-


free diet

2. Provide patient with various recourses to help in the


understanding of FODMAP foods, meal planning tips, recipe
modifications and support groups etc.

Client Goals: Be able to:

1. Properly identify foods and ingredients high in FODMAPs

2. (With help of RD) Put together 5 dinnertime meals that will


take 30 minutes or less to prepare and that are compliant with
the low-FODMAPs dietary protocols

3. Keep a daily food journal to document food consumptions and


symptoms

3. Monitoring / Evaluation:

Visit 2: After 6 weeks assess the patients adherence to the


FODMAP diet based on food journal, and determine if the client
was eating an adequate variety of foods to meet RDIs. Ask
patient to repeat the standardized surveys regarding GI
symptoms and fecal consistency / number of stools per day to
assess a change in symptoms.

Collaborate with patients on ideas regarding how to properly re-


introduce FODMAPs back into diet in a controlled fashion by re-
introducing small portions (2-3 ounces) of foods with increasing
FODMAPS back into diet once every three days. The patient
should continue keeping a food journal to document food
consumption and symptoms.

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