Nutrition and Bowel Health Janice Baker, MBA RDN CDE CNSC BC-ADM Registered Dietitian Certified Diabetes Educator Certified Nutrition Support Clinician Board Certified- Advanced Diabetes Management

Objectives Objectives: 1. Name 2 reasons why constipation may occur and 2 recommendations to manage constipation 2. Identify 3 nutrition diet goals to support optimal healing, recovery and rehabilitation

Constipation- one recommendation may not fit all Several possible causes; generally 3 types of primary or idiopathic constipation Functional- pain/ discomfort related to IBS Slow transit- prolonged time between BMs, abdominal distention, discomfort Outlet obstruction- stricture, pelvic floor dysfunction, cancer, anal stricture, neurological dx Some may have combined forms

Possible causes Hypothyroid Medications Hydration Mobility Diet – low fiber Gastroparesis (diabetes, dysglycemia) Comorbidities ie Parkinson’s disease

Healthy gut from nutrition support = better outcomes, less complications

Treatment options Diet- high fiber (sometimes), regular meals, adequate hydration, routine eating habits Optimize activity OTC treatment; consider prescription meds Primary care/ GI consultation, recommendations based on coexisting dx’s- ie glycemic control, thyroid function, IBS

Healing, Recovery and Rehabilitation

Nutrition Support Pre and Post Op Regular meals /snacks adequate nutrients Avoid restrictive/fad diets Hydration- 6-8 cups fluid/day Adequate protein- goal 25-30 grams/meal Fruits/vegetables, plant foods, whole grains Optimize blood sugar control Oral nutrition supplements may be helpful Communication to nursing staff weight changes/diet needs

Nutrition Strategies Plan pre/ post op- high protein meals + snacks Hydration + protein+ fiber + regular meals Examples…. Yogurt, fresh, dried, canned, frozen fruit eggs, cheese sticks, canned tuna, salmon whole grains, healthful frozen meals nuts / nut butters, beans, nutrition drinks Refer to Registered Dietitian for screening/assessment, nutrition support issues