(b) Celiac disease is an example of malabsorption syndrome. Since the
discovery that the gliadin fraction in gluten (a protein found mainly in wheat) is the
causative factor, a low-gluten, gliadin-free diet has resulted in marked remission of
symptoms.
(c) Inflammatory bowel disease is a term applied to both ulcerative colitis
and Crohn's disease. These two diseases have similar clinical and pathologic features.
They are particularly prevalent in industrialized areas of the world, suggesting that the
environment plays a significant role. The two goals of a therapeutic diet are to support the
tissue-healing process and prevent nutritional deficiency. The diet must supply about 100
grams of protein per day through elemental formulas or protein supplements with food as
tolerated.
e. To Eliminate Food Substances to Which the Patient may be Allergic.
There are three basic approaches to the diagnosis and treatment of food allergies: clinical
assessment, laboratory tests, and dietary manipulation. Diet therapy is individualized.
f. To Adjust Diet Composition. A therapeutic diet may be ordered to aid
digestion, metabolism, or excretion of certain nutrients or substances.
5-11. STANDARD HOSPITAL DIETS
The types of standard diets used by the Department of the Army are found in TM 8-
500, Nutritional Support Handbook.
a. Clear Liquid Diet. This diet is indicated for the postoperative patient's first
feeding when it is necessary to fully ascertain return of gastrointestinal function. It may
also be used during periods of acute illness, in cases of food intolerance, and to reduce
colon fecal matter for diagnostic procedures.
(1) The diet is limited to fat-free broth or bouillon, flavored gelatin, water, fruit
drinks without pulp, fruit ice, Popsicles, tea, coffee or coffee substitutes, and sugar. No
cream or creamers are used. Carbonated beverages may be included when ordered by
the physician; however, they are often contraindicated.
(2) The standard menu mat (DA Form 2902-15R) provides approximately
1146 calories. This diet is below the recommended dietary allowances (RDA) for all
nutrients tabulated except for Vitamin C (ascorbic acid). If the patient is to be on clear
liquids for an extended period of time, the portion sizes should be increased or an
accepted enteral formula may be provided.
b. Full Liquid Diet. This diet is used when a patient is unable to chew or swallow
solid food because of extensive oral surgery, facial injuries, esophageal strictures, and
carcinomas of the mouth and esophagus. It may be used to transition between a clear
liquid and a regular diet for the post-surgical patient.
MD0906
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