1 / 16

ALIMENTATIA SI TULBURARILE DE TRANZIT IN SM

ALIMENTATIA SI TULBURARILE DE TRANZIT IN SM. SEMINARUL NATIONAL DE SM 2009. SM – boala autoimuna, cauze si mecanisme de producere incomplet elucidate Consecinta: ipoteze si recomandari dietetice variate, uneori contradictorii Manifestari clinice polimorfe

alban
Télécharger la présentation

ALIMENTATIA SI TULBURARILE DE TRANZIT IN SM

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. ALIMENTATIA SI TULBURARILE DE TRANZIT IN SM SEMINARUL NATIONAL DE SM 2009

  2. SM – boala autoimuna, cauze si mecanisme de producere incomplet elucidate • Consecinta: ipoteze si recomandari dietetice variate, uneori contradictorii • Manifestari clinice polimorfe • Afectarea directa si indirecta a aparatului digestiv

  3. Scopul recomandarilor dietetice in SM • Posibil rol al alimentatiei in ameliorarea evolutiei bolii • Adaptarea alimentatiei la disfunctiile gastro-intestinale specifice • 5% constipatie • 51% incontinenta fecala • 68% diferite forme de disfunctii intestinale

  4. PREMISE • Prevalenta diferita a SM in functie de obiceiurile alimentare • Rolul acizilor grasi esentiali in • Imunitate • Structura mielinei si a membranei neuronale • Diete sarace in grasimi saturate si bogate in acizi grasi esentiali au dus la scaderea dizabilitatii si a frecventei si severitatii puseelor in SM

  5. Grasimi • Saturate • Trans • Nesaturate • Mononesaturate: masline, alune, avocado, migdale • Polinesaturate : floarea soarelui, soia, poromb, nuci, ulei de peste • acizi grasi esentiali • Omega 3: peste, fructe de mare, soia, nuci • Omega 6: ulei fl soarelui, susan si porumb, leguminoase, legume cu frunze, cereale, viscere

  6. Diete • SWANK • CRAWFORD • EVERS • MC DOUGALL • GREER, etc

  7. Consens – USA National MS SocietyRecomandari 2008 • Minimum 3 mese principale si 2 gustari pe zi • Optimizarea masticatiei si deglutitiei • Mese mici si dese • Alimente moi, taiate, pasate • Bolusuri alimentare mici • Aport de fluide sub forme de gelatine, sucuri

  8. Scaderea cantitatii de grasimi saturate (carne rosie grasa, pielea de la pui sau curcan, unt, produse lactate grase) • Optim: grasimi 30% din calorii, 93% nesaturate • Consum regulat de peste (somon, hering, macrou, ton, sardine) • Folosirea uleiurilor vegetale si de peste

  9. Consum crescut de fasole, mazare, linte, soia, nuci, orez ne-decorticat • Minimum 5 portii de fructe sau legume pe zi • 3 – 4 portii de cereale integrale pe zi • Aport optim de fibre (cresc senzatia de satietate, leaga grasimi in intestin, regleaza tranzitul intestinal) • Evitarea excesului (crampe, diaree)

  10. Aport suficient de calciu si vit D (prevenirea osteoporozei) • surse recomandate: • Suplimente : carbonat de calciu, citrat de calciu • produse lactate degresate, peste, legume (broccoli, spanac, migdale) • surse nerecomandate: produse obtinute din cochilii, dolomite, os (posibil metale toxice)

  11. Antioxidanti: • vit A, C, E, • Seleniu, • CoQ10 • Atentie! Pot stimula sistemul imun (vitC, E) • Se recomanda sursele alimentare (fructe si legume proaspete) nu suplimente

  12. Aport suficient de fluide • Tendinta de consum scazut de fluide -> ITU, tulb deglutitie, scaderea apetitului, hTA • De evitat: cafea si bauturi cofeinizate, alcool, sucuri cu aspartam -> iritatie vezicala • Recomandat: coacaze (fruct, suc, tb) pt preventia ITU

  13. Constipatia in SM • Mecanism predominant indirect (nelegat de leziuni medulare): • Tranzit lent (anticolinergice) • Spasticitate scaderea relaxarii planseului pelvin • Scaderea sensibilitatii rectale • Spasm al sfincterului striat extern

  14. Incontinenta fecala in SM • Mecanisme • Scaderea senzatiei de plenitudine rectala • Scaderea controlului voluntar al sfincterului anal si al planseului pelvin • Scaderea compliantei rectale • Frecvent asociate constipatia-incontinenta

  15. Tratamentul tulburarilor de tranzit in SM • Dietetic • Clisme evacuatorii • Terapia vibratorie • Medicamentos • Laxative (lactuloza, ceaiuri laxative) • Imipramina, propantelina (pt urgenta la defecatie)

  16. SM – o boala cu mecanisme de producere si manifestari clinice complexe, • necesita o abordare terapeutica complexa si completa

More Related