Gut Reaction: Gut Reaction: Dealing with Dealing with

Gastrointestinal Gastrointestinal ComplicationsComplications

Real Life Real Food for Real Life Real Food for Cancer Survivors presented Cancer Survivors presented

by:by:Jennifer Koorenny MS, RD Jennifer Koorenny MS, RD

Topics of Discussion:Topics of Discussion:

►The Gastrointestinal (GI) TractThe Gastrointestinal (GI) Tract

►When Digestion Goes WrongWhen Digestion Goes Wrong

►Remove and Repair Remove and Repair

►RecipesRecipes

Our Digestive Systems RoleOur Digestive Systems Role

►Transports food through the GI tractTransports food through the GI tract►Secretes digestive juices to Secretes digestive juices to

breakdown foods into smaller, usable breakdown foods into smaller, usable forms of nutrients (glucose, amino forms of nutrients (glucose, amino acids, fatty acids, etc) acids, fatty acids, etc)

►Absorb digested foods, Absorb digested foods, micronutrients (vitamins, minerals), micronutrients (vitamins, minerals), water and electrolyteswater and electrolytes

The GI TractThe GI TractTubular structure extending from mouth to anus, Tubular structure extending from mouth to anus,

approximately 30 feet in length, divided into sections approximately 30 feet in length, divided into sections with highly specialized functions.with highly specialized functions.

► Mouth (chewing)Mouth (chewing)► Esophagus (swallowing)Esophagus (swallowing)► Stomach (storage, digestion, rate food moves into SI)Stomach (storage, digestion, rate food moves into SI)► Small intestine: duodenum, jejunum, ileum Small intestine: duodenum, jejunum, ileum

(digestion,(digestion, absorption)absorption)► Large intestine: colon, sigmoid, rectum (water Large intestine: colon, sigmoid, rectum (water

absorption, fiber fermentation, waste excretion)absorption, fiber fermentation, waste excretion)

The GI tract is the second largest surface area of the The GI tract is the second largest surface area of the bodybody

GI FunctionGI Function

►Big role in our body’s detoxification Big role in our body’s detoxification systemsystem

►Regulates much of our infection-Regulates much of our infection-fighting immune systemfighting immune system

►All of the digestive functions of the All of the digestive functions of the bodybody

►Nearly all of the absorptive function of Nearly all of the absorptive function of the body (skin, respiratory the body (skin, respiratory membranes excluded)membranes excluded)

When Digestion Goes WrongWhen Digestion Goes Wrong

►Leaky Gut SyndromeLeaky Gut Syndrome Prolonged medication and antibiotic useProlonged medication and antibiotic use Diet choicesDiet choices Chronic stressChronic stress Environmental ContaminantsEnvironmental Contaminants Gastrointestinal diseaseGastrointestinal disease Overconsumption of alcoholic beveragesOverconsumption of alcoholic beverages Dysbiosis: imbalance of GI flora Dysbiosis: imbalance of GI flora

What is Leaky Gut?What is Leaky Gut?

► Increased intestinal permeability Increased intestinal permeability ►Allows passage of foreign materials Allows passage of foreign materials

to pass into the bloodstreamto pass into the bloodstream Undigested food particles Undigested food particles toxic molecules toxic molecules disease producing bacteria disease producing bacteria

Common Dietary Factors Common Dietary Factors Related to Leaky GutRelated to Leaky Gut

► Low plant food intakeLow plant food intake► Poor quality foodPoor quality food

Highly processed, refined dietHighly processed, refined diet►High animal protein dietHigh animal protein diet► Acidic beverages (sodas, alcohol)Acidic beverages (sodas, alcohol)► Eating on the runEating on the run► Exposure to dietary antigens (food Exposure to dietary antigens (food

sensitivities), microorganisms, bacterial sensitivities), microorganisms, bacterial toxins, chemotherapytoxins, chemotherapy

► Low gastric acid production Low gastric acid production ► Antibiotic or medication useAntibiotic or medication use

Other Factors: Stress and Other Factors: Stress and DigestionDigestion

►Stress Stress Decreases gastric and pancreatic secretionsDecreases gastric and pancreatic secretions Decreases muscle contractions in GI tractDecreases muscle contractions in GI tract Increases constriction of sphinctersIncreases constriction of sphincters Liver, releases glucoseLiver, releases glucose Increases cortisol levels (chronic stress):Increases cortisol levels (chronic stress):

Hyperglycemia Hyperglycemia Decreased immune functionDecreased immune function Water and vitamin lossesWater and vitamin losses

Other Factors: Relaxation and Other Factors: Relaxation and DigestionDigestion

►RelaxationRelaxation Increases gastric and pancreatic secretionsIncreases gastric and pancreatic secretions Increases GI motilityIncreases GI motility Relaxes sphinctersRelaxes sphincters Liver, glycogen synthesisLiver, glycogen synthesis Gall bladder, contracts to release bile when Gall bladder, contracts to release bile when

signaledsignaled

Remove to RepairRemove to Repair

►Requires identification of possible Requires identification of possible offendersoffenders Keep a detailed diet diaryKeep a detailed diet diary Track GI function, noting gas, bowel Track GI function, noting gas, bowel

movements, moods, any changes in skin movements, moods, any changes in skin integrity, etc.integrity, etc.

Note changes in stress level or physical Note changes in stress level or physical signs of chronic stresssigns of chronic stress

Stress: Mind-Body Stress: Mind-Body ConnectionConnection

►Avoid or reduce exposure to stressors, Avoid or reduce exposure to stressors, oror

►Learn to manage them Learn to manage them Yoga Yoga MeditationMeditation HobbyHobby Physical ActivityPhysical Activity Deep BreathingDeep Breathing Exit a situation when possibleExit a situation when possible Consult a professional counselorConsult a professional counselor

Identify Potential Food Identify Potential Food SensitivitiesSensitivities

Notice whether certain types of food are Notice whether certain types of food are related to pain, rashes, GI discomfort:related to pain, rashes, GI discomfort:

►Night shades (tomatoes, potatoes, Night shades (tomatoes, potatoes, eggplant, peppers)eggplant, peppers)

►WheatWheat►GlutenGluten►DairyDairy►SoySoy

(This is not a comprehensive list)(This is not a comprehensive list)

Eliminate Potential Eliminate Potential OffendersOffenders

►Elimination Diet*Elimination Diet* Remove potential offenders from diet for a Remove potential offenders from diet for a

specified time period – usually 3-4 weeksspecified time period – usually 3-4 weeks►May require eliminating all foods from a familyMay require eliminating all foods from a family

““Challenge” all foods individually for 3-5 Challenge” all foods individually for 3-5 days to assess for return of symptomsdays to assess for return of symptoms

Re-eliminate foods that cause a reactionRe-eliminate foods that cause a reaction Process takes one-four months to completeProcess takes one-four months to complete

*Guidance from a dietitian is recommended*Guidance from a dietitian is recommended

Repair: Treating Repair: Treating InflammationInflammation

► Reduce spicy and acid forming foods, Reduce spicy and acid forming foods, alcohol, coffee, teaalcohol, coffee, tea

► Eat foods containing pre- and probioticsEat foods containing pre- and probiotics► Include whey protein with glutamineInclude whey protein with glutamine►Get adequate amounts of calcium, Get adequate amounts of calcium,

magnesium, iron, zinc, seleniummagnesium, iron, zinc, selenium►Modify textures of foods (soups, Modify textures of foods (soups,

smoothies, pureed or soft foods)smoothies, pureed or soft foods)

Repair: Restoring BacteriaRepair: Restoring Bacteria

There are more bacteria in our There are more bacteria in our intestinal tract than cells in our body.intestinal tract than cells in our body.

Pre-biotics (FOS): Pre-biotics (FOS): Support the Growth of “Good Bacteria”

Foods naturally containing Foods naturally containing FOS:FOS:

► BananasBananas►GarlicGarlic►OnionsOnions► Leeks Leeks ► SoybeansSoybeans►whole grains whole grains ►HoneyHoney►Most fruits Most fruits

► BlueberriesBlueberries► AsparagusAsparagus► PeasPeas► LegumesLegumes► EggplantEggplant► Jerusalem Jerusalem

artichokesartichokes

Pro-biotics: the “Good Pro-biotics: the “Good Bacteria”Bacteria”

Natural food Natural food sources:sources:

► Cultured yogurtCultured yogurt► TempehTempeh►MisoMiso► Sourdough breadSourdough bread►Naturally fermented Naturally fermented

vegetables vegetables (sauerkraut, kimchi)(sauerkraut, kimchi)

Foods fortified:Foods fortified:► Soy yogurtSoy yogurt► Some juices: ie Some juices: ie

Good BellyGood Belly®®► others?others?

Repair: Improving Repair: Improving AbsorptionAbsorption

► Partial digestion (digestive enzymes – papaya, Partial digestion (digestive enzymes – papaya, pineapple, acidophilus – yogurt, buttermilk. pineapple, acidophilus – yogurt, buttermilk. Consult physician if this continues; Rx may be Consult physician if this continues; Rx may be required)required)

► Liver detoxification (brassica family of Liver detoxification (brassica family of vegetables, Vitamin C, E, beta carotene, B vegetables, Vitamin C, E, beta carotene, B vitamins)vitamins)

► Improve Colon Health (vitamins D, K, C, organic Improve Colon Health (vitamins D, K, C, organic coconut oil)coconut oil)

► Reduce Constipation (fiber and fluids, flaxseed Reduce Constipation (fiber and fluids, flaxseed meal, probiotics, FOS, aloe vera juice)meal, probiotics, FOS, aloe vera juice)

► Reduce Diarrhea (increase soluble fiber intake, Reduce Diarrhea (increase soluble fiber intake, temporarily remove insoluble fiber, probiotics)temporarily remove insoluble fiber, probiotics)

Maintenance: Dietary Maintenance: Dietary ChangesChanges

►Eat whole foods and less processed Eat whole foods and less processed foodsfoods Read ingredient lists and look for foods Read ingredient lists and look for foods

containing <5 itemscontaining <5 items Include 2 ½ – 3 cups of vegetables dailyInclude 2 ½ – 3 cups of vegetables daily Increase plant proteinsIncrease plant proteins Increase whole grainsIncrease whole grains Learn to cook from scratchLearn to cook from scratch

►Reduce meat intake Reduce meat intake ►These may require some initial lifestyle These may require some initial lifestyle

changes, but they do get easier!changes, but they do get easier!

Online Food PlannerOnline Food Plannerwww.myfoodmyhealth.comwww.myfoodmyhealth.com

►Online weekly meal planner for multiple Online weekly meal planner for multiple health conditions & food allergieshealth conditions & food allergies 20+ health conditions including: celiac, 20+ health conditions including: celiac,

autism, candidiasis, diabetes, etc.autism, candidiasis, diabetes, etc. Food allergies including: wheat, dairy, gluten, Food allergies including: wheat, dairy, gluten,

soy etc.soy etc. Delicious & nutritious chef-created recipesDelicious & nutritious chef-created recipes Easy to prepare in less than 30 minutesEasy to prepare in less than 30 minutes International flavorsInternational flavors Whole, natural ingredientsWhole, natural ingredients

Only the Tip of the Ice-BergOnly the Tip of the Ice-Berg

Gastrointestinal problems are serious Gastrointestinal problems are serious and these recommendations are not and these recommendations are not comprehensive and are made to help comprehensive and are made to help you troubleshoot potential problems. you troubleshoot potential problems.

This presentation is not intended as This presentation is not intended as treatment and if problems are a treatment and if problems are a concern, it is recommended you discuss concern, it is recommended you discuss them with your doctor or request an them with your doctor or request an appointment with a registered dietitian.appointment with a registered dietitian.

Recipes: Mango LassiRecipes: Mango Lassi

► 1 cup frozen mango chunks (probably about 1 cup frozen mango chunks (probably about 1/2 fresh mango)1/2 fresh mango)

► 3/4 cup low-fat kefir or yogurt3/4 cup low-fat kefir or yogurt► 2 tsp ginger syrup (see recipe) or 1 tsp honey 2 tsp ginger syrup (see recipe) or 1 tsp honey

(optional)(optional)► Ice, if desiredIce, if desired

► Whirl all ingredients in a blender or mini food Whirl all ingredients in a blender or mini food processor. Pour into a large glass and eat with processor. Pour into a large glass and eat with a spoon. Serves one generously.a spoon. Serves one generously.

Recipe: RaitaRecipe: Raita► 1/2 large English or seedless cucumber, or 1 1/2 large English or seedless cucumber, or 1

standard cucumberstandard cucumber► 1/2 cup low-fat or nonfat plain yogurt (I like 1/2 cup low-fat or nonfat plain yogurt (I like

European Style, which is thicker than normal yogurt European Style, which is thicker than normal yogurt but not as thick as Greek-style)but not as thick as Greek-style)

► 1/4 teaspoon fine sea salt1/4 teaspoon fine sea salt► 1 clove of fresh garlic (optional) 1 clove of fresh garlic (optional) ► Peel the cucumber and seed if necessary. Using a Peel the cucumber and seed if necessary. Using a

box grater, grate the cucumber. Take cucumber box grater, grate the cucumber. Take cucumber pulp in your hand and squeeze with both hands pulp in your hand and squeeze with both hands over the sink to drain (a ton of water will come out). over the sink to drain (a ton of water will come out). In a small bowl, combine cucumber, yogurt, salt, In a small bowl, combine cucumber, yogurt, salt, and garlic powder. Stir and taste for salt. and garlic powder. Stir and taste for salt.

Thank you!Thank you!

Any Questions?Any Questions?