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    KM is a 36-year-old female admitted to the hospital with stomach pain and severe diarrhea. A biopsy showed signs of celiac disease including flattened mucosa and villus atrophy. She tested positive for celiac antibodies and was diagnosed with celiac disease and related malnutrition and anemia. She reports feeling constantly hungry but experiences immediate diarrhea after eating, especially after fried foods or beef. Her weight is significantly below her usual weight and labs show signs of malnutrition. She requires a gluten-free diet and refeeding plan to address her involuntary weight loss and malnutrition due to celiac disease and malabsorption.

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    Adime

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    357 views2 pages
    KM is a 36-year-old female admitted to the hospital with stomach pain and severe diarrhea. A biopsy showed signs of celiac disease including flattened mucosa and villus atrophy. She tested positive for celiac antibodies and was diagnosed with celiac disease and related malnutrition and anemia. She reports feeling constantly hungry but experiences immediate diarrhea after eating, especially after fried foods or beef. Her weight is significantly below her usual weight and labs show signs of malnutrition. She requires a gluten-free diet and refeeding plan to address her involuntary weight loss and malnutrition due to celiac disease and malabsorption.

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    KM is a 36-year-old female admitted to the hospital with stomach pain and severe diarrhea. A biopsy showed signs of celiac disease including flattened mucosa and villus atrophy. She tested positive for celiac antibodies and was diagnosed with celiac disease and related malnutrition and anemia. She reports feeling constantly hungry but experiences immediate diarrhea after eating, especially after fried foods or beef. Her weight is significantly below her usual weight and labs show signs of malnutrition. She requires a gluten-free diet and refeeding plan to address her involuntary weight loss and malnutrition due to celiac disease and malabsorption.

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    357 views2 pages

    Adime

    Uploaded by

    api-276849892
    KM is a 36-year-old female admitted to the hospital with stomach pain and severe diarrhea. A biopsy showed signs of celiac disease including flattened mucosa and villus atrophy. She tested positive for celiac antibodies and was diagnosed with celiac disease and related malnutrition and anemia. She reports feeling constantly hungry but experiences immediate diarrhea after eating, especially after fried foods or beef. Her weight is significantly below her usual weight and labs show signs of malnutrition. She requires a gluten-free diet and refeeding plan to address her involuntary weight loss and malnutrition due to celiac disease and malabsorption.

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    of 2

    ADIME

    #2 Assignment
    Medical Nutrition Therapy
    Celiac Disease

    KM is a 36 year old female admitted to the hospital with stomach pain and severe
    diarrhea. A bowel biopsy indicates: flat mucosa and villus atrophy and hyperplastic
    crypts-inflammatory infiltrate in lamina propia. She has tested positive TTG, EMA
    antibodies. Her admitting diagnosis is celiac disease with secondary malabsorption
    and anemia. You interview the patient and she tells you that she is hungry all of the
    time. She also states that when she does eat (especially large amounts) she almost
    immediately has diarrhea. She does not have any nausea or vomiting. KM states that
    when she eats fried foods or beef, her diarrhea seems worse. She has mostly been
    eating noodle soups, some chicken, crackers and sprite.
    Ht: 53
    Wt: 92 lbs UBW: 112(1 month ago)
    Labs: albumin- 2.9g/dL, prealbumin- 14mg/dL, Hgb- 10.5g/dL, Hct- 35%, Ferritin-
    12
    Diet Order: NPO


    Sasha Sheftel
    ADIME #2 Write-up
    ADIME Note #2
    A:
    KM is a 36 y/o female admitted to the hospital with stomach pain and severe
    diarrhea. A bowel biopsy indicates: flat mucosa, villus atrophy, and
    hyperplastic crypts-inflammatory infiltrate in lamina propia. Has positive
    tests for TTG and EMA antibodies. Patient indicates she feels hungry all of
    the time and when she does eat she immediately has diarrhea. She mostly
    has been eating noodle soup, chicken, crackers and sprite.

    36 y/o female Dx: celiac disease with secondary malabsoprtion and anemia

    Ht. 5 3 CBW: 92# UBW: 112# IBW: 115# Pt. 80% of UBW/IBW

    BMI: 16.8 (CBW) 19.9 (UBW)

    EER: 1300-1800 kcal/day EPR: 41-50 g/protein/day

    Estimated Fluid Requirements 1300-1800 mL/day
    Labs: albumin- 2.9g/dL, prealbumin- 14mg/dL, Hgb- 10.5g/dL, Hct- 35%,
    Ferritin- 12
    D:
    1. Involuntary weight loss R/T diarrhea and malabsorption, especially
    following consumption of fried foods and meats AEB 18% unexplained
    weight loss
    2. Malnutrition R/T severe diarrhea AEB BMI <18.5
    3. Altered GI function R/T flat mucosa, villus atrophy, and hyperplastic
    crypts-inflammatory infiltrate in lamina propia AEB positive tTG and EMA
    antibodies
    I:
    1. Consult with KM about taking in 1300-1800 kcal, 41-50 g protein, and
    1300-1800 mL fluid per day in order to gain 1 pound per week over the next
    20 weeks and accommodate for protein malabsoprtion.

    2. Consult with KM about a lactose-free, gluten-free diet

    3. Educate KM about gluten-free food options

    4. Advise KM to slowly start incorporating lactose into diet

    5. Advise KM to attend celiac disease support groups
    ME: 1. Patient will gain 20 pounds in 20 weeks to be back to UBW

    2. Patient will comply with a gluten-free diet

    3. Patient will be eating small amounts of lactose

    4. Patient will fully understand celiac disease and have reached out to peers
    for support
    Signature
    Sasha Sheftel, Dietetics Student

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