CASE STUDY 3

GASTROINTESTINAL DISEASES

Gastro intestinal disease refers to disease involving the gastrointestinal tract, namely
the esophagus, stomach, small intestine, large intestine and rectum, and the accessory organs
of digestion, the liver, gallbladder and pancreas.
Gastritis is the combination of two words, gastric and itis. Gastrium or gastric means
the stomach and itis refer to the inflammation. Gastritis involves damage to the lining of the
stomach or duodenum. These disorders are usually caused by stomach acid (especially
hydrochloric acid), digestive enzymes (especially pepsin), helicobacter pylori infection and
use of certain drugs such as non steroidal anti inflammatory drugs.
CAUSES
Use of excessive alcohol, stress, inflammation in your stomach and intestines,
stomach ulcers, certain illness such as diabetes or kidney failure.
SYMPTOMS
Heart burn
Dyspepsia
Nausea and vomiting
Abdominal pain
Belching
Bloating
Flatulence
FOODS INCLUDED
Fruits and vegetables
Starchy carbohydrate
Fish
Yoghurt
Cereals
Bran
FOODS AVOIDED
Spicy food
Citrus fruits
Cheese
 Chocolate
Dairy products
GENERAL INFORMATION
Name : Karthick.A
Gender : Male
Age : 54
Religion : Hindu
Occupation : Bus Driver
Date of admission : 22/12/2022

HOSPITAL DETAILS
MRD No : 16075809
Ward No : 012

MEDICAL HISTORY
Past Medical History : Gastritis hypertension

Present Complaints : Abdominal pain and discomfort

Diagnosis : Gastritis

NUTRITIONAL STATUS EVALUATION 1] Anthropometric Assessment

PARAMETERS ASSESSMENT
Height 157cm
Weight 50kg
BMI 20.3kg/m2
IBW 50

NUTRITIONAL SCREENING ON ADMISSION

• Social history : Doesn’t had any form of tobacco habits but
had an abnormal food intake
• Family history : No family members are affected by gastero
intestinal disease
• Diet history : Non vegetarian and no food allergy
Allergy : No
 Activity : Doesn’t involved in any form of physical activity
Sleep pattern : abnormal sleeping pattern
2] Biochemical Assessment
TEST NAME RESULT NORMAL VALUE

Hemoglobin 8.2gm 11-13gm/dl

MCV 90 80-100fl

MCH 26.44 27-33g/dl

Potassium 4.32 3.5-5.0mEq/l

Creatinine 1.52 0.66-1.09mg/dl

SGPT 40 7-56units/l

SGOT 16 5-40units/l

3] Biophysical Assessment
Blood pressure :120/80
Pulse rate :90/min
Respiration :22/min
EF(Ejection fraction) :60%
Temperature :98.6oF
Total intake :1400ml
Total output :1700 ml

4] Clinical Assessment
ORGANS OBSERVATION
Skin Normal
Eye Normal
Hair Normal
Nail Normal
Mouth Normal
Tongue Normal

6] Dietary Assessment
Food Habit : Non- vegetarian
Food Allergy : No
Diet prescribed: Bland diet
FOOD FREQUENCY RECORD
FOODITEM DAILY WEEKLY MONTHLY OCCASSIONALLY
Cereals 

Pulses 

GLV 

Roots &Tubers 

Milk 

Fats &oils 

Other Vegetables 

Nuts 

Fried foods 

Junk foods 

Meat/Egg/Fish 

Fruits 

Sugar 

24 HOUR RECALL
TIMING MENU QUANTITY

Early morning Milk- 100ml

Breakfast Idly 2no

Sambar 50ml

Mid- morning - -

Lunch Rice 300g

Sambar 100ml

Cabbage 100g

Evening Milk 100ml

Dinner Dosa 1no

Chutney 50ml
CALCULATION
Food Amount Energy(kcal) Protein(g) Carbohydrate(g) Fat(g)
item

Milk 100ml 65 4 6 3

Idly 3no 210 6 45 0

Sambar 50ml 21.25 1.375 3.75 0

Rice 300g 315 9 67.5 0

Sambar 100ml 42.5 2.27 7.5 0

Cabbage 100g 45 1 10 0

Milk 100ml 65 4 6 3

Dosa 1no 70 2 15 0

Chutney 50ml 20 0.25 5 0

Sugar 10g 40 - 5 -

Oil 15ml 135 - - 15

TOTAL 1028 30.2 170.5 21

APROXIMATELY NUTRITIVE VALUE

• Energy : 1028 kcal
• Protein : 30.24g
• Fat : 21g
• Carbohydrate : 170.5g

MEDICATIONS
DRUGS DOSAGE
T.CEFTUM 500mg
T.PAN 400mg
T.DYTOR 5mg
T.MODALAI 100mg
T.SHELCAL 500mg
T.CARDARONE 200mg
NUTRITIONAL STATUS OF THE PATIENT
 DIETARY ASSESSMENT: Non vegetarian and doesn’t have any food
allergy
 DIET PRESCRIBED: Bland diet has been prescribed to the patient
DIET ORDER
DATE DIET ORDER
22/12/2022 Dairy product of foods like low fat milk and
plain butter are suggested.
23/12/2022 Oats meal foods are suggested.
24/12/2022 Vitamin and Mineral rich foods are
consumed.

DIET PRESCRIBED IN HOSPITAL DAY-1

TIMING MENU QUANTITY

Early moning - -

Breakfast Idly 2no

Sambar 50ml

Mid-morning Pomegranate juice 100ml

Lunch Rice 100g

Vegetable curry 50ml

Carrot 50g

Evening Sundal 50g

Dinner Idly 3no

Sambar 50ml

Late night Milk 100ml

CALCULATION
Food Item Amount Energy(kcal) Protein(g) Carbohydrate(g) Fat(g)

Idly 2no 140 4 30 0

Sambar 50ml 21.25 1.375 3.75 0

Pomegranate 100ml 20 0.5 5 0
juice

Rice 100g 105 3 22.5 0

Vegetable 50ml 7.75 0.25 1.75 0

curry

Carrot 50g 15.5 0.5 3.5 0

Sundal 50g 42.5 2.75 7.5 0.25

Idly 3no 210 6 45 0

Sambar 50ml 21.25 1.375 3.75 0

Milk 100ml 65 4 6 3

Sugar 5g 20 - 5 -

Oil 15ml 135 - - 15

Total 803.25 23.5 133.75 18.25

TOTAL INTAKE

 ENERGY ( Kcal )- 803.25 k.cal

 PROTEIN ( g ) -23.5 g

 CHO ( g ) -133.75g

 FAT ( g ) - 18.25g

Day 2-MENU

TIMING MENU QUANTITY

Early morning Milk 100ml

Breakfast Idly 3no

Sambar 50ml

Midmorning Pomegranate Juice 100ml

Lunch Rice 200g

Sambar 100ml

Evening Sundal 100g

Dinner Chapathi 2no

Milk 100ml

Bed time - -

CALCULATION

Food item Amount Energy(kcal) Protein(g) Carbohydrate(g) Fat(g)

Milk 100 ml 65 4 6 3

Idly 3no 210 6 45 0

Sambar 50 ml 21.25 1.375 3.75 0

Pomegranate 100ml 40 0.5 10 0

juice

Rice 200g 210 6 45 0

Sambar 100ml 42.5 2.75 7.5 0.25

Sundal 100g 42.5 2.75 7.5 0.25

Chapathi 2no 140 4 30 0

Milk 100 ml 65 4 6 3

Sugar 15g 60 - 15 -

Oil 15ml 135 - - 15

Total 1031.25 31.25 162.25 21.25

TOTAL INTAKE

 ENERGY ( Kcal )-1031.25 k.cal

 PROTEIN ( g ) - 31.25 g

 CHO ( g ) - 162.25g

 FAT ( g ) - 21.25g

DAY – 3 MENU

TIMING MENU QUANTITY

Early morning Milk 200 ml

Break fast Idiappam 3no

Sundal curry 50ml

Vegetable kootu 100g

Mid – morning Apple juice 200ml

Lunch Rice 200g

 Dhal 50g

Vegetable curry 50ml

Cabbage 100g

Post lunch Pomegranate juice 200ml

Evening Milk 100ml

Peanut boiled 100g

Dinner Idly 3no

Chutney 100g

Bed time Milk 200ml

CALCULATION

Food items Quantity Energy(kcal) Protein(g) Carbohydrate(g Fat(g)

)

Milk 200ml 130 8 12 6

Idiappam 3no 210 6 45 0

Sundal curry 50ml 42.5 2.75 7.5 0.25

Vegetable 100g 45 1 10 0
kootu

Apple juice 200ml 80 1 20 -

Rice 200g 210 6 45 0

Dhal 50g 42.5 2.75 7.5 0.25

Vegetable 50ml 22.5 0.5 5 0
curry

Cabbage 100g 45 1 10 0

Pomegranate 200ml 80 1 20 0
juice

Milk 100ml 65 4 6 3

Peanut 100g 138 6 6 10

boiled

Idly 3no 210 6 45 0

Chutney 100g 45 1 10 0

Milk 200ml 130 8 12 6

Sugar 20g 80 - 20 -

Oil 20ml 180 - - 20

Total 1755.5 56 281 46

TOTAL INTAKE

 ENERGY ( Kcal )-1755.5k.cal

 PROTEIN ( g ) -56 g

 CHO ( g ) -281g

 FAT ( g ) - 46g

SUGGESTED MENU:

TIMINGS MENU QUANTITY

EARLY MORNING MILK 100ml

BREAKFAST UTHAPPAM 3nos

BRINJAL SAMBAR 50h

CARROT CHUTNEY 50g

 POMEGRANATE JUICE 100ml

LUNCH RICE 1 cup

GREEN GRAM DHAL 50g

CABBAGE PORIYAL 50g

EVENING APPLE JUICE 200ml

DINNER IDLY 3nos

VEG KURUMA 50g

BEETROOT CHUTNEY 50h

BEDTIME MILK 100ml

CALCULATION:

FOOD INGRIENTS AMOU ENERGY[k CHO[g] PROTEIN[ FAT[g]

ITEMS NT cal] g]

MILK COW”S MILK 200ml 134 8.8 6.4 8.2

UTHAPP PARBOILED 75g 259.9 59.2 4.8 0.3

AM RICE

BLACK GRAM 25g 86.75 14.9 6 0.35

DHAL

SAMBAR BRINJAL 5g 1.2 0.2 0.07 0.015

TOMATO 5g 1 0.18 0.045 0.01

REDGRAN 25g 83.75 14.4 5.575 0.425

DHAL

CARROT CARROT 20g 9.6 2.12 0.18 0.04

CHUTNE
Y

ONION 10g 5 1.26 0.18 0.01

POMEGR POMEGRANA 100 65 14.5 1.6 0.1

ANATE TE
JUICE

RICE PARBOILED 1008 346 79 6.4 0.4

RICE
GREENG GREENGRAM 20g 69.6 11.98 4.9 0.24
RAM
DHAL

ONION 15g 7.5 1.665 0.18 0.015

CABBAG CAGGAGE 50 13.5 2.3 0.9 0.05

E
PORIYAL

APPLE APPLE 100g 59 13.4 0.2 0.5

JUICE

IDLY PARBOILED 75g 259.9 59.2 4.8 0.3

RICE

BLACKGRAM 25g 86.75 14.9 6 0.35

DHAL

VEG CARROT 5g 2.15 0.53 0.045 0.01

KURUMA

BEANS 5g 7.9 1.49 0.37 0.05

ONION 10g 5 1.26 0.18 0.01

TOMATO 5g 1 0.18 0.045 0.01

BEETRO BEETROOT 10g 8.6 1.76 0.34 0.02

OT
CHUTNE
Y

ONION 5g 2.5 0.63 0.09 0.005

TOTAL 1513.35 303.8 50.68 11.46

TOTAL INTAKE:

ENERGY 1513.35

CARBOHYDATE 303.8g

PROTEIN 50.68g
 FAT 11.46g

SUMMARY:

The patient Mr.Karthick .A is 54 years old admitted in the hospital with the present
complaints of abdominal pain and discomfort. He has the past history of gastritis and
hypertension. The BMI (20.3) shows that the patient is normal. The biochemical assessment
shows that the hemoglobin level is normal. The clinical assessment shows that the eye,
mouth, ear was normal, lip and tongue was normal. The dietary assessment shows that the
patient calorie intake is normal. The food frequency shows that the patient's diet include all
the food groups. On the diagnosis of the disease and nutritional assessment the patient was
given drug and dietary treatment. Drugs were prescribed by the physician and the diet order
prescribed by the dietitian. Bland diet has been prescribed to the patient.