Case

• OP, 29 years old, male, single, Filipino, Roman

catholic, make up artist,
• Height: 5’ 5”
• Weight: 99 lbs

• CC: bloody diarrhea, alterations in bowel

movement, loss of apetite, abdominal pain
 HPI
• The present condition started 6 monthsPTA when the
patient started experiencing crampy abdominal pain after
a full meal. The patient did not take any medications.
• 5 months PTA the patient experienced on and off diarrhea
and loss of appetite. Weight loss was also noted. The
patient takes loperamide (diatabs, 500mg) OD after each
episode of loose bowel movement.
• 4 months PTA, the patient still experienced crampy
abdominal pain, accompanied by constipation and bloody
stools. The patient modified his diet to a high fiber diet
and took in plenty of fluids. An eight kg weight loss was
noted.
• 2 months PTA, the patient experienced on and off
diarrhea accompanied by black stools. He also noted
easy fatigability and difficulty of breathing. Loperamide
(diatabs 500 mg) was taken OD for each episode, and
diet was still high in fiber consisting of fruits and
vegetables
• 1 month PTA, the symptoms were progressively worse;
pallor and a weight loss of 3 kg was noted. Black stools
was now accompanied by streaks of blood.
• 1 hr PTA, sudden crampy abdominal pain with a scale of
9/10 was experienced by the patient. The patient took
magnesium hydroxide aluminum hysroxide simethicone
(kremil s, 500 mg) which did not relieve symptoms. The
patient was brought to the emergency room and was
subsequently admitted
 Pertinent findings
• Rectal bleeding
• Diarrhea
• Abdominal cramping
• Pain
• Loss of appetite
• Weight loss
• Pallor
 Diagnosis
• Ulcerative colitis
 Computations
• Height: 165.1 cm
• Weight: 45 kgs

• IBW: (165-100) – ((165-100)*.10) = 58.5 kgs

• ABW = IBW + 0.4(actual weight - IBW)
• ABW= 58.5+ (.04(45-58.5))= 53.1
• BMR= 1 x 24 x 53.1 = 1274.4 kcal = 1274 kcal
• PA= 1274 x .75 = 955.8 kcal
• SDA= .6 ( 1274+ 956) = 1338 kcal
• TER: 1338 + 956 + 1274 = 3,568 kcal
• CHO – 40-60% of TER
• CHON – 10-15% of TER
• FAT - 25-35% of TER

For MV:
CHO = 60%
CHON = 15%
FAT = 25%
• TER: 3,570 kcal

• CHO: 3570 x 0.6 = 2142 = 2140 kcal /4 = 535 g

• CHON : 3570 x .15 = 535.5 = 540 kcal/4 = 135 g
• Fats: 3570 x .25= 892.5 = 890 kcal/4 = 99 g

• well-balanced diet that's high in protein, complex

carbohydrates, whole grains, and good fats
LIST MEASURE CHO CHON FAT ENERGY
535 gram 135 gram 99 gram 3570 Kcal
IA
Vegetable A
IB 3 9 3 48
Vegetable B
II 4 40 160
Fruit
III 2 24 16 20 340
Milk
IV 19 437 38 1900
Rice
V 10 80 20 500
Meat
VI 12 60 540
Fat
VII 5 25 100
Sugar
Total 535 137 100 3588
LIST MEASURE Breakfast Snack Lunch Snack Dinner Snack

IA

Vegetable
A
IB 3 2 1
Vegetable
B
II 4 1 1 1 1
Fruit
III 2 1 1
Milk
IV 19 3 3 3 5 3 2
Rice
V 10 3 3 1 3
Meat
VI 12 2 2 2 4 2
Fat
VII 5 1 1 1 1 1
Sugar
 MENU
• Breakfast:
• Snack
– 1 small lakatan – 1 cup low fat milk
– ½ cup yoghurt with 1 – Peanut butter and
tsp. honey or caramel strawberry jelly
sandwich
– 5 pcs brohas » 4 tsps. Peanut
– 1 cup rice butter
» 1 cup
– Pork liver bistek style strawberries
• 3 slices liver » 2 pcs. Rolls
• 2 tsps. Butter » 1 tbsp.
strawberry jam
• Lunch – 10 pcs caramel pili
– Sinampalukang nuts
manok
• Malunggay • Snack
• Squash
– 2 pcs. Kutsinta (6 cm)
• Onions
– Chicken sandwich
• 1 slice papaya
• 6pcs. Pan de sal
• 1 ½ chicken breast
• ½ shredded chicken
• 1 cup rice breast
– 10 pcs pretzels • 8 tbsps. Sandwich
spread
• Dinner • ½ cup prawns
• 1 ½ cups tahong
– 1 slice mango
medium • Puso ng saging
– 1 cup rice • Snack
– 1 pc yema – ½ cup ice cream
– Seafood kare-kare – ½ bar peanut brittle
• Peanut butter 4 tsps – 1 pc cinnamon roll
• 1 pc medium fish fillet (9x6 cm)
 Avoid…
• alcohol • meats
• caffeine • nuts, crunchy nut butters
• carbonated beverages • popcorn
• dairy products, if lactose • products containing
intolerant sorbitol (sugar-free gum
• dried beans, peas, and and candies)
legumes • raw vegetables
• dried fruits, berries, fruits • refined sugar
with pulp or seeds • seeds
• foods containing sulfur or • spicy foods, sauces
sulfate
• foods high in fiber,
including whole-grain
products
• hot sauce, pepper