Aids/HIV information, Symptoms, treatment

1. Occurs in >80% HIV patients
2. Candida albicans-most common fungus-causes anorexia/dysphagia
3. Psychological depression
4. Delayed stomach emptying-ANS effects
5. Esophageal ulcers may discourage swallowing-viral/bacterial
6. Infiltrating masses-Kaposi’s sarcoma

Total small bowel disease

1. Frequently caused by parasites.
2. 4-8 bowel movements/day. Patients will stop eating to decrease bowel movements.
3. Rx:
   • Short term parenteral nutrition
   • Next, minimal (5%) fat, lactose-free diet to stimulate gut function (Elemental enteral diet);
   • Monitor serum albumin; adjust nitrogen

Partial small bowel disease

1. Intermittent diarrhea
2. Fluid, electrolyte, B12 losses
3. Sometimes only terminal ileum involved like Crohn’s disease
4. Rx:
   • Small, frequent feedings
   • Low fat, low lactose, caffeine-free
   • Elemental diet may be needed if steatorrhea present

Large bowel disease

1. Generalized inflammatory disorder
2. Causes rapid wasting, when chronic
3. Eating avoidance common
4. May be caused by virus, bacteria, parasite or neoplasm
5. Rx:
   • Small, frequent feedings
   • Low in fiber, residue, lactose, fat, caffeine-to reduce bowel movements

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