Reference no: EM132436641
Problem: Mr. Bonilla is an 88-year-old male of Asian descent with a height of 5'3". He is a retired head of a family-owned textile business. Until two years ago, he was generally healthy despite being overweight. At that time, his wife passed way and his health began to decline drastically. His weight dropped from 162 to 102 pounds. He became severely dehydrated and was hospitalized briefly for rehydration. One major factor contributing to this significant weight loss, aside from dealing with the grief of losing his wife, was that his wife prepared all of his meals, and he did not know how to take over the task himself. With this deterioration, Mr. Bonilla also developed occasional bowel incontinence, causing him to retire from his business and further isolating him from the support of his family and friends.
He has since moved in with his daughter, and she provides him with a number of small meals throughout the day. His current weight is 126 lbs.
Mr. Bonilla was recently seen by his physician for strep throat, and was started on antibiotics. During the course of taking the medication, his bowel incontinence increased, and he developed gas, abdominal pain, and changes in stool consistency. He was eventually diagnosed with irritable bowel syndrome (IBS). He reported that during his adolescence he had been diagnosed with lactose intolerance and several food allergies, including wheat, which appeared to be the main trigger for episodes of eczema during his childhood.
According to his daughter, he maintains a fairly repetitive diet including turkey, chicken, tofu, white rice, potatoes, brown rice cakes, baked yams, and a variety of vegetables served in a soup (peas, carrots, green beans, onions, and broccoli). He gets at least 64 to 72 ounces of water a day served with his meals or in the soup. His diet lacks dairy products and fruits. He states he cannot tolerate anything acidic such as citrus fruits without nausea. His daughter also avoids using oil or butter in food preparation since this seems to trigger pain related to the IBS.
Required:
- How are the symptoms of IBS and lactose intolerance related?
- What kind of dietary adjustments are necessary with lactose tolerance?
- What effect might the administration of an antibiotic have upon Mr. Bonilla's problems with lactose intolerance
- What sources of calcium are available in Mr. Bonilla's diet, considering his restriction of milk products?
- Comment on Mr. Bonilla's dietary patterns in relation to his IBS.