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Osteoporosis: Osteoporosis is a medical condition in which bones become weak and brittle. The
WHO defines osteoporosis in terms of a decline in bone mineral density. Osteoporosis is a
multifactor disease that occurs when the bone mineral density becomes so low that the body is
unable to withstand ordinary strains done to the body. There are two types of primary
osteoporosis, distinguished by sex, the age at which fractures occur, and the kinds of bone that
are involved. Secondary osteoporosis occurs when an identifiable drug or disease process causes
bone tissue loss.10,11
Rickets: Rickets is a disease apparent in children, involving impaired mineralization of growing
bones. It is caused by deficiency in vitamin D, calcium, and phosphorus. Rickets is characterized
by structural abnormalities of the weight-bearing bones. Treatments for rickets disease include
oral preparations of the vitamin or intake of natural sources rich in the vitamin that is deficient.12
DEXA scan: or dual-energy x-ray absorptiometry scan assesses bone mineral density and it is
and enhanced form of X-ray technology used to measure mineral, fat and boneless lean tissue
compartments.13
Bone Densitometry: is a test similar to an X-ray, which uses tissue absorption of photons to
measure bone mass. It is primarily used to detect osteopenia and osteoporosis.14
Bone Mineral Density (BMD): is a medical term that refers to the amount of mineral matter in
the bones. In a clinical setting, BMD is used as an indicator of osteoporosis and fracture risk.15
Parathyroid Gland: small endocrine glands located in the neck that produces parathyroid
hormone (PTH). PTH regulates the concentrations of calcium in the blood.16
Anaphylaxis: is a severe allergy that may be life threatening, and it is characterized by a drop on
blood pressure and a narrowing of the airways, blocking normal breathing. Other signs and
symptoms may that indicate anaphylaxis are skin rashes, nausea and vomiting.17
Celiac Disease: autoimmune disorder in people genetically predisposed to gluten intolerance.
The disease is characterized by immune attacks to the small intestine that lead to damage on the
villi and intestinal lining causing malabsorption of nutrients. Celiac Disease can be treated by
adoption a gluten-free diet.18
Irritable Bowel Syndrome: a widespread condition that affects the large intestine and it is
characterized by chronically recurring abdominal discomfort and/or pain and altered bowel
habits such as constipation and diarrhea.19
II Dietary Supplements: In a table format, please include purported uses, mechanism of action, adverse reactions or
contraindications, and drug-supplement interaction
Supplement 2027
Aloe
Purported Use
Possibly effective for:
Constipation
Cold sores (HSV)
Itchy rash on skin or
mouth
Psoriasis
Insufficient evidence:
HIV
Sunburn, burns
Skin damage d/t
radiation
Cancer
DM
Dry skin, dandruff
Wound healing
Bitter melon
Insufficient evidence:
Diabetes (DM)
Adverse Reactions /
Contraindications
Contains gel that may GI Aloe latex may cause stomach
cause positive changes pain, cramps, diarrhea
in skin condition
Life Stage Avoid in children,
pregnancy and lactation
Contains latex that has Conditions Use with caution in:
laxative effects
DM may cause hypoglycemia,
inflammatory bowel disease aloe
latex acts as irritant
Avoid in: hemorrhoids-exacerbates
condition, pre/post surgery
Other Long term use of aloe latex
may cause kidney problems, blood
in urine, low potassium, muscle
weakness, weight loss, and heart
disturbances
High dose of aloe latex are linked
to kidney failure and may be fatal
(>1g/day)
Mechanism of Action
Drug-Supplement
Interactions
Digoxin: laxative effects of aloe
latex can potassium levels
which side effects of digoxin
Antidiabetes drugs may cause
hypoglycemia
Medications taken by mouth
laxative effects can amount of
medicine absorbed by body
Diuretics laxative effects of
aloe latex can potassium
levels too much
Laxatives can laxative
effects and cause
dehydration/low minerals in
body
Warfarin (Coumadin) laxative
effects of aloe latex can
diarrhea, which can effects of
warfarin and risk of bleeding
Sevoflurane (used during
surgery) may bleeding
during surgical procedures
Contains chemical that Life Stage Avoid in pregnancy and Antidiabetes drugs may cause
acts like insulin to help lactation may cause menstrual
hypoglycemia
Black Cohosh
Carnitine
Insufficient evidence:
PMS and painful
menstruation
Breast cancer
Infertility
Labor induction
Osteoporosis
Acne
bleeding
Conditions Use caution with: DM
may cause hypoglycemia
Avoid in: glucose-6-phosphate
dehydrogenase (G6PD) deficiency
may cause anemia, headache,
fever, and coma; pre/post surgery
Other Safety of long-term use (>3
months) is unknown
Contains chemicals
GI Stomach upset, cramping
that may reduce
Life Stage Avoid in: pregnancy and
inflammation and may lactation may risk of
work similar to
miscarriage
serotonin
Conditions Avoid in: breast cancer
and hormone-sensitive conditions
May or effects of
that could be affected by estrogen;
estrogen depending on liver disease; protein S deficiency
which part of the body risk of blood clots
Other Headache, rash, vaginal
spotting/bleeding, weight gain,
may be associated with liver
damage
Effective for:
Kidney disease
Anticoagulants (Sintrom,
Coumadin) may effects of
Cartilage
Bovine (BC)
and Shark
(SC)
Chamomile
It is important in heart
and brain function,
muscle movement and
Insufficient evidence for: other processes.
High cholesterol
Muscle disorders
Retts syndrome,
ADHD
Lyme disease
Improving athletic
performance/enduran
ce
Insufficient evidence:
Shark cartilage may
Life Stage: Avoid in pregnancy and
help prevent tumor
lactation (unknown effects)
Cancer
growth by blocking
Osteoarthritis
blood vessel growth
Shark: bad taste, N/V/C, stomach
Psoriasis
upset, low BP, dizziness, high
Hemorhoids (BC)
Bovine cartilage may blood glucose, high Ca levels,
Poison ivy (BC)
provide chemicals
fatigue
Acne (BC)
needed to rebuild
Rectal Itching (BC) cartilage, may reduce Bovine: N/D, swelling, local
swelling, and may help redness, tiching
RA (BC)
with wound healing
Wound healing
Possibly effective:
Contains chemicals
Life Stage: Avoid in pregnancy and
(German)
Anxiety
Colic
Diarrhea
Upset stomach
(dyspepsia)
Oral mucositis
Insufficient evidence:
Dermatitis, eczema
Gingivitis
Insomnia
Common cold
Hemorrhoids
Vaginitis
Wound healing
Cranberry
Chromium
effectiveness of drugs
Medications changed by the
liver (eg Mecavor, Allegra)
may effects/side effects of
drugs
Sedatives (benzodiazepines,
CNS depressants) may
sleepiness and drowsiness
Tamoxifen may
effectiveness of drug
Anticoagulants (warfarin)
may effects and slow blood
clotting
Contain chemicals that Life Stage Food is safe to consume Anticoagulants/Antiplatelet
prevent bacteria from but avoid supplements in
drugs (Coumadin) effects of
sticking to cells lining pregnancy and lactation
slowing blood clotting
the urinary tract
Conditions Use caution in:
atrophic gastritis and
Medications changed by the
Contains salicylic acid hypochlorydia may affect B12
hnliver (eg Elavil, Valium,
which can reduce
absorption, DM sugar sweetened Glucotrol) may rate of
swelling, prevent blood cranberry juice may blood
metabolism in liver and may
clots
glucose
effects/side effects (minor
Other: Avoid if you have allergy to interaction)
salicylic acid
Avoid if you have kidney stones
oxalates in cranberry extracts may
risk of stones
Chromium is an
GI Nausea
Chondroitin
Pre-diabetes
Depression
PCOS
Weight loss,
increasing muscle
Improving athletic
performance
Increasing energy
Possibly effective for:
Osteoarthritis (OA)
Chondroitin is a
building block of
cartilage. It may slow
the breakdown of
cartilage in joints
(osteoarthritis) and
possibly restore lost
cartilage.
hypoglycemia
Anticoagulants/antiplatelets
(Coumadin) taking
chondroitin with glucosamine
the effects of warfarin on blood
clotting
Levothyroxine (Synthroid)
may how much the body
absorbs, decreasing effects
(take drug 30 minutes before, or
3-4 hours after chromium)
NSAIDs - may chromium
levels in body and risk of
adverse effects
Cranberry
Chemotherapy: CoQ10
antioxidant activity may
effectiveness
Antihypertensives: taken with
CoQ10, may cause BP to drop
too low
Anticoagulants/Antiplatelets
(Coumadin): CoQ10 may
blood clotting, therefore the
effectiveness of warfarin
Anticoagulants/Antiplatelet
drugs (Coumadin) effects of
slowing blood clotting
Medications changed by the
liver (eg Elavil, Valium,
Glucotrol) may rate of
metabolism in liver and may
effects/side effects (minor
interaction)
Fish
Oil/Omega3/DHA
Effective for:
High TG levels
Likely effective for:
Heart disease
Possibly effective for:
Age-related macular
degeneration (AMD)
Atherosclerosis
ADHD
Asthma
Bipolar disorder,
psychosis,
developmental
coordination disorder,
Raynauds syndrome
HBP
RA
Stroke, angina, HBP,
heart failure, heart
transplant
Flaxseed
Oil/Pill
Garlic
Insufficient evidence:
High cholesterol
RA or OA
BPH
ADHD
Atherosclerosis
Heart disease, HBP
Dry eyes/skin
DM
Constipation
Possibly effective for:
Atherosclerosis
Certain cancers
(colon, rectal,
stomach)
HBP
Ringworm
Jock itch
Athletes foot
Insufficient evidence:
CHD, MI
BPH
OA
Hayfever
Cold & flu
Low BP
Hemorrhoids
Asthma, bronchitis,
SOB
Flaxseed provides
PUFAs such as ALA
that have antiinflammatory
properties
GI Burning in mouth/stomach,
heartburn, gas, N/V/D
Life Stage Avoid in medicinal
amounts in children, pregnancy
and lactation (food amounts is ok)
Conditions Avoid in: bleeding
disorders, pre surgery; Use caution
in hypotension, GI problems
Other Bad breath, body odor, skin
burn when applied to skin, GIT
irritation
10
Ginkgo
Maintaining healthy
liver function
Possibly effective for:
Anxiety
Mental function,
dementia,
schizophrenia,
Alzheimers disease
Vision problems
(glaucoma, in DM)
Peripheral vascular
disease
PMS
Tardive dyskeinesia
Vertigo, dizziness
Insufficient evidence:
Age related memory
loss
Lyme disease
Sexual dysfunction
Atherosclerosis,
Stroke, heart disease,
Raynauds syndrome
Chronic fatigue
syndrome (CFS)
Improves blood
circulation
Anticoagulant/Antiplatelet
drugs may effects of
slowing blood clotting
Medications changed by the
liver (eg Celexa, Valium,
Elavil, Flexeril) may rate of
metabolism in liver and effect
of drugs
Antidiabetes drugs may or
insulin and blood glucose levels
in T2DM
Anticonvulsants may effects
of drugs
Xanax effects of drug
Trazodone (Desyrel) may
cause serious side effects in
brain and coma
HCTZ may BP when taken
with ginkgo
11
Glucosamine
Goldenseal
Likely effective:
Osteoarthritis
Glucosamine sulfate is
naturally found in the
body and used in
producing tendons,
Possibly effective for:
Temporo-mandibular ligaments, cartilage
and thick fluid
joint arthritis
surrounding joints
Insufficient evidence:
Knee pain
Multiple sclerosis
Interstitial cystitis
Glaucoma
Weight loss
Insufficient evidence:
Contains berberine
which can have
UTIs
antibacterial and
Digestive disorders
antifungal properties
such as stomach
upset, ulcers, colitis, and may prevent e.coli
from attaching to
gastritis,
urinary tract walls
hemorrhoids,
constipation
Berberine may lower
Anorexia
BP and improve
Menstrual
arrhythmia and lower
irregularities
blood glucose and
CFS
LDL
Conjunctivitis
Common cold
Hay fever
GI N/D/C, heartburn
Life Stage Avoid in pregnancy and
lactation (unknown effects)
Conditions Use caution in T2DM
may blood glucose; High
cholesterol may cholesterol
levels; HBP may BP; Avoid
pre/post surgery
Other Drowsiness, skin reactions,
headache
Use with caution if you have
shellfish allergy
Anticoagulant/Antiplatelet
drugs may effects of
slowing blood clotting
Antimitotic chemotherapy
may rate that tumor cells can
copy and drug effectiveness
Acetaminophen may interfere
with how well each works
Antidiabetes drugs may
effects of drug on controlling
blood glucose levels
12
Grape Seed
Extract
Contains flavonoids
which have antioxidant
effects, lower LDL
levels, relax blood
vessels, prevent heart
disease
Anticoagulant/Antiplatelet
drugs may effects of
slowing blood clotting
Phenacetin may
effectiveness of drug when
taken together
Medications changed by the
liver (eg Clozaril,
Flexeril,Zyprexa) may rate
of metabolism in liver and
effectiveness of drugs
13
Echinacea
Immunosuppresants may
effectiveness of drugs
Medications changed by the
body (eg cyclosporine,
Cardizem, estrogens) or liver
(eg Clozaril, Flexeril, Zyprexa)
may effects/side effects of
drugs
14
Ginseng
(American)
Possibly effective:
DM
Respiratory Tract
infections
Contains ginsenosides
that seem to affect
insulin levels in the
body and lower blood
glucose
Anticoagulant/Antiplatelet
drugs may effects of
slowing blood clotting
Antidiabetes drugs may cause
hypoglycemia
MAOIs may cause too much
stimulation and lead to anxiety,
headache, restlessness, and
insomnia
15
Hawthorn
Antihypertensives (Beta
blockers, Ca-channel blockers)
may effects of rugs
Digoxin may effects and
side effects of drug
Sexual dysfunction drugs (eg
Viagra, Cialis, Levitra) may
cause hypotension
Medications that blood flow
(eg nitroglycerin, isosorbide)
may effects and cause
dizziness/lightheadedness
Seems to have
antioxidant activity
and may
accumulation of fats in
liver and aorta by
excretion of bile,
cholesterol formation,
and enhancing LDL
receptors
16
Horse
Chestnut
17
Melatonin
Melatonin is naturally
found in the body and
regulates night and day
cycles or sleep-wake
cycles. melatonin
signals the body to
prepare for sleep, and
levels prepare the body
to awake.
18
Milk Thistle
Peppermint
Oil
19
headache
SAMe (SAdenosyl-LMethionine)
Saw Palmetto
GI V/D/C
Life Stage Avoid in pregnancy and
lactation (unknown effects)
Conditions Avoid in: bipolar
disorder may induce mania;
Parkinsons disease may
exacerbate symptoms; pre/post
surgery may affect CNS
Other dry mouth, headache, mild
insomnia, anorexia, sweating,
dizziness, nervousness
Poorly understood:
Nutr Avoid with supplements that
Saw palmetto seems to slow blood clotting (eg garlic,
shrink the inner lining ginger, ginseng)
that puts pressure on
GI N/V/D/C
the tubes that carry
Life Stage Avoid in pregnancy and
urine and possibly acts lactation
as an inhibitor of 5- Conditions Avoid in pre/post
surgeries may slow blood
reductase which
clotting
converts testosterone
Other Dizziness, headache
into
dihydrotestosterone
(DHT) which may
encourage prostate
enlargement
20
St. Johns
Wort
Contains hyperforin
and hypericin that act
on chemical
messengers in the
nervous system that
regulate mood
21
Turmeric
Anticoagulants/Antiplatelet
Drugs (eg aspirin, warfarin,
ibuprofen, Plavix): effects of
slowing blood clotting
Antidiabetes Drugs (eg
glimepiride, glyburide,
glipizide): effects may
cause hypoglycemia
Azulfidine EN-Tabs
(Sulfasalazine) (for UC)
absorption and effects/side
effects of drug
Talinolol (p-glycoprotein
inhibitor) absorption and
effects/side effects of drug
22
Yohimbe
Insufficient evidence:
Erectile dysfunction
General sexual
problems and sexual
problems caused by
SSRIs
(antidepressants)
Aphrodisiac
Orthostatic
hypotension
Contains yohimibine,
an alpha-2-blocker that
BP and blood flow
and nerve impulses to
the genitals
Antihypertensives (eg
clonidine, enalapril, losartan,
HCTZ, effects of drugs
MAOIs effects and side
effects of yohimbe/drugs
Tricyclic antidepressants (eg
Elavil, Tofranil) may lead to
heart problems
Phenothiazines effects and
side effects of yohimbe
Stimulants (eg epinephrine,
phentermine) effects, may
cause tachycardia and HBP
23
III Medications: In a table format, please include classification, indication, mode of action, and drug-nutrient interaction (1.5 point
each 30 points)
Medication 27, 41-43 Classification
Alendronate
Bisphosphonate
(Fosmax)
Risedronate
(Actonel)
Ibandronate
(Boniva)
Bisphosphonate
Bisphosphonate
Indication
Osteoporosis,
Pagets disease,
heterotopic ossification
treatment
Osteoporosis,
Pagets disease,
heterotopic ossification
treatment
Osteoporosis,
Pagets disease,
heterotopic ossification
treatment
Osteoporosis,
Pagets disease,
hypercalcemia or
malignancy therapy &
bone metastases
treatment
Zoledronic acid
(Reclast)
Bisphosphonates
(Parenteral)
Calcitonin
(Fortical)
Mode of action
Strengthens bones by
inhibiting bone removal
(resorption) by osteoclasts
& increases bone density
Strengthens bones by
inhibiting bone removal
(resorption) by osteoclasts
& increases bone density
Strengthens bones by
inhibiting bone removal
(resorption) by osteoclasts
& increases bone density
Strengthens bones by
inhibiting bone removal
(resorption) by
osteoclasts, increases
bone density & lowers
blood calcium release
from bones
Increases bone density &
strength
Inhibits bone removal by
osteoclasts & promotes
bone formation by
Avoid alcohol
24
Denosumab
(Prolia)
Orlistat
Belviq
Antiobesity
Overweight/ obesity
Weight control agent, treatment
Lipase inhibitor
weight management
treatment
Antiobesity
Overweight/ obesity
osteoblasts.
Inhibits osteoclasts from
breaking down bone,
RANK ligand inhibitor
N/A
Decreases bone
Limit alcohol
N/A
Reduces symptoms of
menopause i.e. hot
flashes, vaginal dryness,
caused by decreased
estrogen, reduces bone
resorption & increases
bone formation, as a
contraceptive (in
combination) prevents
ovulation
Blocks enzyme that
breaks down the fat
(lipase) & decreases
absorption of dietary fat
(30%)
Reduces weight and helps
in maintaining weight loss
Acts on serotonin
25
treatment
weight management
treatment
Overweight/ Obesity
treatment
Weight management
treatment
Contrave
Antiobesity
(with opioid
antagonist,
aminoketone
antidepressant)
Phentermine
Qsymia
phentermine/
topiramate
Antiobesity
appetite suppressant
Orabase
Local Anesthetic
Pilocarpine
(Salagen)
Anti-Xerostomia
Tetracyline
Antibiotic,
antiarthritic,
anti-acne
receptors to suppress
appetite and hunger
Decreases appetite, curbs
hunger and food cravings
Avoid SJW
Avoid alcohol
Avoid alcohol
Avoid caffeine
Suppresses appetite by
affecting the CNS
26
Antifungal,
anticryptococal
meningitis
anticandidiasis
Acyclovir
Antiviral
Famciclovir
Antiviral
27
IV Questions
1. Describe how the following nutrient and/or factor may affect rickets and/or osteoporosis risk?
Both osteoporosis and rickets are diseases characterized by a decrease in bone mineral density and a weakening of the bones. Rickets
is more prevalent in children and it stems from a Vitamin D deficiency. In adults it manifests as osteomalacia. Osteoporosis is
commonly seen in adults and older individuals. Since vitamin D helps absorb calcium from the stomach, a deficiency in either of these
two nutrients may increase the risk for rickets and osteoporosis.
a. Alcohol
Excessive alcohol consumption causes bone loss and increases the risk of osteoporosis. More than 2 to 3 ounces of alcohol daily
interferes with adequate calcium absorption by the stomach and pancreas. Alcohol also, has a toxic effect and kills the bone-making
cells, osteoblasts. Alcohol also has a detrimental effect on bone health by affecting the levels of cortisol and parathyroid hormone
(PTH). High levels of cortisol induce osteoporosis by increasing bone breakdown and decreasing bone formation. Increased PTH,
another bone-damaging hormone leaches calcium from the bones.
Drinking too much alcohol can also cause Vitamin D deficiency and lead to the onset of rickets. Vitamin D deficiency can lead to bone
demineralization.
Thus, excessive alcohol consumption can impair both the status of calcium and vitamin D and lead to the development of bone disease
such as osteoporosis and rickets.28-30
b. Long-term Steroid use
Glucocorticoid administration has been purported as the most common cause of secondary osteoporosis. In patients with long-term use
of these anti-inflammatory steroid hormones, there was noted an increased risk for bone fractures. Rapid reduction in bone mineral
density has been detected in patients taking glucocorticoids with a relative risk for fractures of 75% in the first three months after
steroid therapy was initiated. Immediate discontinuation of glucocorticoids showed immediate improvement. Glucocorticoids induce
osteoporosis by decreasing the production of new osteoblast precursors and causing premature apoptosis of the mature osteoblasts.
Thus, it is suggested that long-term steroid use causes osteoporosis.31
c. Calcium Deficiency
Adequate calcium in the diet during childhood and adolescence is crucial in maximizing calcium retention in the bones and increased
bone density. A diet low in calcium that lacks milk and dairy products is often adopted during adolescence, especially in girls and this
may have detrimental effects on bone health later on in life leading to osteoporosis. Studies show that getting enough calcium early on
in life when programmed mesenchymal stem cells replicate to provide all the bone-forming cells for an entire life is key for optimal
bone health throughout life.
28
Severe calcium deficiency in growing children can also cause rickets. Calcium deficiency rickets causes hyperparathyroidism and
increases FGF23 levels, which decrease absorption and increase excretion of phosphate and also increases 1,25(OH)2D concentration
which increases the release of calcium from the bones into the blood. Both, FGF23 and 1,25(OH)2D inhibits bone mineralization.32-33
d. Vitamin Deficiency
Vitamin D maintains calcium levels by promoting calcium absorption from the gastrointestinal tract. Vitamin D deficiency makes it
difficult to maintain proper calcium balance and leads to the development of rickets. Children in industrialized countries and colder
climates are especially prone to development of rickets where exposure to sunlight is limited. Severe vitamin D deficiency is also seen
in children with dark skin due to a low endogenous vitamin D synthesis. To prevent rickets it is generally recommended administration
of 400 IU/day of vitamin D3 supplementation.10, 34
e. Malnutrition
Malnutrition is characterized by an inability to provide sufficient nutrients in the body. The lack of adequate nutrient may stem from a
reduced intake of food, intake of food that lacks nutritive value or the bodys inability to uptake the nutrients provided by the food in
the body. Other social and environmental factors may put children and adults at risk for malnutrition such as lack of access to fresh
fruits and vegetable and/or low income. As children shift into adolescence, frequently there is change in the diet from milk and milk
products that contain calcium and Vitamin D to sodas and snacks. Girls especially will tend to adopt a diet that lacks adequate
macronutrients from a body image concern. This may significantly reduce the nutrition value of the ingested foods and thus lead to
diseases such as rickets and osteoporosis later on in life.
Adults may also suffer from malnutrition for several reasons mentioned above. As the age progresses, missing on foods that are high
in calcium and avoiding sun exposure may lead to the onset of osteoporosis.35
29
2. In a table format, define the following terms and describe their symptoms. Also discuss nutritional recommendation
(diet modifications and/or restrictions) that would help to alleviate these conditions and their symptoms:
Condition36-40
Odynophagia
Definition
Painful swallowing
Symptoms
1. Burning sensation when swallowing
2. Squeezing sensation around throat when
swallowing drinking or eating
Mucositis
Inflammation of the
mucous membrane
lining the oropharynx
and esophagus
Oral
Candidiasis
Infection caused by
fungi or yeast
Xerostomia
Dry mouth
Nutritional Recommendation(s)
1. May interfere with nutritional intake in some
patients with oral or esophageal cancers
2. Avoid caffeinated drinks, mint, and alcohol
(can aid in giving acid reflux)
1. Daily oral care
2. Avoid tobacco, alcohol and irritating foods
3. Use bland rinses (bland liquids and soft solids
are usually better tolerated in individuals with
oral esophageal mucositis)
4. Avoid strong- flavored, acidic, or spicy foods
5. Commercially prepared liquid medical food
supplements can be useful.
1. Increase kilocalorie and protein intake;
2. Administer oral supplements
3. Provide caries risk reduction education
certain medications
Effect: increased caries risk, pain, no moistening
power, tendency of food to stick, dysgeusia
Esophagitis
Inflammation of the
esophagus
1. Reflux
2. Ingestion of a corrosive agent
3. Viral or bacterial infection, intubation, radiation,
or eosinophilic infiltration
*Symptoms may impair the ability to consume a
sufficient diet, interfere with sleep, work, and
overall quality of life.
31
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32
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