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This course aims to introduce students to understanding digestive physiology in order to apply these principles to health and diseases affecting eating.

Learning Outcomes:

Upon successful completion of the course, students should be able:

• to be familiar with the mechanisms of digestion, absorption, gut motility, sensation and secretion and how they impact on appetite/eating/nutrients intake.

• to understand the effects of diseases on those mechanisms in a clinical context both from a healthcare professional and patient’s perspective.

• to understand the role of psychosocial factors on disordered eating and the ethical principles of nutritional support.

Course Topics and Student Learning Activities:

Unit 1: Introduction to the course. Basic gut anatomy, physiology, motility, hunger-satiety cycle, causes, consequences and treatment of eating disorders. Ethical controversies of nutritional support will be explored. Case Study at the end of the lectures. The unit will introduce the students to the gut anatomy, motility and physiology in normal digestion and absorption. It will explore the role of gut sensation, motility and secretion, and hormones/mediators in influencing appetite and nutrient intake. It will examine the causes, consequences and cure of eating disorders. The ethical controversies arising in complex cases around nutritional support will be explored. The presentation of a Case Study at the end of the lectures will illustrate some of the principles explored in the unit applied to a real-life clinical situation.

Unit 2: Basics of intestinal failure and refeeding syndrome, factors influencing appetite and nutrients intake, ethics of nutritional support, nutrition in alcohol-related liver disease and metabolic syndrome. This unit will provide an understanding of the principle of intestinal failure and the importance of preventing refeeding syndrome. It will discuss ethical principles in nutritional support and the impact of liver disease (alcohol-related) and metabolic syndrome on nutrition. The implications of coeliac disease (particularly refractory coeliac disease) on nutrition will be explored with practical examples. The presentation of a Case Study at the end of the lectures will illustrate some of the principles explored in the unit applied to a real-life clinical situation.

Unit 3: Swallowing disorders, principles of oral and enteral feeding, nutrition in obesity and after bariatric surgery, and obesity in adolescents. This unit will explore the mechanical problems with swallowing and their assessment, discuss the management of oral and enteral feeding, the medical and surgical approach to obesity and the concepts of nutrition in obesity, including adolescents, and eating after bariatric surgery. The presentation of a case study at the end of the lectures will illustrate some of the principles explored in the unit applied to a real-life clinical situation.

Unit 4: Psychological factors controlling satiety, motility disorders and disordered eating, Fad diets, how mental illness affects nutrition, and nutrition in patients with advanced cancer. This unit will discuss how mental illness causes and is caused by nutritional disorders, examining the role of fad diets. The impact of psychological and social factors on eating behaviour will be discussed. Additionally a patient will be invited to talk to the students about anorexia to provide an insight on a patient’s perspective. The presentation of a Case Study at the end of the lectures will illustrate some of the principles explored in the unit applied to a real-life clinical situation. The role of nutrition in patients with advanced cancer will be explored from a clinical point of view.

Unit 5: Food allergy in paediatrics, nutrition in coeliac disease, pancreatic exocrine insufficiency and inflammatory bowel disease. Case Study at the end of the lectures and an interactive quiz. This unit will explore the functional and organic aspects of anorexia in Crohn’s disease. It will discuss the principles of food allergy in paediatric, the importance of nutrition (support and treatment) in inflammatory bowel disease and the management of pancreatic exocrine insufficiency to treat/prevent malabsorption. The presentation of a Case Study at the end of the lectures will illustrate some of the principles explored in the unit applied to a real-life clinical situation. At the end of this unit there will be a quiz based on some of the principles of the entire course.

Teaching and Learning Methods:

1- Class room teaching
2- Case Studies
3- Patient’s lecture/perspective
4- Interactive Quiz

Grading and Evaluation:

MCQ exam - 50%
Short Answer Questions exam - 50%


Recommended Reading:

The Life Long Learning (LLL) programme in Clinical Nutrition and Metabolism by ESPEN offers 120 training modules grouped in 40 topics. Access is free.