Patient
RP

Height: 6 ft 3 in

Weight: 234 lbs

BMI: 29.2

Registered Dietitian

Chelsea Pambianco, RD

Insurances: Aetna,Anthem,Blue Cross Blue Shield,Cigna,United Healthcare

Diagnosis and Treatment Plan

Session Notes (05/31):

Client advised that he had a few episodes of blurred vision, which he is unable to connect with anything. Client previously had migraines, which caused blurred vision prior to occurring, but he is not developing a migraine. Client is stopping doxycycline tomorrow, and not planning to continue with psyllium husk powder since he has achieved regular BMs.

Nutrition Diagnosis (PES statement)

Altered GI function r/t constipation AEB client's report of daily, BSS type 1 stools that are difficult to pass.

Goals Set at Session (05/31):

1. Continue to consume a minimum of 60 oz water, daily, with the goal of maintaining consistent hydration and promoting BM regularity. 
2. Aim to consistently consume 30-35g fiber daily with a focus on insoluble fiber sources, with the goal of increasing the transit time of stools though the large intestine. Examples of foods high in insoluble fiber include whole grains (wheat bran, quinoa), raspberries, strawberries, almonds, walnuts, lentils, kale, and potatoes with skin. Refer to the handout provided for additional examples.  
3. Continue taking 600 mg magnesium daily, at night, with the goal of utilizing the dietary supplement as a natural laxative to promote increased transit time and softening of stools. If BM consistency or frequency changes, the dosage can be increased or decreased by 200 mg every 2 days with a maximum dosage of 1000 mg/day.
4. Review the macronutrient changes made in MyFitnessPal and evaluate your average intake in comparison to the goals set. 
5. Consider resuming taking a multivitamin, daily, with the goal of ensuring that all of your vitamin and mineral needs are met (in particular, vitamin A for vision support).

Nutrition Education Provided:

  • Provided education on appropriate macronutrient ratios, and discussed targets for each macronutrient. Provided examples of how to achieve appropriate distribution with meals.
  • Recommended resuming taking a multivitamin to ensure that all nutrient needs are covered, due to blurred vision episodes and low intakes of vitamin A (per MyFitnessPal log).
Topics Discussed

IBS

Appointment History

Number of Sessions: 6

Last Updated: May 31, 2024