Phenylketonuria also known as PKU is a genetic metabolic disorder when the patient can not metabolise amino acid phenylalanine. Amino acids are found in foods and are used by our bodies to make proteins, any excess amino acids are broken down and discarded of by our bodies but patients with PKU cannot break down the amino acid so this builds up in the body and can be dangerous and in severe cases can cause brain damage. Babies are tested at birth for this defect but may have symptoms such as fair skin and hair, tantrums and bad behavior.Vitamin c deficiency which is also known as scurvy. is when not enough vitamin C is in a persons diet. This is usually found in fruit and vegetables such as strawberries, oranges, grapefruit, kiwi, red and green pepper. Having a vitamin c deficiency can also reduce the absorption of iron in the body which can make the patient have the following symptoms feels very tired, bruises easier, bleeding gums, dry splitting hair and dry skin.Coeliac disease is an auto immune disease when the patient has an intolerance to gluten found in wheat protein, barley and rye. The gluten causes damage to the lining of the small intestine. Some symptoms that might occur are diarrhoea, excessive wind, constipation, nausea, vomiting, stomach pain, cramping and bloating of the stomach. There is no suitable medication for the condition as it is diet related. The best thing to keep the symptoms at bay is to have a gluten free diet. Cut gluten out of the diet, things such as bread, rice, pasta. There are lots of gluten free alternatives available now in most supermarkets. Although there is certain amount allowed to be prescribed on the NHS by the GP. Iron and Vitamin B supplements will help with any deficiencies in the diet. Scurvy is a disorder caused by prolonged Vitamin C deficiency, this is caused by a lack of vitamin c in the diet. Without vitamin c new collagen can’t be formed. Collagen is found in skin and bones. Main symptoms are tiredness, gum disease. The best treatment is Vitamin C supplements, these can be taken daily. As well as including Vitamin C rich products into the diet such as oranges, grapefruit, strawberries. Ferrous gluconate is used to treat iron deficiency anaemia. It works by being absorbed into the stomach, stored in the liver and spleen, red bone marrow and intestinal mucosa. This is then is carried around the body to make more haemoglobin inside red blood cells. Red blood cells carry oxygen around the body. Main side effects include constipation, diarrhoea, gsatro intestinal irritation, nausea, black stools. Information was found on wikipedia, BNF and course notes. Orlistat is used to aid weight loss. It works by reducing the amount of fat being absorbed into the body allowing it to be passed straight through the digestive system and excreted in stools. Orlistat works to inhibit the enzymes that break down the fat so that it can’t be absorbed into the stomach. The patient will have to take orlistat alongside a healthy low fat diet otherwise there can be some not very nice side effects. The more fat in the diet the more fatty stools will be causing diarrheoa, stomach pain, oily stools, headaches, urgency to go to the toilet. UTI’s. The information i found was in the BNF and also from previous training i had when we sold Alli, the half strength over the counter version of orlistat. Parenteral or intravenous nutrition is when a patient is fed through a catheter in the arm or chest to deliver nutrients straight through a large vein. This can be used for as long as the patient needs it. This could be suitable for Mr Jackson however there is a high cost to the treatment as it requires a lot of equipment, it also needs extra care to avoid infection and clotting which requires 24 hours care.. Also the nutrition needed takes lot sof storage and short stability. I would say that this wouldn’t be the best option for Mr Jackson.Naso-gastric is whent he patient is fed through the nose. This is only a short term option usually around 6 weeks and is not recommended in patients that suffer from gastro oesophagol reflux. So this would not be suitable for Mr Jackson.PEG feed is a more long term option. This is when the patient will fed straight into the stomach through a tube giving the nutrients needed to the patient. As this bypasses the gastro intestinal tract it will reduce the risk of heartburn. An initial operation will need to take place to fit the tube and as long as the wound is looked after and kept free from infection then it can be a good option for Mr Jackson. Medication can also be fed through the PEG. Megalobastic anaemia is a condtion when there a large and abnormal red cells in the body. The symptoms of this condition is tiredness, anemia symptoms as well as indigestion and diarrhoea. The condition can be caused by a low amount of folic acid or Vitamin B12. This is seen in patients that are alcoholics, pregnant, cancer patients or those with coeliac disease. Symptoms of megalobastic anaemia are tiredness, lethargy, headaches, palpitations, loss of appetite and weight loss. Treatment includes taking an iron supplement such as folic acid or Vitamin B12. Also increasing foods in the diet rich in folic acid like leafy green vegetables, mushrooms, fruit and nuts. Some complications can include increase in heart rate, loss of vision and memory loss.