Oxford OesophagoGastric Centre

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1 If you have diarrhoea Common Problems and Helpful Hints This may be due to illness or the effects of treatment. While you have diarrhoea it may be helpful if you reduce your fibre intake. This is only a temporary measure and a normal diet can be followed after the diarrhoea stops. The following tips may be helpful: Make sure you drink plenty of fluids to replace the water lost in diarrhoea but avoid fresh fruit juices While the diarrhoea persists avoid high fibre foods such as wholemeal bread, biscuits and flour, high fibre breakfast cereals, nuts, dried fruits, peas, sweet corn and beans You should also avoid fresh fruit, but you could try tinned fruit such as pears and peaches. You may find that some fresh vegetables aggravate the diarrhoea, but you could try boiled or mashed potatoes, cauliflower florets, carrots, swede Choose light, easily digested foods such as chicken, white fish, white bread, mashed potato, white rice and pasta. Choose yoghurt, milk puddings, jelly or light sponge cake for pudding Avoid highly spiced and very greasy foods Speak to your doctor about anti-diarrhoea medication As your bowel habit returns to normal, gradually re-introduce foods into your diet as tolerated. If you find you are avoiding a lot of foods from your diet for a long time, or that you are losing weight, or have any other questions regarding diet, please contact the Dietician. If you suffer with soreness or pain on eating or swallowing Speak to your doctor or nurse about suitable pain control for you Use pain control prior to eating or drinking Start off with something bland Avoid spicy or acidic foods such as curry, chillies, pepper, tomato sauce, vinegar and citrus fruits Avoid alcohol, especially spirits Avoid very hot or very cold food and drinks Add cold milk to soups If you are having radiotherapy, avoid food with artificial sweeteners Choose soft, smooth textures e.g. soup, yoghurt, custard Sweeten fruit or fruit juice with sugar, glucose to reduce its acidity. Fruits such as tinned apricots, pears, peaches and mangoes can be made into smoothies

2 Moisten your food with gravy or sauce for example If you are eating slower, try dishing up half a meal, then reheat the rest Chew all food well Avoid rough food such as toast, crackers or biscuits Good oral hygiene is important even if your mouth is sore. Use a soft toothbrush and fluoride toothpaste after every meal If you suffer with nausea or vomiting Make the most of good days and better times during the day Take small frequent meals throughout the day. Sickness is often worse if you have long periods without food, so try not to go more than 2-3 hours without eating or drinking Cold foods and drinks are often more acceptable so allow your meals to cool down before eating Dry foods such as toast, plain or ginger biscuits may be helpful if you can manage them, especially first thing in the morning Chilled drinks sipped slowly through a straw often help you to feel better e.g. flat cola, ginger ale, blackcurrant squash or herb teas containing ginger Sucking boiled sweets (fruit or mint) or ice lollies may be helpful Don t wear tight clothing and avoid lying flat after eating Eat your meals in a well ventilated room. If you can take some fresh air before a meal this can help Avoid fatty and fried foods Try to avoid cooking smells This may not be your best time to eat your favourite foods as they may then become associated with nausea and could put you off them Ask your doctor for advice about anti-sickness medication for you Try to stay calm and relaxed during meal times If you have a dry mouth / throat Speak to your doctor or nurse about artificial saliva or salivary replacement stimulants that may help you To moisten food, add gravy, sauce, cream, evaporated milk, ice-cream or custard as appropriate Sip small amounts of drink often to help moisten your mouth Drink plenty of nourishing liquids such as full fat milk, milkshakes, hot milky drinks such as hot chocolate, Horlicks, Ovaltine and yoghurt drinks

3 Try sucking ice-cubes, sugar-free fruit sweets, sugar free chewing gum, pineapple or frozen pineapple juice in ice-cubes or citrus flavours such as lemon and lime, but be careful of citrus flavours if your mouth is sore Use a mouth water spray Good oral hygiene is particularly important to prevent tooth decay. You should clean teeth after each meal with a soft toothbrush and fluoride toothpaste Sugar-free chewing gum that contains xylitol, such as Wrigleys, Orbit or Smint helps to protect your teeth from dental caries Some medications can make the dryness worse ask your doctor or pharmacist about all drugs that you are taking Some people find acupuncture helpful, ask your specialist nurse for advice Chewing and jaw movements can stimulate saliva production. Check with your Speech and Language Therapist if you are on a modified diet, for advice on how to do this safely If you have oral thrush, take the medication that you have been given for this Try to breathe through your nose as much as possible Make sure you are having enough fluid - ask the dietician if you are unsure Avoid sticky, chewy and dry foods such as bread, cold meat, chocolate, peanut butter See our diet sheets for practical ideas on soft moist or purée foods. If you have swallowing problems, check with your Speech and Language Therapist first If your taste has changed Go along with your food cravings and enjoy the foods that you can take Try eating food cold or warm rather than hot Experiment as much as possible with different foods and flavours. Retry foods you previously did not enjoy and try new foods Sharp tasting foods like fresh fruit and bitter boiled sweets are refreshing and can leave a pleasant taste in the mouth. Be careful with this if you are in pain If you have lost your taste, try sharp and stronger flavours e.g. bitter jams, strong cheese such as blue-veined or extra mature varieties, goat s yoghurt. Try adding meat extracts such as Oxo, Bovril or Marmite to meat dishes for extra taste Choose food/drink that you like the taste of. These may be different from your normal diet. If you prefer sweet food and drink, remember the importance of dental hygiene to prevent dental decay If meat doesn t taste right, try eating fish, eggs, cheese, beans or lentil dishes instead If all food tastes salty to you, try adding sugar but remember the importance of oral hygiene If food tastes sweet to you, try adding salt

4 If you have lost weight, are losing weight or have a small appetite Take advantage of times when you do have an appetite Eat small, frequent meals and snacks, large meals can be off putting Choose nourishing drinks such as full fat milk, milkshakes, hot milky drinks such as hot chocolate, Horlicks, Ovaltine and yoghurt drinks in preference to water, squash, tea or coffee Try foods that are quick and easy to prepare e.g. frozen or convenience foods or prepare foods in advance Alcohol can stimulate your appetite if taken in small amounts before a meal. If you are taking medication or are having treatment, check with your doctor or pharmacist whether you may try this Remember that good oral hygiene is important to prevent tooth decay Enrich your food/drinks by adding the following: To soups: add cream, grated cheese, milk powder, evaporated milk, puréed beans or lentils, ground nuts, croutons. Try making cuppa soup with milk. To sauces: add butter or margarine (not low fat), evaporated milk, cream, full fat natural yoghurt, grated cheese, ground nuts. To creamed potato: add cream, butter or margarine (not low fat) or olive oil, grated cheese, full fat mayonnaise or salad cream, ground nuts, milk based sauces. To vegetables: add butter, margarine (not low fat) or olive oil, grated cheese, full fat natural yoghurt, full fat mayonnaise. To puddings: add sugar, glucose, honey, syrup, seedless jam, full fat yoghurt, cream, evaporated milk, butter or margarine (not low fat), custard, ice-cream, sorbets, ground nuts. To milky drinks: add ice-cream, sugar, glucose, cream, evaporated milk, milk powder. To one pint of full fat milk: add four tablespoons of milk powder e.g. Marvel, Five Pints before use to make fortified milk. Keep this in the fridge and use as required. To breakfast cereals: add fortified milk, evaporated milk, full fat yoghurt, cream, sugar, glucose, honey, syrup, puréed fruit, ground nuts. Ideas for adding flavour to your food Dried and fresh herbs, spices, fruit, vegetables or other strongly flavoured foods may be used in cooking to bring out the flavour of dishes. They can be useful if for example you are experiencing some loss of taste. Avoid spice or acidic flavours if your mouth is sore. Food Fish Try using Allspice, tarragon, tartar sauce, lime, salsa, bay leaves, cayenne pepper, dill, parsley, lemon juice, curry powder

5 Chicken Lamb Pork Beef Veal Omelette or scrambled egg Potatoes Rice Pasta Noodles Salads Green vegetables Carrot Tomato Peppers, tomato, courgette, sweet potato Dill, garlic, ginger, marjoram, paprika, parsley, tarragon, orange, lemon, oregano, Cajun, curry paste, pesto, cook in sauces, cranberry Basil, fennel, marjoram, mint, onion, apricots, rosemary, redcurrant, garlic, soya sauce Cloves, garlic, ginger, sage, thyme, apple, pineapple, soya sauce, mustard, apricot, leek Bay leaves, black pepper, chilli, tomato, mustard, horseradish, Worcester sauce, garlic, peppercorn Tarragon, bay leaves Cayenne or black pepper, chilli, chives, paprika, tarragon, green/red pepper, cheese, tomato, bacon, parsley Strong cheese, bay leaves, black pepper, dill, garlic, mint, nutmeg, parsley, onion, yoghurt, chives, chilli powder, Cajun spice, mixed herbs Bay leaves, cardamom, coriander, garlic, turmeric, nutmeg, green/red pepper, egg, saffron, stock cubes Pesto and other stir through sauces, garlic, basil, black pepper, tomato, strong cheese, stock cubes Soya sauce, stock cubes, stir in sauces Dill, oregano, basil, black pepper, yoghurt, lemon juice, olives, chives, dressings, fruit e.g. orange, apple, nectarine, feta or blue cheese, vinaigrette, mayonnaise Black pepper, lemon, mint, gravy Thyme, black pepper, cumin, orange juice Basil, marjoram, oregano, onion, black pepper, salt, mozzarella cheese Roasted in the oven with oil and garlic or herbs

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