Low Dietary Fibre Diet (Low Residue)

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1 Low Dietary Fibre Diet (Low Residue) Author: Anna Guest, Dietitian Issued By: Department of Nutrition and Dietetics Musgrove Park Hospital Taunton TA1 5DA Tel : (01823) Fax: (01823) Produced: November 2010 Review date: November

2 This information sheet explains the foods to include and reduce on a low fibre/low residue diet. Your Dietitian will help support you to make any dietary changes needed. What is dietary fibre? Dietary fibre is the part of foods that your body is not able to digest, it therefore passes through the stomach and into the large bowel (the lower part of the gut). Here, some fibre is fermented by harmless bacteria, which produces gas (or wind). The rest forms the bulk of your stools and promotes healthy movement of the gut. NOTES If you have further queries regarding your diet, please contact your Dietitian: What is a low fibre or low residue diet? Usually, in health, a diet high in fibre is encouraged to keep the gut working well. This would include plenty of fruits, vegetables and wholemeal foods. However, in certain medical conditions, it may be important to reduce your intake of these foods - this is known as a low fibre or low residue diet. NAME: DATE: DIETITIAN: Telephone

3 Reintroducing dietary fibre Once your bowel function has returned to a healthy pattern, you may be able to gradually reintroduce the fibre containing foods into your diet. If you are unsure whether this is appropriate in your case, ask your Doctor or Dietitian. The following gives some guidance on adding fibre back to your diet over 1-2 weeks: 1. Start by adding 1-2 portions of peeled, stewed or tinned fruit, or well boiled vegetables per day 2. Increase this to 3-5 portions per day 3. Swap to wholemeal bread if this is your normal choice 4. Start to include small amounts of fresh, raw, less well cooked fruit and vegetables as desired. Reintroduce bean, peas, sweetcorn, dried fruits and nuts last to test your individual tolerance. N.B. Patients with colostomy or ileostomy bags should discuss reintroducing fibre foods with their Dietitian or stoma nurse for further advice. By reducing the fibre you take in from foods, the amount of undigested food or residue entering your large bowel is also reduced. This can be important where there is a narrowing or obstruction in the bowel (making stools difficult to pass). It is also important temporarily where there is a need for the gut to heal, for example, after bowel surgery or if the bowel is inflamed. In this case, once the bowel has healed and the passage of stools returns to a healthy pattern, the fibre in your diet can be gradually reintroduced. Vitamins and minerals Restricting some foods in your diet can make it difficult to meet the amount of vitamins and minerals you need. Therefore, it is recommended that you take an A-Z style complete multivitamin and mineral supplement whilst following a low fibre diet. It is not necessary to take high doses of specific vitamins or minerals. If you are unsure, ask your Dietitian for advice. 10 3

4 Foods to include: Breads, cereals and potatoes White bread and white flour or cornflour products Low fibre breakfast cereals (including cornflakes and rice crispies) without dried fruit or nuts White pasta and white pasta dishes (without vegetables e.g. macaroni cheese) White rice and white rice dishes (without fruit or vegetables e.g. rice pudding) Ground rice, semolina, tapioca and sago Peeled potatoes (boiled or mashed) Jacket potato flesh (leaving the skin uneaten) Meats, fish and other protein sources All fresh, frozen or tinned meat, fish, poultry and offal Meat, poultry or fish in white flour batter, pastry or white breadcrumbs Pastry products without vegetables (e.g. sausage roll and pork pies) Quorn or tofu Eggs Milk and dairy products All types of milk, cream and plain cheeses Plain or flavoured yoghurt or fromage frais (without fruit pieces, muesli or nuts) Custard and ice cream (without fruit pieces) Fruit and vegetables Clear, strained/smooth fruit or vegetable juices (without fruit bits) 4 A word about meals during a hospital stay When choosing meals, snacks and drinks during a hospital stay, try to follow the advice in this leaflet as much as possible. If you are unsure about which dishes to choose, ask your Dietitian or the Ward Housekeeper to help. Some recommended choices from the menu include: White sandwiches (without salad) Meat, poultry & gravy meals Cod in parsley sauce White rice or creamed/mashed potato Plain or cheese omelette Gala pie or Scotch egg Custard Ice cream Cheese & (white flour) crackers 9

5 Meal suggestions Breakfast: Smooth fruit juice Cornflakes or Rice crispies with milk White bread/toast with honey/marmite Egg or bacon with white toast/bread Snack meals: Cheese on white toast Sandwiches on white bread without salad Sausage rolls Evening Meal: Roast, grilled or minced meat with boiled potatoes Macaroni cheese Cheese and Potato pie Spaghetti Carbonara Fish in white sauce with mashed potato Puddings: Treacle sponge pudding and custard Smooth yoghurt Chocolate Mousse Jelly and ice cream 8 Foods to include continued... Cakes, biscuits & snack foods Cakes, scones and pancakes made with white flour, without dried fruit or nuts (e.g. sponge cake) Plain or cheese scones, crumpets Sweet pastries without fruit or nuts Biscuits made with white flour, without dried fruit or nuts (e.g. rich tea, custard creams) White flour crackers and crisp-breads Rice-cakes Miscellaneous foods. Herbs, spices and flavourings Yeast extract, smooth peanut butter, honey Jams, marmalades and preserves without pips, pith or fruit peel (e.g. lemon curd, bramble jelly) All sauces, salad dressings and ketchups without seeds or vegetables pieces Soups without vegetables pieces or croutons (e.g. cream of chicken or tomato, chicken noodle soup, consommé) Chocolate and sweets without dried fruit or nuts (e.g. fudge, mints, boiled or jelly sweets) Beverages. All hot & cold drinks (except those with added fibre) including tea, coffee, malted drinks, milk & milkshakes, yoghurt drinks, squashes, cordials, and fizzy drinks 5

cereals containing dried fruit and/or nuts Wholemeal pasta and brown rice Bran, oats, oatmeal, and barley Skins of jacket potatoes, tough parts of roasted or chipped potatoes, and crisps Meats, fish

6 Foods to avoid: Breads, cereals and potatoes All brown, wholemeal or added-fibre breads and wholemeal flour products (e.g. granary, wheatgerm, high fibre white bread, multigrain, spelt, soft grain, seeded breads and rolls) High fibre breakfast cereals - wheat biscuits, branflakes, shredded wheat, porridge, muesli, cereals containing dried fruit and/or nuts Wholemeal pasta and brown rice Bran, oats, oatmeal, and barley Skins of jacket potatoes, tough parts of roasted or chipped potatoes, and crisps Meats, fish and other protein sources Meat, poultry or fish in wholemeal breadcrumbs or wholemeapastry Tough or gristly parts of meat or poultry Pastry products containing vegetables (e.g. pasties, pies and quiches) Nuts and seeds Beans, pulses and lentils Milk and dairy products Cheese containing fruit pieces Yoghurt, fromage frais or ice cream containing fruit pieces, muesli or nuts Milk puddings containing dried fruit (e.g. bread & butter pudding) Fruit and vegetables All fresh, frozen, tinned or dried fruit and vegetables 6 Foods to avoid continued... Cakes, biscuits & snack foods Fruit cake, fruit loaf, malt loaf, fruit buns and scones Teacakes, hot-cross buns and flapjacks Biscuits made with wholemeal flour, dried fruit or nuts (including digestives, oatcakes, coconut biscuits, garibaldi biscuits, fig rolls) Wholegrain, farmhouse or multigrain crackers and crisp-breads Bombay mix, pretzels, popcorn, potato crisps Miscellaneous foods. Jams, marmalades and preserves containing pips, pith or fruit peel (including mincemeat) Whole-nut or crunchy peanut butter Pickles and chutneys Sauces and salad dressings containing vegetables or seeds Soups containing vegetables or croutons Chocolate and sweets containing fruit or nuts (including sugared almonds) Beverages. Drinks with added fibre N.B. Fizzy drinks are best avoided by people with colostomy bags. If you have an ileostomy, you may require specific guidance from the medical team regarding drinking fluids. 7

Low Residue Diet. Information for patients. Name. Your Dietitian. Dietitian contact number:

Low Residue Diet. Information for patients. Name. Your Dietitian. Dietitian contact number: Low Residue Diet Information for patients Name Your Dietitian Dietitian contact number: 0118 322 7116 Dietary advice for people with Inflammatory Bowel Disease What is Inflammatory Bowel Disease? Chrons