Low fibre diet. Information for patients. Name. Your Dietitian. Dietitian contact number:

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Low fibre diet Information for patients Name Your Dietitian Dietitian contact number: 0118 322 7116

Following a low fibre diet Fibre is the part of plant foods that cannot be digested. It is found in cereals, fruits, vegetables, nuts and seeds. Symptoms of abdominal pain, diarrhoea and bloating, associated with certain bowel conditions may be made worse by a high fibre diet. Selecting lower fibre foods can help to improve some symptoms. A balanced diet is varied and contains adequate amounts of all the nutrients essential for good health. Choose a variety of foods from the following four main food groups. This will ensure that you get the right balance of nutrients in your diet. 1

1. Bread & cereals (low fibre) These foods should form the basis of your diet. It is best to fill up on plenty of these at each meal. They provide energy, B-vitamins, iron and fibre. 2. Fruit & vegetables (as tolerated) These provide essential vitamins, minerals and fibre. The fibre content of different fruit and vegetables varies and it is not usually necessary to cut all of them out. Small amounts of high fibre fruit and vegetables may be tolerated. 3. Meat & alternatives These foods provide us with protein, iron and B-vitamins. 4. Milk & milk products These foods provide protein and calcium for strong bones. Take plenty of fluids, 8 10 cups per day, including a glass of pure fruit juice or fruit drink with added Vitamin C, as a low fibre diet can also be low in Vitamin C. Use the following tables to choose a variety of suitable foods for your meals and snacks. 2

Food group & portion size Bread, cereals, rice, pasta. One portion: 2-4tbsp cereal 1 slice of bread 2-3 plain crackers 2-3 tbsp rice, pasta or mashed potato 2 new potatoes or half a baked potato (without the skin) Recommended daily portion: 7-14 (include starchy foods at all meals) Fruit & vegetables. One portion: Banana or apple (peeled) 1 slice of melon 1 small glass of clear fruit juice 3 heaped tbsp of allowed vegetables 2 new potatoes or half a baked potato (without the skin) Recommended daily portion: 5 or more 3

Low fibre foods (ALLOWED) High fibre foods (AVOID) White bread & rolls White flour & white flour products e.g. biscuits, cream crackers Potatoes no skin Refined breakfast cereals e.g. Cornflakes, Rice Krispies White rice and pasta Wholemeal, granary, soft grain and brown bread Wholemeal flour, bran, wholegrain crispbreads Digestive & whole wheat biscuits. Flapjacks & cereal bars Wholegrain or bran cereals e.g. Weetabix, branflakes, shredded wheat, muesli & porridge Brown rice, wholewheat pasta Fruit: melon (no skin or seeds), tinned mandarins, tinned grapefruit, tinned peaches (without pith), fruit juice (clear and without pith ie: apple juice) Vegetables: Potato and sweet potato, (without skins) pumpkin, squash, root vegetables: carrots, parsnip, swede, turnip, beetroot, celeriac, lettuce, peeled cucumber, skinned & deseeded, tomatoes, cauliflower & broccoli florets (no stalks), peeled marrow, aubergine, courgette. All vegetables must be well cooked. Aim to remove all skins and seeds. All fruit not in the low fibre foods column, including skins, pips, seeds and dried fruits. Potato skins, pulses peas, beans (including baked beans) lentils, celery, sweet corn, peppers, raw vegetables, French or runner beans, mange tout, radish, onions, Quorn, green leafy vegetables for example cabbage, artichokes. 4

Food group & portion size Milk & dairy foods. One portion: ⅓ pint of milk Small pot smooth yoghurt 2 tbsp plain cottage cheese 1 ½ oz (40-45g, matchbox size) cheese Recommended daily portion: 3 Protein One portion: 2-3 oz (60-85g) meat, poultry 4-5 oz (120-140g) fish 2 eggs Recommended daily portion: 2-3 Fatty & sugary foods. One portion: 2 tsp spread, butter, oil or salad dressing 2 tsp sugar, jam or honey 1 mini chocolate bar 1 scoop ice cream 1 tbsp cream Recommended daily portion: 0-4 5

Low fibre foods (ALLOWED) Cheese High fibre foods (AVOID) Yoghurt containing fruit pieces and nuts Milk Plain and set yoghurt Meat, poultry and offal Fish no bones Eggs Tough or stringy meats Fish with edible bones e.g. tinned salmon, sardines or pilchards Tinned or ready meals containing vegetables Pulses -beans, lentils, peas Nuts and nut butter Plain cake or hot puddings (sponges & crumbles), ice cream, jelly, mousse Plain milk puddings(rice/semolina) Sugar, glucose, jelly jams, honey, syrup, lemon curd Boiled sweets, plain toffee and chocolate Butter, margarine, oil, cream Cakes and desserts with fruit and nuts or wholemeal flour Coarse marmalade Jam with pips or skins Toffee or chocolate with fruit or nuts 6

Miscellaneous Low fibre foods Clear or sieved soups, sauces and gravy Vinegar, lemon juice High fibre foods Unclear or unsieved soups, sauces and gravy (or soups containing vegetables) Spices (as tolerated) Marmite, Bovril Pickles, chutney Note: tbsp = tablespoon, tsp = teaspoon Some menu ideas to try Breakfast ideas Apple juice plus either: Cornflakes / Rice Krispies with milk Buttered white toast with seedless jam Poached egg on white toast Main meal ideas Roast beef with mashed potato, cauliflower florets, Yorkshire pudding and gravy Spaghetti in creamy ham sauce Boneless fish in white sauce with rice and carrots Grilled chicken with rice and peeled marrow Pasta served with tomato sauce and grated cheese 7

Snack ideas Macaroni cheese Cream of tomato soup with added diced meat served with a buttered white bread roll Toasted tuna sandwich (made with white bread) Ham omelette with white bread roll Between meals ideas Plain or cheese scones Crumpets and seedless jam Cream crackers with meat pate or soft cheese 8

Introducing new foods You may be able to slowly re-introduce fibre into your diet, as your symptoms improve. Introduce one new food at a time, in small amounts. It is advisable to try cereal fibre first, e.g.: wholemeal bread, and leave very fibrous foods out, such as celery, raw vegetables and pulses. If discomfort occurs, withdraw the food, and retry at a later time. Avoid those foods known to upset you. If you are following a low fibre diet for a prolonged period, it is advisable that you see a dietitian to have the nutritional adequacy of your diet checked. 9

Notes 10

Royal Berkshire NHS Foundation Trust London Road Reading RG1 5AN Telephone 0118 322 5111 www.royalberkshire.nhs.uk Produced by: Berkshire Healthcare Foundation Trust Dietitians, July 2012 Reviewed: February 2017 Review due: February 2019 11