Learning Materials
Low – Residue Diet
A low residue (low fiber) diet is recommended when patients need to avoid foods which may obstruct narrowed intestinal areas or irritate an inflamed colon. This is achieved by limiting the amount of fiber in the diet. Foods that have a high fiber content are wholegrain cereals, whole-meal bread/ biscuits, nuts, seeds, dried fruits, and skin/stalks of fruits and vegetables.
Dietary fiber is the undigestible part of plants that maintains the structure of the plant. Dietary fiber includes cellulose, hemicellulose, polysaccharides, pectins, gums, mucilages, and lignins. Although they are chemically unrelated, they all resist digestion by the human body. It is this resistance that makes these fibers important in both the normal functioning and in disorders of the large intestine or colon.
In certain medical conditions, it is important to restrict fiber. These include acute or subacute diverticulitis, colitis, and the acute phases of certain inflammatory conditions of the bowel -- ulcerative colitis or Crohn's disease. After some types of intestinal surgery, a low fiber, low residue diet may be used as a transition to a regular diet.
The duration for a low residue diet depends on the reason for the diet. Hence it can last from a few days prior to surgery/scope to a few weeks during a flare-up of inflammatory bowel disease Depending upon individual food selection, the Low Fiber, Low Residue Diet is adequate in all nutrients (National Research Council's Recommended Dietary Allowance). If the diet must be strict and followed over a long period of time, the intake of fruits and vegetables may not be adequate; and/or on a low residue diet, there may not be enough calcium included. In these cases, a multi-vitamin supplement or liquid nutritional supplement may be needed.
It is important to maintain a balanced diet even on a low residue diet especially if it is to last a few weeks. Fiber from fruits and vegetables can be reduced by skinning/peeling skins from fruits and vegetables and sieving vegetables after cooking. Alternatively, drink blended fruit and vegetable juices that have been sieved.
Useful Tips
- Eat small meals- take small portions and chew well.
- Eating frequently at regular intervals, i.e. every 3-4 hours.
- Eating in a relaxed atmosphere and relaxing after meals may help.
- Avoid foods with extreme temperatures that is, food that is too hot or too cold.
- Adding only one new food at a time. This will help you to rule out foods that irritate your bowel. Take your time and experiment gradually.
- Drink BETWEEN, not WITH meals. Avoid caffeine or alcohol as these may irritate the lining of the intestinal walls.
- Avoid foods that are too spicy.
If a low fiber or low residue diet results in abdominal cramps or discomfort, notify the dietitian or physician immediately
Summary
If a low residue diet is essential for long term, do not overly restrict your diet as you need good nutrition. Choose your foods selectively and ensure your meals are well balanced. Eating is not only fun, but it is very important for your overall health.
Suggested Foods
| Foods Allowed | Foods to Avoid | |
|---|---|---|
| Bread and Cereals | White bread. Plain muffins. Refined breakfast cereals (eg. Cornflakes, Rice Krispies, Cocoa Puffs). Plain crackers, biscuits. White rice, pasta. Refined flours, corn flour. | Wholegrain / wholemeal bread. Wholegrain / fruit muffins. Whole grain cereals (eg. Wheaties, muesli, All Bran, oatmeal, bran, wheatgerm). Brown rice, wheat pasta. Wholemeal flour, pearl barley. |
| Fruit (2-3 servings a day only) |
Canned fruit except pineapple. Ripe fresh fruit without skin or seeds: banana, melons. Fruit juices with no pulp. | All skins / stalks and seeds. Apricots, berry fruits (Strawberries, raspberries), cherries, figs, kiwi, lemon, oranges, mango, papaya, plum, prunes. All dried fruits (raisins, dried apricot). |
| Vegetables | Flesh only (no peel, skin, seeds or stalks). Cooked vegetables only: asparagus tips, cauliflower tips, onion, potatoes without skin, yellow squash, green beans, wax beans, spinach, pumpkin, eggplant, beets, carrots. Tomato puree / paste or fresh/canned tomatoes without skin or seeds. Strained vegetable juices. | All stalks, skin and seeds. Raw / salad vegetables. Broccoli, cabbage, raw carrots, celery, cucumber, mushrooms, peas, raw spinach, corn, whole tomatoes, turnip. Vegetable juices with pulp. |
| Milk and Dairy (2 or more cups daily) |
All milk products – whole / low fat / skim milk. Milk shakes. Flavored milk, evaporated milk, yogurt (plain, vanilla, chocolate, banana). Soy milk. | Yogurt containing fruit or nuts. |
| Meats and Protein | Lean beef, veal, lamb, mutton, pork, bacon, ham, chicken, turkey. Fish – cooked or fileted (tuna, salmon). Eggs, tofu. Cheese, plain cottage cheese, ricotta cheese, cream cheese. Creamy peanut butter. | Chunky peanut butter, nuts, seeds, dried beans, dried peas. |
| Desserts | Custard, ice cream, Jello, puddings, plain cakes. Hard candy, marshmallow, plain chocolates (in moderation). | Ice cream containing fruits / nuts. Cakes / puddings / pies containing whole meal flour / dried fruits/ nuts, coconut and fruits which are not allowed. |
| Fats and Oils | All oils, margarine, butter. | |
| Beverages | Apple juice, grape juice, cranberry juice. Soft drinks, soda, mineral water, weak tea or coffee. | Strong tea or coffee. |
| Miscellaneous | Sugar, honey, maple syrup. Pepper, salt. Gravy, tomato sauce, soy sauce. | Popcorn, pickles, horseradish, relish. Jam with peel / skin (eg. raspberry, marmalade). Seeds – pumpkin, sunflower, sesame. |
Summary
If a low residue diet is essential for long term, do not overly restrict your diet as you need good nutrition. Choose your foods selectively and ensure your meals are well balanced. Eating is not only fun, but it is very important for your overall health.