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Low residue diet

Date issued: November 2022

Review date: November 2024

Ref: C-157/Dietetics/CK/Low Residue Diet/Gastro v5

PDF:  Low residue diet final November 2022 v5.pdf [pdf] 349KB

Low residue diet

Nutrition and Dietetics Department

Why follow a low residue diet?

A low residue diet is recommended when people need to avoid foods that may irritate an inflamed bowel or obstruct narrowed parts of the bowel.

What is residue?

Residue is the fibrous part of food that is not fully digested by the body. It is found in plant foods, such as wholegrain cereals, legumes (beans, peas and lentils) and fruit and vegetables. A low residue diet may be recommended:

  • When experiencing diarrhoea, caused by a flare up of inflammatory bowel disease such as Crohn’s disease or ulcerative colitis, or as a result of pelvic radiotherapy.

  • To ease the passage of stools through the bowel when there is an obstruction or stricture (narrowing) .

How long will I be on the diet?

A low residue diet is usually only needed for a short period of time, until the affected bowel has settled down and your symptoms are better. However, there are sometimes occasions when a low residue diet may be needed or for a longer length of time or permanently. This could be the case if the doctors suspect or have confirmed that you have a stricture or obstruction of your bowel. Your doctor/ dietitian will advise you on when you can return to a normal diet.  You may be advised to take a multivitamin and mineral supplement.

How will I need to change my diet?

You should still have regular, well-balanced meals but choose your foods from the ‘allowed’ list (see section on ‘Foods to include and foods to avoid/limit’).

Steps that you can take

  • Aim to have small, frequent meals throughout the day rather than one or two large meals, especially if your appetite has been poor.

  • Have balanced meals. Choose a variety of foods from the low fibre food choices. You need foods from all of the food groups on the Eatwell Guide (see figure below).

  • Cooking, chopping or blending food does not change the fibre content.

  • Peeling and removing seeds or pith does lower the fibre content.

  • Some of the low fibre food may not agree with you. If a food makes your symptoms worse, do not eat it for a while until you feel better.

Foods to include and foods to avoid

Fibre is mainly found in wholegrains, legumes (beans, peas and lentils) and fruit and vegetables. From the following lists, aim to choose foods from the

‘Low fibre’ category most often and avoid or limit foods from the ‘Higher fibre’ food list.

Food to incluce and avoid

 

Foods to include

Foods to avoid/limit

Food group

Low fibre foods

Higher fibre foods

Cereals

All ‘low fibre’ cereals e.g. Cornflakes, Frosties®, Rice Krispies®, Ricicles®, Sugar Puffs®, Coco Pops®, millet flakes.

High fibre cereals, e.g. Branflakes, Weetabix®, Shredded Wheat®, muesli, All Bran®, Ready Brek®, porridge. Cereal with dried fruit, nuts or seeds.

Bread

White bread, white rolls and plain buns including white bagels, English muffins, waffles, pancakes, white pitta, flour tortilla, plain chapatti and poppadoms.

Any bread product made from wholegrain flour, bran, rye, nuts, seeds or dried fruits, including wholemeal, granary, high fibre, multigrain and currant or malt bread. Fruit muffins, scones and pastries.

Biscuits

All plain or cream biscuits e.g. Rich Tea, Nice biscuits, custard creams, ginger nuts, wafers.

High fibre biscuits such as digestives or wholemeal crackers. Biscuits containing fruit or nuts e.g. Garibaldi, nut cookies, flapjacks.

Other grain products

White rice, white pasta, white noodles, semolina, tapioca, sago.

Wheat bran, barley, wholewheat pasta, popcorn, wholemeal and brown pasta, wholemeal flour, brown rice, couscous pearl barley and quinoa.

 

Food to include and avoid

 

Foods to include

Foods to avoid/limit

Food group

Low fibre foods

 

Higher fibre foods

Vegetables

 

1-2 portions/day

 

(1 portion = 3 tablespoons)

 

Eat flesh only (no seeds, peel, pith or stalks). Can include potatoes

well boiled and mashed. Soft – well cooked ‘pulpy’ vegetables including mashed, pureed and creamed varieties such as mashed potato or mashed sweet potato, pureed squash, pureed swede, carrots, peeled courgette, peeled aubergine.  Peeled, finely chopped and cooked onions and mushrooms e.g. in cottage pie.

Tinned tomatoes, passata and tomato puree.

Smooth or sieved soup. Strained vegetable juices.

All vegetable seeds, peel, pith or stalks. Avoid raw or cooked ‘stringy’ vegetables including, cabbage, curly kale, celery, sweetcorn, cucumber, leeks, peppers, peas, pumpkin, spinach, cauliflower, broccoli, and sprouts.

 

All raw vegetables and salad.  

 

Soup with pieces e.g. minestrone.

Vegetable juices with pulp.

 

 

 

Fruit

 

1-2 portions/day

 

(1 portion = 3 tablespoons)

 

 

Eat flesh only (no seeds, peel, pith or stalks). Can include tinned apricots, peaches and pears. Ripe fresh fruit without skins or seeds such as peeled apple or pear. Ripe bananas.

 

Stewed fruit (no skins/seeds).

 

All fruit juices and fruit-flavoured drinks without pulp.

 

 

All fruit seeds, peel, pith, stones or stalks, including all citrus fruits e.g. oranges, grapefruit, lemons etc.,

kiwi, raspberries and strawberries as they contain seeds. Pineapple and other ‘stringy fruits’ e.g. mango. All dried fruit eg raisins, prunes, dates and figs.

Raw tomatoes.

Smoothies, all fruit juices with pulp

and prune juice.

 

 

 

Meat, fish and alternatives

All tender lean meat e.g. beef, lamb, pork, chicken, turkey, corned beef, ham, gammon, bacon, liver, kidney, veal and rabbit.

 

Fish e.g. cod, haddock, plaice and salmon. They can be grilled, baked, poached or steamed.

 

Eggs and tofu.

Grisly, tough or fatty meats and tough skin including meat pies, pasties, sausages and crackling.

 

Fish with lots of small bones e.g. pilchards.

Quorn.

Pulses including baked beans, butter beans, kidney beans, chickpeas and lentils (if vegetarian, discuss with dietitian).

 

 

 

Food to include and avoid

 

Foods to include

Foods to avoid/limit

Food group

Low fibre foods

 

Higher fibre foods

Milk and milk products

All types of milk, cream, sour cream, crème fraiche, fromage frais, smooth yoghurt, butter, margarine and cheese.

Any milk product containing fruits, nuts, seeds or cereals, including yoghurt, cheese with added  fruit or nuts.

Sweets and puddings

Custard, ice cream, milk puddings, clear jelly, smooth coconut milk and frozen yoghurt.

 

All plain cakes e.g. Madeira cakes, Victoria sponge and iced buns.

 

Hard candy, plain/milk/white chocolate, toffee, fudge, mints, fruit gums, pastilles, jelly sweets and marshmallows.

Ice cream containing fruit and nuts.

Any cakes, puddings and pies

including any of the following ingredients: wholemeal flour, dried fruit, nuts, dried coconut and any fruits that should be avoided.

 

Chocolate with dried fruit, nuts or seeds.

 

Drinks

 

Water, soft drinks or herbal tea.    Limit caffeine to 3 cups per day (e.g. tea, coffee). Alcohol: Men and women should not regularly drink more than 14 units of alcohol a week. Ideally, this should be spread evenly over three days or more.

Caffeine-containing drinks such as espresso, energy drinks and cola (see section ‘Useful tips’ for more information about this).

Miscellaneous

Oils, salad dressings, ketchup, gravy, soy sauce, pepper, salt, herbs and spices in moderation (dried or finely chopped).

Jelly-type jams (e.g. lemon curd), sugar, artificial sweeteners, honey, golden syrup and treacle.

Plain pretzels (without sesame seeds), crisps and mini cheddars.

Wholegrain mustard, pickles, relish, houmous, coleslaw, chutney and liquorice root.

Jam or marmalade with skin, peel or pips, peanut butter and mincemeat.

Popcorn, corn chips. All nuts and seeds including pumpkin, sunflower and sesame seeds.

Useful tips

  • Chew food slowly and thoroughly.

  • Avoid food that is too hot or too cold.

  •  Avoid large quantities of caffeine or alcohol as these may worsen your symptoms.

  • Avoid fizzy drinks as they may worsen your symptoms.

  • Reduce your intake of manufactured foods and cook using fresh ingredients where possible.

Suggested meal plan example

Breakfast

  •  Low fibre cereal (from the ‘Foods to include’ section) with milk and sugar (if desired).

  • White bread or toast with margarine or butter and honey, marmite or seedless jam.

Mid-morning snack

  • Sweet or plain biscuit.

  • Fruit (from the ‘Foods to include’ section) or plain yoghurt.

Lunch

  • Meat, chicken, fish or eggs.

  • White pasta, rice, bread, potato (no skin).

  • Vegetables (from the ‘Foods to include’ section).

Mid-afternoon snack

  • Sweet or plain biscuit.

  • Fruit (from the ‘Foods to include’ section) or plain yoghurt.

Evening meal

  • Meat, chicken, fish or eggs.

  • White pasta, rice, bread, potato (no skin).

  • Vegetables as allowed.

Evening snack

  • Similar to mid-morning or mid-afternoon snack.

How do I return to a higher fibre diet?

Once advised by your health care professional that you can return to a normal diet, it is best to slowly reintroduce the foods you have avoided back into your diet one at a time and in small amounts. If any particular food does not agree with you, avoid it and introduce it again at a later time.

How do I contact you?

If you have any questions about this diet, or are having any problems with your food e.g. lack of appetite, please do not hesitate to contact the Dietetic Department (8.30am to 4.30pm, Monday to Friday). If we are unable to take your call, please leave a message and we will call you back.

 

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