Modified Fibre Diet for the Prevention of Bowel Obstruction

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Modified fibre diet for the prevention of bowel obstruction

What is fibre? • Bananas Fibre is the part of the plant that humans • Oats and oat bran cannot digest. It passes through the • Barley bowels mostly undigested, giving bulk to • Chia seeds the stool. It can also act as a sponge to • Legumes and pulses (e.g. kidney help absorb fluid and soften the stool. beans, chickpeas) • Okra, eggplant Why modify fibre intake? For most people, a high fibre diet is good 2. Insoluble fibre: found in the rough, for keeping the bowels healthy. However, hard part of the plant, for example skins, in people who have areas in their bowel grains and seeds. It does not dissolve in that have become narrowed from water and adds bulk to the stool. strictures or other causes, a high fibre Examples include: diet (particularly insoluble fibre) increases My • Fruit (skin and seeds have the most NutritionMy bulk in the bowel and can makeNutriti onfibre) symptoms worse. Reducing the amount • Vegetables (skin and seeds) of fibre passing through narrowed parts of • Whole-grain products e.g. breads, the bowel may help reduce the risk of pasta, brown rice, quinoa food causing a bowel obstruction and • Nuts and seeds improve symptoms such as pain, • Wheat and rice bran abdominal cramping, gas or feeling of fullness. How to modify fibre intake?

• Remove stalks, stems, pips, seeds Different types of fibre and skins from fruit and vegetables. 1. Soluble fibre: dissolves in water to • Chop and cook vegetables well. form a thick gel in your bowels and • Reduce tough, fibrous fruit and softens the stool. vegetables – chop these foods finely Examples include: where possible (e.g. celery, mango). This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team. Disclaimer: www.health.qld.gov.au/global/disclaimer Reviewed: May 2020 Copyright: www.health.qld.gov.au/global/copyright-statement Due for review: May 2022

• Avoid dried fruits, nuts & seeds. • Avoid any food that is tough or stringy • Strain fruit and vegetable juices and (e.g. tough gristly meat). soups. • Some people find they need to have • Avoid wholegrain, high fibre breads soft/puree foods to limit symptoms. and cereals. Use white varieties • During times when symptoms where possible. increase, resting the bowel by taking fluids for a short period of time may How to prevent constipation on a help improve symptoms. modified fibre diet? • Read food labels and avoid foods

• Have fruit and vegetables with stalks, stating they are high in fibre. • stems, pips, seeds and skins Eat small and regular meals. removed. Pureed or soft/well-cooked • It is still important to have a variety of fruit and vegetables may be better foods in your diet. Aim to maintain a tolerated. balanced diet by including food from • Drink plenty of water. Ask your the following groups:  dietitian how much you should be Refined breads, cereals, rice and pasta drinking a day. Most people need My  around 8-10 glasses of fluids per day.Nutrition My Vegetables Nutrition  • If still constipated, discuss with your Fruit  doctor regarding use of laxatives (e.g. Dairy (milk, yoghurt, cheese)  Coloxyl or Lactulose). Meat, fish, poultry, eggs

General hints

• Follow a diet low in fibre, particularly

low insoluble fibre.

• Chew all food well. If a food cannot be

chewed thoroughly, it should be

avoided.

• Eat slowly in a relaxed setting. • Cook your food well – this can make some foods easier to chew.

This is a consensus document from Dietitian/ Nutritionists from the Nutrition Education Materials Online, "NEMO", team. Disclaimer: www.health.qld.gov.au/global/disclaimer Reviewed: May 2020 Copyright: www.health.qld.gov.au/global/copyright-statement Due for review: May 2022

FOOD INCLUDE INCLUDE MODERATE LIMIT GROUP AMOUNTS of soluble (low in total fibre) (high insoluble and total fibre as desired fibre) Bread, • White bread, crumpets, • Oats/oatmeal, instant, • Wholemeal or wholegrain cereals, scones, English muffins ½ cup cooked bread rice, pasta, • White pita bread • Breakfast biscuits e.g. • Bread containing intact noodles • Refined breakfast cereals 2 BelVita grains, nuts, seeds, e.g. Rice Bubbles, • Barley, ¼ cup cooked coconut or dried fruit Cornflakes • Chia seeds,1 teaspoon • Oat bran - unprocessed, • White rice, pasta, sago, • Sourdough bread, 2 raw tapioca, semolina slices • Wholegrain breakfast • White flour, cornflour • Light rye bread, 1 slice cereals or any with dried • Plain sweet and savoury fruit, nuts or coconut biscuits or cakes e.g. Muesli, All-Bran, Weetbix • Wild rice, brown rice, brown pasta • Wholemeal flour, wheatgerm • Sweet and savoury biscuits or cakes made with seeds, nuts, dried fruit or coconut Dairy • All varieties of milk • Desserts containing • Desserts containing dried foods • Plain yoghurt, custard, peeled and stewed fruit fruit, chunky fruit pieces, vanilla Fruche, plain cheese, • Nutritional supplements nuts, seeds or coconut plain or flavoured ice cream with fibres • Milkshakes made with whole fruits, seeds and high fibre cereals

Meat, fish, • Any tender, soft meat, • Smooth nut butters, 1 • Nuts & seeds poultry, chicken and fish tablespoon • Crunchy nuts or seed eggs, • Tofu • Legumes e.g. baked butters (e.g. peanut butter, nuts, • Eggs and soy products beans, kidney beans, 2 tahini) legumes tablespoons

FOOD INCLUDE INCLUDE MODERATE LIMIT GROUP AMOUNTS of soluble (low in total fibre) (high insoluble and total fibre as desired fibre) Vegetables Ensure vegetables are peeled • Eggplant, 1 cup • Raw vegetables and well-cooked where able: • Sweet potato, no skin, • Vegetables with small • Potato ¼ cup seeds (e.g. cucumber) • Pumpkin • Carrot, peeled, ¼ cup • Stringy vegetables (e.g. • Zucchini • Turnip, cooked, 3 slices celery, broccoli stems, • Cauliflower and broccoli • Spring onion/onion, bean sprouts, asparagus) florets cooked, ½ cup • Vegetables with tough • Mushrooms • Okra, cooked, ½ cup skins (e.g. peas, corn) • Avoid all other vegetables Suitable salad vegetables are: not listed in foods to • Tomato and cucumber with include. skins and seeds removed • Shredded lettuce • Capsicum, 1 cup cooked • Well strained vegetable juice • Tomato puree or paste Fruit • Melons (no seeds) • Banana, 1 small • Fruit with skin, pips or of a • Seedless grapes • Apple, no skin, 1 small very “fibrous” texture - e.g. • Well-cooked fruit no • Cherries, 1 cup pears, pineapple skin/pips • MyOranges, pip removed, • Dried fruit • Canned fruits except Nutrition1 smalMy l • Fruit with small seeds pineapple • NutritionPawpaw/pa paya, 2/3 (e.g. kiwi fruit, figs, dates, • Fruit juice – no pulp cup pomegranate) • Grapefruit, 1 small • Raspberries • Peeled peaches & • Blackberries nectarine, 1 medium • Juice with pulp • Blueberries, ½ cup Other • All fats including butter, • Popcorn margarine, mayonnaise, oils • Coconut • Sugar, honey, syrups • Chocolate with nuts and • Boiled lollies, jubes, fruit chocolate with no fruit, nuts • Chutney and pickles or coconut • Jams or pastes with nuts • Spreads without seeds or and seeds skin • Soup made from allowed ingredients, Bonox • Desserts made from allowed foods (jelly, ice-cream, custard) • Gravy, salt, pepper, dried herbs & spices

Suggested meal plan

BREAKFAST 1 Glass strained fruit juice Rice bubbles / 1/2 cup cooked oats with milk White toast / sourdough bread / crumpets with margarine / butter / honey / jam (no seeds) / vegemite Egg / cheese if desired LUNCH Tender meat / chicken / fish / egg / cheese White bread with margarine / butter Tinned fruit / 1x fresh banana / 1x peeled peach / 1/2 cup blueberries with custard or yoghurt Cup of tea / coffee DINNER Soup (made with allowed ingredients) Tender meat / chicken / fish / egg / cheese Potato (peeled) / white rice / pasta / 1/4 cup cooked barley / 1 tsp of chia seeds sprinkled Allowed vegetables – peeled and well cooked Bowl of plain ice cream Cup of tea / coffee SNACKS Melons, tinned fruit, 1x small banana, ½ cupMy blueberries , 1x peeled nectarine, 1x peeled peach, yoghurt, milk, cheese & low-fibreNutrition crackersMy Nutrition For further information contact your dietitian: ______