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Diet that limits stool



A low-residue diet is a diet intended to reduce certain constituents of the
bowel, often with consequence for functional behaviour of the bowel. It may be
prescribed for patients with ailments or functional gastrointestinal disorders
mitigated by fewer and smaller bowel movements each day.

The diet may be used as part of the bowel preparation before a diagnostic
procedure such as colonoscopy or as a short-term therapy for acute stages of
gastrointestinal illnesses such as Crohn's disease, diverticulitis, bowel
obstruction, and ulcerative colitis. In addition, a low-residue diet is often
prescribed before and/or after abdominal surgery or cancer treatments.

A low-fiber diet is a low-residue diet eliminating dietary fiber in particular.
The terms are not always distinguished, but when they are, a low-residue diet
will include additional restrictions on foods such as dairy products, which do
not contain fiber but do develop residue after digestion.

If the problem lies with fermentable carbohydrates instead, the patient may be
directed to a low-FODMAP diet. Some monotrophic diets, such as the carnivore
diet, are implicitly low-residue, but may also sacrifice nutrition.


CONTENTS

 * 1 Dietary guidelines
   * 1.1 Standard guidelines
   * 1.2 Variations
     * 1.2.1 Quantity of Fiber
     * 1.2.2 Grains
     * 1.2.3 Fruits
     * 1.2.4 Vegetables
     * 1.2.5 Meat and other proteins
     * 1.2.6 Dairy
     * 1.2.7 Condiments and spreads
     * 1.2.8 Beverages
     * 1.2.9 Nutritional quality
 * 2 Conditions that may require a low-residue diet
 * 3 Uses
   * 3.1 Colonoscopy
   * 3.2 Crohn's Disease
   * 3.3 Diverticulitis
   * 3.4 Aviation
 * 4 Terminology
 * 5 See also
 * 6 References


DIETARY GUIDELINES[EDIT]


STANDARD GUIDELINES[EDIT]

Almost all low-residue diets make the following
recommendations:[1][2][3][4][5][6][7][8][9][10][11]

Food type Eat/Drink Avoid Grains Breads and other baked goods made from refined
white flour Whole grain breads and baked goods Cold cereals made from refined
flours, such as cornflakes and rice krispies Whole grain cereals such as bran
flakes White rice, noodles, refined pasta Brown rice, whole wheat pasta, and
other whole grain foods Fruits Fruit juices without pulp, except prune juice
Juices with pulp or seed, prune juice Soft fruits such as bananas and melons
Dried fruits, berries Canned or well-cooked fruit Coconuts, popcorn Vegetables
Vegetable juices without pulp Juices with pulp or seed Potatoes without skin
Potato skins Canned or well-cooked vegetables Meat, Other Protein Well-cooked
tender meat, fish, poultry, eggs Tough meat, meat with gristle Beans, peas,
legumes, nuts Dairy Milk All dairy if lactose intolerant Soft, mild cheeses
Strong cheeses Plain yoghurt Yoghurt or cheese containing nuts, berries, raw
fruit Oils Vegetable oils, margarine, butter Fried foods


VARIATIONS[EDIT]

QUANTITY OF FIBER[EDIT]

A low-fiber diet is not a no-fiber diet. A 2015 review article recommends less
than 10 grams of fiber per day.[12] Other sources recommend that a patient on a
low-fiber diet eat no more than 10–15 grams of fiber per day.[5] Some sources
recommend serving sizes that contain no more than 2 grams per serving.[5][6]

GRAINS[EDIT]

Some diets recommend limiting servings of baked goods to 2 grams per
serving.[5][8] Other diets recommend limiting these servings to just 1 gram per
serving.[7][9] Most diets also recommend eating warm cereals such as cream of
wheat, cream of rice, grits, and farina.[3][6][8][10]

FRUITS[EDIT]

Some diets allow additional raw fruits such as very soft apricot, canned fruit
cocktail, grapes, peaches, papayas, plums, or citrus fruits without
membrane,[1][2][3][4][5][10] but two rule out all raw fruits.[6][9] Some allow
applesauce, other fruit sauces, or peeled and well-cooked apples.[1][3][5][8]

VEGETABLES[EDIT]

Many diets specifically recommend tomato sauce[1][2][3][8] and prohibit
pickles.[1][2][3][4][5][8][11] Two diets actually limit the well-cooked
vegetables to yellow squash without seeds, green beans, wax beans, spinach,
pumpkin, eggplant, asparagus, beets, and carrots.[2][5] Two diets allow some raw
vegetables: lettuce, cucumber (without seeds), and zucchini.[5]

MEAT AND OTHER PROTEINS[EDIT]

Some diets allow smooth peanut butter[5][10] or smooth nut butters.[8][6] Some
diets allow tofu.[5][6][7][10]

DAIRY[EDIT]

Some diets limit dairy to 2 cups per day.[2][10] One diet allows 1.5 ounces
(40 g) of hard cheese.[5] Several diets allow pudding or custard,[5][7][9][11]
sherbet,[3][8][6][10][11] whipped cream,[5][10] or ice cream.[3][4][8][7][9][11]
A couple of diets suggest specific lactose-free products for the lactose
intolerant, such as soy milk or whipped cream.[5][6] One diet prohibits whole
milk, half and half, cream, sour cream, and regular ice cream.[8]

CONDIMENTS AND SPREADS[EDIT]

Some diets allow mayonnaise,[3][5][8][6][9][10][11] ketchup,[3][8] sour
cream,[3][7][11] cream cheese,[6] smooth sauces and salad
dressings,[3][5][7][9][10][11] plain gravies,[10][11] or whipped cream.[5][10]
Several diets allow jelly, honey, and syrup.[3][9][11] Many prohibit jam,
marmalade, and preserves.[2][3][4][8][9][11]

Several diets prohibit highly spiced food,[1][3][4][5] but some allow spices,
cooked herbs, and seasonings.[8][9][11]

BEVERAGES[EDIT]

Several diets specifically prohibit caffeine[1][3][8] (two of these allow
decaffeinated coffee, tea, and other drinks),[3][8] but some allow coffee, tea,
and carbonated drinks.[10][11]

NUTRITIONAL QUALITY[EDIT]

If the diet must be strict and followed over a long period of time, the intake
of fruits and vegetables may not provide adequate amounts of vitamin C and folic
acid. The quantity of calcium may also be inadequate if dairy products are
restricted. In these cases, a multivitamin supplement or liquid nutritional
supplement may be needed.[1][2]


CONDITIONS THAT MAY REQUIRE A LOW-RESIDUE DIET[EDIT]

A low-fiber diet may be used to prepare for or recover from various medical
procedures:[1][2][4][5]

 * Abdominal surgery
 * Colonoscopy
 * Internal hemorrhoid surgery

A low-fiber diet may also be used during acute stages of the following
conditions, to rest the bowels:[1][2][4][5]

 * Bowel inflammation
 * Crohn's disease
 * Diverticulitis
 * Ulcerative colitis
 * Radiation therapy to the pelvis and lower bowel
 * Chemotherapy
 * Gastroparesis


USES[EDIT]


COLONOSCOPY[EDIT]

The most common preparation for a colonoscopy is a clear liquid diet accompanied
by laxatives. However, this may not be the most effective preparation. A 2015
guideline issued by The Standards of Practice Committee of the American Society
for Gastrointestinal Endoscopy recommends using a low-residue diet instead, also
accompanied by laxatives,[13] because of evidence that it performs at least as
well for bowel cleansing and is associated with better patient
satisfaction.[14][15]


CROHN'S DISEASE[EDIT]

A 2016 review of the research found that a semi-elemental whey hydrolyzed
protein (WHP) diet is superior for treatment of Crohn's disease.[16]


DIVERTICULITIS[EDIT]

While a low-fiber diet is generally used for acute diverticulitis, the NIH
guidelines recommend a high-fiber diet for patients with diverticulosis (a
condition that may lead to diverticulitis).[17] A Mayo Clinic review from 2011
showed that a high-fiber diet can prevent diverticular disease.[18]


AVIATION[EDIT]

In preparation for long-duration toiletless military flights, the crew is
sometimes instructed to have a low-residue meal as their last meal before the
flight. For example, this was the case with Blackbird pilots.[19]


TERMINOLOGY[EDIT]

Most sources treat low-fiber and low-residue diets as identical, but some make a
distinction based on the difference between fiber and residue. Dietary fiber is
the indigestible part of food made from plants. Residue includes not only fiber
but also other materials found in the colon after digestion. When this
distinction is made, a low-fiber diet simply reduces fiber intake by eliminating
or limiting high-fiber foods such as raw fruits and vegetables. A low-residue
diet includes restrictions on foods such as dairy products, which do not contain
fiber but do develop residue after digestion.

The American Academy of Nutrition and Dietetics' removed the low-residue diet
from its Nutrition Care Manual because there is no scientifically accepted
quantitative definition of residue and there is no method to determine the
residue produced by a food.[12][20][21]


SEE ALSO[EDIT]

 * Carnivore diet (zero-fiber)
 * Dietary fiber
 * Gastroenterology
 * High-residue diet


REFERENCES[EDIT]

 1.  ^ a b c d e f g h i j "Low Fiber/Low Residue Diet". ATLANTIC COAST
     GASTROENTEROLOGY ASSOCIATES. Atlantic Coast Gastroenterology. December 17,
     2008. Retrieved April 29, 2017.
 2.  ^ a b c d e f g h i j "Low Fiber/Low Residue Diet". Jackson|Siegelbaum
     Gastroenterology. Jackson|Siegelbaum Gastroenterology and West Shore
     Endoscopy Center. November 3, 2011. Retrieved April 29, 2017.
 3.  ^ a b c d e f g h i j k l m n o p q "Should You Try a Low-Residue Diet?".
     WebMD. October 25, 2016. Retrieved April 29, 2017.
 4.  ^ a b c d e f g h "Low residue diet" (PDF). Great Western Hospital. Great
     Western Hospital NHS Foundation Trust. May 15, 2012. Retrieved April 29,
     2017.
 5.  ^ a b c d e f g h i j k l m n o p q r s t u Wax, Emily; Zieve, David;
     Ogilvie, Isla (August 14, 2016). "Low-fiber diet". Medline Plue. ADAM
     Health Solutions. Retrieved May 1, 2017.
 6.  ^ a b c d e f g h i j "Low-Fiber Nutrition Therapy". New York Presbyterian.
     Retrieved April 26, 2017.
 7.  ^ a b c d e f g "Diverticulitis Diet". Mayo Clinic. Mayo Foundation for
     Medical Education and Research. August 15, 2009. Retrieved July 5, 2012.
 8.  ^ a b c d e f g h i j k l m n o p Manual of Clinical Nutrition Management
     (PDF). Compass Group. 2013.
 9.  ^ a b c d e f g h i j "Low FIber Diet" (PDF). Rush University Medical
     Center. Retrieved May 3, 2017.
 10. ^ a b c d e f g h i j k l m Clinical Dietitians Nutrition Service.
     "Low-Fiber, Low-Residue Diet" (PDF). Northwestern Memorial Hospital.
     Retrieved May 3, 2017.
 11. ^ a b c d e f g h i j k l m "Low-Residue/Low-Fiber Diet". University of
     Pittsburgh Medical Center. UPMC. Retrieved May 3, 2017.
 12. ^ a b Vanhauwaert, Erika; Matthys, Christophe; Verdonck, Lies; De Preter,
     Vicky (November 2015). "Low-Residue and Low-Fiber Diets in Gastrointestinal
     Disease Management". Advances in Nutrition. 6 (6): 820–827.
     doi:10.3945/an.115.009688. PMC 4642427. PMID 26567203. Retrieved April 26,
     2017. This narrative review focuses on defining the similarities and/or
     discrepancies between low-residue and low-fiber diets and on the diagnostic
     and therapeutic values of these diets in gastrointestinal disease
     management.
 13. ^ Saltzman, John R.; Cash, Brooks D.; Pasha, Shabana F.; Early, Dayna S.;
     Muthusamy, V. Raman; Khashab, Mouen A.; Chathadi, Krishnavel V.; Fanelli,
     Robert D.; Chandrasekhara, Vinay; et al. (April 2015). "Bowel preparation
     before colonoscopy". Gastrointestinal Endoscopy. 81 (4): 781–794.
     doi:10.1016/j.gie.2014.09.048. PMID 25595062. This is one of a series of
     documents discussing the use of GI endoscopy in common clinical situations.
     The Standards of Practice Committee of the American Society for
     Gastrointestinal Endoscopy prepared this document that updates a previously
     issued consensus statement and a technology status evaluation report on
     this topic
 14. ^ Wu, Keng-Liang; Rayner, Christopher K; Chuah, Seng-Kee; Chiu, King-Wah;
     Lu, Chien-Chang; Chiu, Yi-Chun (2011). "Impact of low-residue diet on bowel
     preparation for colonoscopy". Diseases of the Colon & Rectum. 54 (1):
     107–112. doi:10.1007/DCR.0b013e3181fb1e52. PMID 21160321. S2CID 25592615.
 15. ^ Helwick, Caroline (May 23, 2016). "Low-Residue Diet Acceptable for Bowel
     Prep". Medscape. WebMD. Retrieved April 29, 2017.
 16. ^ Alexander, Dominik D; Bylsma, Lauren C; Elkayam, Laura; Nguyen, Douglas L
     (May 6, 2016). "Nutritional and health benefits of semi-elemental diets: A
     comprehensive summary of the literature". World Journal of Gastrointestinal
     Pharmacology and Therapeutics. 7 (2): 306–319. doi:10.4292/wjgpt.v7.i2.306.
     PMC 4848254. PMID 27158547.
 17. ^ Strate, Lisa L. "Diverticular Disease". NIH. National Institutes of
     Health. Retrieved April 30, 2017.
 18. ^ Tarleton, S; Dibaise, JK (January 17, 2017). "Invited Review: Low-residue
     diet in diverticular disease: Putting an end to a myth". Nutrition in
     Clinical Practice. 26 (2): 137–42. doi:10.1177/0884533611399774.
     PMID 21447765.
 19. ^ "SR-71 Pilot Interview Richard Graham Veteran Tales". YouTube. Archived
     from the original on December 21, 2021.
 20. ^ Alpers, David H.; Taylor, Beth E.; Bier, Dennis M.; Klein, Samuel
     (January 21, 2015). Manual of Nutritional Therapeutics. Lippincott Williams
     & Wilkins. Meant for quick retrieval of vital information regarding the
     management of nutritional issues in patients with gastroenterological
     problems--either primary or as the consequence of other medical disorders,
     such as diabetes, hyperlipidemia and obesity. The book addresses normal
     physiology and pathophysiology, and offers chapters on diseases that can
     lead to specific nutritional problems. The clinical focus is on therapeutic
     nutrition and dietary management.
 21. ^ Cunningham, Eleese (April 2012). "Are Low-Residue Diets Still
     Applicable?". Journal of the Academy of Nutrition and Dietetics. 112 (6):
     960. doi:10.1016/j.jand.2012.04.005. PMID 22709819.


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