People struggling with inflammatory bowel disease, Crohn’s disease, gastroesophageal reflux disease, ulcerative colitis, or other digestive conditions require a specific type of changed eating and elimination of various foods from a diet that can help to ease the symptoms of gastrointestinal disorders. For this purpose, one of the frequently recommended diets by nutritionists and dietitians is the Low residue diet. Let’s see: what is a low residue diet?
Low residue diet, also known as low-fiber diet, is a type of diet that limits the intake of dietary fiber to less than 10-15g per day and also restricts the food items such as milk which can trigger the painful symptoms of certain gastrointestinal diseases and can increase the colonic residue and stool weight. It is called low-residue because it excludes the indigestible material, causing it to produce smaller amounts of stool less frequently.
The residue is regarded as a material left in the digestive tract of the body after the initial stages of digestion and absorption of nutrients. This material is called residue because it contains much fiber, which the body can’t digest fully, producing bulk in stool. Dietary fiber is categorized as soluble and insoluble dietary fiber and includes various forms such as lignins, cellulose, hemicellulose, polysaccharides, pectins, gums, and mucilages. These all forms cannot be digested by the human body and are avoided in a low-residue diet.
Foods Allowed on a Low-Residue Diet:
- Refined grain products such as white pieces of bread and flour, white rice
- Cereals and pasta having the label of less than 2g fiber
- Juices without any pulp or seeds
- Eggs, fish and meat
- Margarine, butter, oil, mayonnaise and salad dressings
- Fruits without seeds or peels
- Certain types of canned fruits without seeds and peels
- Soft cooked vegetables like beets, carrots, eggplant, mushrooms
- Less than 2 cups from dairy such as milk, yogurt, puddings
- Clear broths and strained soups
- Smooth ricotta and cottage cheese
Foods Not Allowed on a Low-Residue Diet:
- Any whole-grain breads and cereals like flax, oatmeal
- Whole wheat pasta
- Vegetables in raw form and with skin like cabbage, kale, cauliflower
- Any dried fruits and berries
- Fruits with skin and seeds
- Tough and coarse meats with gristle
- Crunchy peanut butter and sauces
- Dried peas, beans and lentils
- Popcorn
- The unprocessed form of coconut
- Spicy foods
- Caffeine such as coffee
- Prune juice or juices with pulp or seeds
- Chocolate
Options of Meals from Food Groups:
| Breakfast | Lunch | Dinner |
|---|---|---|
| Decaffeinated coffee with cream and sugar | Baked chicken, white rice with canned carrots or green beans | Tender roast beef with white rice and cooked carrots |
| Cup of juice with no-pulp | Salad including baked chicken, American cheese or smooth dressing, white dinner roll | White dinner roll with margarine |
| Scrambled eggs | Baked potato without skin, sour cream, and butter sauce | Pasta with butter or olive oil with French bread and fruit cocktail |
| Waffles, French toast, or pancakes | Hamburger with white and seedless bun. | Baked chicken with white rice or baked potato without skin or along with cooked green beans |
| White bread toast with margarine or jam without pulp | Salad having meat that is not coarse or tough with soft vegetables | Broiled fish with white rice and canned green beans |
Sample Menu for a Low Residue Diet:
| Breakfast | Snack | Lunch | Snack | Dinner |
|---|---|---|---|---|
| Eggs | Tuna | Tuna on a white bread | Peeled apples | White rice with steamed vegetables |
| White toast | Crackers | Soup | Banana | Baked chicken |
| Canned fruit | Peanut butter | Crackers | Refined grain pasta | Baked potato with skin removed, butter |
| Water | Yogurt or smooth cheese | Water | Mayonnaise | Broiled fish with pasta and olive oil |
Relation of Various Food Groups with a Low-Residue Diet:
Although fiber is necessary for the body, and provides satisfaction to cravings and adds bulk to stool. But, still, in some health conditions, it becomes difficult to tackle this in the diet. There are various food items present in all sorts of food groups with more significant amounts of fiber. Here is the detail of foods that can aim for on a low-residue diet to avoid the worst consequences.
Dairy Group:
Consuming food items from this group in moderation is okay as dairy products such as milk and milk products are the primary nutrients. However, dairy can sometimes trigger other symptoms which hinder the digestion process, such as lactose intolerance.
Fruits and Vegetable Group:
Fruits of all kinds are allowed except those having skin and peels on them and seeds. Bananas, cantaloupe, avocado are the best options to consume as fruits. Cooked and steamed vegetables in the mild form are easier to digest and are recommended, such as beets, carrots, spinach, asparagus. Raw vegetables or having skin and seeds are not recommended.
Meat and Meat Product Group:
Animal products have zero fiber content, so there is no particular restriction from this group but still try to opt for meat’s leaner and tender options. The egg is also the best way to get proteins, and in the boiled form, they are also easy to digest
Bread and Cereals Group:
All types of whole-wheat grains and products from this group are excluded. Only refined and enriched grains are included to consume, such as white bread and plain crackers.
Fats and Oils Group:
Fats and oils are considered to increase weight, and people tend to restrict them fully from their diet when trying any diet. But, consuming fats and oils in butter, mayonnaise, sauces in a low-residue diet is okay and doesn’t cause any problem.
Situations for Starting a Low-Residue Diet:
1. Crohn’s Disease:
Crohn’s disease is an autoimmune and inflammatory bowel disease affecting some parts of the gastrointestinal tract, mainly the small intestine and colon. It can be as gastroduodenal Crohn’s disease affecting only the stomach and duodenum, as jejunoileitis affecting the only jejunum of the GI tract, as ileitis in which the only ileum, which is the last part of the small intestine is affected, as ileocolitis in which the ileum and colon both are a variation of Crohn’s.
There is no specific treatment and cure for Crohn’s disease, but adopting specific dietary changes such as initiating a low-residue diet can help in lessening the symptoms of pain and cramping. Crohn’s disease is a situation to start a low-residue diet in which limiting the fat intake, fiber, and dairy intake provide relief from worsening symptoms.
2. Ulcerative Colitis:
Ulcerative colitis is an inflammatory bowel disease that affects the colon and rectum. The rectum cells are destructed, causing sores and inflammation, leading to ulcers that rise to the colon.
Ulcerative colitis is also a reason to start a low-residue diet. It becomes difficult to digest and consume food during this disease due to ulcers and inflammation, emptying the stomach more frequently. A low-residue diet can help relieve some symptoms and help meet the nutritional needs of the body.
3. Colonoscopy:
Colonoscopy is a medical procedure performed to detect abnormal changes in the colon. The colonoscope is used for this purpose in which a camera is attached at the end of a thin and long tube inserted in the colon to detect any cancer, inflammation, and sores present in the colon.
Before performing this procedure, it is necessary to prepare the body and stomach, and the intestine must be emptied. A low-residue diet is one of the best options to empty the intestine and helps to produce less stool. It also helps to relieve the pain and recover after the colonoscopy.
4. Bowel Surgery:
Bowel surgery involves ileostomy, colostomy, or resection of the gastrointestinal tract. After any bowel surgery, consuming a diet rich in calories and nutrients is impossible as the digestive system cannot assimilate and digest the nutrients properly.
To recover from the effects of surgery, a low-residue diet is a good option having low fiber and fats products producing less stool.
Working on a Low Residue Diet:
The rationale behind the low-residue involves the creation of a meal plan which creates a little demand on the digestive tract. Moreover, the biggest challenge is to adjust to the dietary restrictions along with providing adequate nutrition.
An adult consumes 2000 calories per day with a dietary fiber intake of at least 25g per day. But, on a low residue diet, the dietary fiber intake sticks to just 10-15g per day. This intake can be adjusted with consultation with a nutritionist or a registered dietitian.
1. Duration and Timings:
Duration and timing for following a low-residue diet depend on why a doctor recommends it. Before a colonoscopy or before any gastric surgery, a low-residue diet is recommended to prepare the colon or bowel for surgery and empty it with any undigested material to produce less stool.
In the same way, for any digestive disorder, a low-residue diet is recommended for a more extended period. For a shorter period, a low-residue diet can be managed and overseen easily. But for a more extended period, it must be worked closely with the doctor.
2. Cooking Tips and Methods for Food:
A low residue diet can be cooked by using the easiest cooking methods making the food light and easy to digest, such as:
- Steaming
- Blanching
- Boiling
- Poaching
- Microwaving the food
Using all these methods, food prepared will be easier to digest and soft, effortlessly passing the intestine without causing any irritation. If spices and seasonings irritate the gut, such things can also be avoided and should not be included in a dish.
Modifications in Low-Residue Diet:
Modifications in a low residue diet are also important factors to follow. If we talk about a diabetic person, following a low residue diet is difficult for such a patient because refined carbohydrates such as white bread and other items can badly impact the blood sugar level.
So, the focus should be placed on the portion size controls and counting carbohydrates for each meal and snack in such a case. Priority should be given to leaner protein sources and low-carbohydrate vegetables, which are a part of the low-residue diet and can control the blood sugar level.
During pregnancy, eating a well-balanced diet is necessary for the proper nourishment and growth of the fetus. Following a low-residue diet will create detrimental impacts on health, such as low intake of fiber will create bowel irregularities, and a person may feel constipated. Consult a doctor to avoid such cases, create some temporary diet changes in a low-residue diet, or intake supplements is also a good option.
If a person is preparing the body for colonoscopy, it is often said to avoid purple and red foods and drinks such as red gelatin, beets, and purple drinks. These foods can temporarily discolor the tissues with these colors, which may hinder the scope. Red color might seem like blood.
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Considerations for Low-Residue Diet:
Here are few considerations which should be kept in mind while making changes to the diet.
Sustainability:
Items included in a low-residue diet are often available in plentiful sources at market and grocery stores. But still, if the symptoms appear suddenly, it is good to stock items like boxed pasta or canned food items before being handed as they are non-perishable.
Moreover, a person can also be pureed versions of fruits and vegetables in cans can also be brought according to diet if someone cannot prepare fruits and vegetables according to the diet. Pre-cut, pre-cooked or peeled fruits and vegetables can also be brought, which reduces the time too.
Nutritional Practices:
Consuming a low-residue diet for a long time can result in inadequate nutrition and calories. To overcome such nutritional losses, a person must consult a registered dietitian to suggest nutritional supplements. Nutritional supplements can help to fulfill the nutritional losses and deficiencies of vitamins and minerals.
Through blood tests, a person can also check vitamin and electrolyte levels of the body, and their adjustments in diet can help prevent the loss from the body. Following a low-residue diet for a long time might result in deficiencies of micronutrients in the body, so a person must consult a registered dietitian to modify the diet appropriately.
Flexibility:
It might be challenging for some people to follow a restricted diet if they are not in the habit of planning. Day-to-day schedules help a lot in managing the plan and change up how to eat in some diets. It is now easy to purchase items for any diet as they are readily available in various grocery stores and marts.
If a person plans to dine out, then following the pattern of a low-residue diet is not difficult. The chef or restaurant owner can be asked about preparing food and ingredients included in the dish. A person can demand notification in any dish, such as swapping the white bread instead of whole wheat bread.
Dietary Restrictions:
Dietary restrictions are one of the main parts to be considered when following any restricted diet. Following a restricted diet becomes more complex I a person is suffering from one or more problems like food allergy or gluten intolerance.
If a person follows a gluten-free diet, then the food items approved for a low residue diet might create problems for that person, and foods allowed on a gluten-free diet will cause problems for a low-residue diet. So, this case requires special attention and focus on selecting ingredients, including pasta, cereals, nuts, and seeds.
Similarly, if a person follows a vegetarian diet, all the low-residue animal products, including eggs and dairy, would be excluded. Such people only rely on plant-based sources of protein such as beans and legumes. But, these products are not a part of a low-residue diet, so it requires a particular sort of attention again in preparing a meal plan for such cases.
Community and Support:
Community support also helps a lot in tackling and dealing with the diseases as people learn a lot from discussions and experiences of other people suffering from the same disease. A patient can ask the doctor and other healthcare members for their practical answers regarding health.
Similarly, talking to those who have undergone the same problem related to yours also clears many things. Such people can give you a different perspective and can share much better rather than a doctor. You can also ask for in-person support groups by talking to your doctor and can join online groups or message boards where specific conditions regarding health are discussed.
Cost and Pricing:
Following a wide range of supplements for managing the optimal intake of nutrients in a restricted diet might be a high-cost part of the diet. You can ask your doctor or healthcare provider for the promotions, coupons or patient assistance programs regarding the prescriptions.
Benefits of Low-Residue Diet:
- Low-residue diets are less likely to create peristalsis movement because of the lesser undigested material consumed via food. It has been noted that the high-fiber diet includes the skin or roughage, which is left behind as undigested material and makes the stool bulky. The intestines work hard to move this undigested material to the rectum and require contracted movements. Following a low-residue diet avoid such contractions and is helpful in bowel-related diseases.
- Studies have shown that consuming a low-residue diet helps reduce inflammatory bowel disease.
- It has also been studied that a liquid-based low-residue diet is beneficial for people facing Crohn’s disease.
- A low-residue diet is also beneficial in preparing the bowel before resection and avoids the hindrance from solid waste during surgery.
- Similarly, following a low-residue diet instead of directly following a regular diet helps heal faster after surgery.
Pros and Cons of Low-Residue Diet:
| Pros of a Low Residue Diet | Cons of a Low Residue Diet |
|---|---|
| Low-residue contains a very little amount of fiber and thus creates little residue, so little stomal output is seen which is beneficial for those facing ileostomy or colostomy. | Low-residue fiber is low in fiber content which is a significant source of nutrition for the good bacteria of the intestinal tract. Such bacteria gain nutrients from digesting the fiber and plays important role in the wellbeing of humans. So, a diet low in fiber changes the volume and diversity of the bacterial population and affects health. |
| A low-residue diet slower the transit of food through the intestines. In this way, food is available for a longer time for digestion and this enhances the absorption of food. It creates a positive impact on health. | In a low-residue diet, refined carbohydrates and fruits and vegetables without skin are used. These all items are lower in vitamins and minerals as grains are refined and peels of fruits contain essential nutrients. This leads to nutritional deficiencies impacts negative status. |
| A low residue diet temporarily helps to settle intestinal symptoms such as diarrhea, pain, inflammatory bowel disease, diverticulosis, and intestinal surgery. | Following a low residue diet is not a long-term and viable strategy for optimal nutrition and growth. |
| A low residue diet contains refined items that are easier to digest and assimilate such as noodles and kinds of pasta. This diet is less demanding on the intestinal tract. | A low residue diet is although easier to assimilate but this reduces the digestive capacity and leaves less energy available for functions and other activities. |
Side Effects of Low Residue Diet:
- A low-residue diet is lower in most nutrients like vitamins, minerals and fiber. Thus, it also has many side effects on health, such as:
- Following a low-residue diet can create constipation issues as the diet is low on fiber which does not ease the digestive mechanism, and less stool is produced due to lesser roughage in the diet. For this purpose, fiber supplements are recommended.
- Iron deficiency anemia can develop in patients following a low-residue diet, leading to fatigue and shortness of breathing.
- Bleeding from gums, weight loss, and loss of appetite are also faced by many people following a low-residue diet, a sign of vitamin C deficiency.
- In the same way, numbness and tingling in hands and feet and trouble remembering things are some neurological symptoms people face following a low-residue diet, indicating that diet is low in vitamin B12.
Limitations of Low Residue Diet:
- A low-residue diet is beneficial for managing the symptoms of the acute or heightened episodes of increased abdominal pain, infection and inflammation. But, this diet has a limitation that it is not recommended for those suffering from an inflammatory bowel disease or other chronic diseases.
- It is not recommended during inflammatory bowel disease as it does not reduce inflammation and does not treat the underlying cause of the condition.
- A low-residue diet is relatively low in nutrients, especially vitamins and minerals, leading to nutritional deficiencies and can lead to other gastrointestinal symptoms such as constipation.
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