When your doctor says you have an inflammatory bowel disease (IBD) -- like Crohn's disease or ulcerative colitis -- he may suggest a low-residue diet.
The basic idea is that you'll eat foods that are easy to digest and cut back on those that aren't.
What Is a Low-Residue Diet?
It limits high-fiber foods, like whole-grain breads and cereals, nuts, seeds, raw or dried fruits, and vegetables.
"Residue" is undigested food, including fiber, that makes up stool. The goal of the diet is to have fewer, smaller bowel movements each day. That will ease symptoms like diarrhea, bloating, gas, and stomach cramping.
Your doctor may recommend this diet for a little while when you have a flare, or after surgery to help with recovery.
What You Can Eat
- Refined or enriched white breads and plain crackers, such as saltines or Melba toast (no seeds)
- Cooked cereals, like farina, cream of wheat, and grits
- Cold cereals, like puffed rice and corn flakes
- White rice, noodles, and refined pasta
Fruits and Vegetables
The skin and seeds of many fruits and vegetables are full of fiber, so you need to peel them and avoid the seeds.
These vegetables are OK:
- Well-cooked fresh vegetables or canned vegetables without seeds, like asparagus tips, beets, green beans, carrots, mushrooms, spinach, squash (no seeds), and pumpkin
- Cooked potatoes without skin
- Tomato sauce (no seeds)
Fruits on the good list include:
- Ripe bananas
- Soft cantaloupe
- Canned or cooked fruits without seeds or skin, like applesauce or canned pears
Milk and Dairy
They're OK in moderation. Milk has no fiber, but it may trigger symptoms like diarrhea and cramping if you're lactose intolerant. If you are (meaning you have trouble processing dairy foods), you could take lactase supplements or buy lactose-free products.
Animal products don't have fiber. You can eat beef, lamb, chicken, fish (no bones), and pork, as long as they're lean, tender, and soft. Eggs are OK, too.
Fats, Sauces, and Condiments
These are all on the diet:
- Margarine, butter, and oils
- Mayonnaise and ketchup
- Sour cream
- Smooth sauces and salad dressing
- Soy sauce
- Clear jelly, honey, and syrup
Sweets and Snacks
You can satisfy your sweet tooth on a low-residue diet. These desserts and snacks are OK to eat in moderation:
- Plain cakes and cookies
- Gelatin, plain puddings, custard, and sherbet
- Ice cream and ice pops
- Hard candy
- Pretzels (not whole-grain varieties)
- Vanilla wafers
Safe beverages include:
- Decaffeinated coffee, tea, and carbonated beverages (caffeine can upset your stomach)
- Juices made without seeds or pulp, like apple, no-pulp orange, and cranberry
- Strained vegetable juices
What You Can’t Eat
On this plan, you’ll stay away from:
- Coconut, seeds, and nuts, including those found in bread, cereal, desserts, and candy
- Whole-grain products, including breads, cereals, crackers, pasta, rice, and kasha
- Raw or dried fruits, like prunes, berries, raisins, figs, and pineapple
- Most raw vegetables
- Certain cooked vegetables, including peas, broccoli, winter squash, Brussels sprouts, cabbage, corn (and cornbread), onions, cauliflower, potatoes with skin, and baked beans
- Beans, lentils, and tofu
- Tough meats with gristle, and smoked or cured deli meats
- Cheese with seeds, nuts, or fruit
- Crunchy peanut butter, jam, marmalade, and preserves
- Pickles, olives, relish, sauerkraut, and horseradish
- Fruit juices with pulp or seeds, prune juice, and pear nectar
How to Make It Work for You
As long as you follow the general guidelines for the diet, you can mix and match as much as you’d like. There are many meal options to choose from on a low-residue diet:
- Decaffeinated coffee with cream and sugar
- Cup of juice, such as no-pulp orange juice, apple juice, or cranberry juice
- Scrambled eggs
- Waffles, French toast, or pancakes
- White-bread toast with margarine and grape jelly (no seeds)
- Baked chicken, white rice, canned carrots, or green beans
- Salad with baked chicken, American cheese, smooth salad dressing, white dinner roll
- Baked potato (no skin) with sour cream and butter or margarine
- Hamburger with white seedless bun, ketchup, and mayonnaise -- and lettuce if it doesn't make your symptoms worse
- Tender roast beef, white rice, cooked carrots or spinach, white dinner roll with margarine or butter
- Pasta with butter or olive oil, French bread, fruit cocktail
- Baked chicken, white rice or baked potato without skin, and cooked green beans
- Broiled fish, white rice, and canned green beans
Everyone is different. You may be OK with some of the things listed under "foods to avoid," while other items on the "foods to enjoy" list may bother you. So keep a food diary for a few weeks. Track what you eat and how it makes you feel, so you know what works for you.
If you enjoy whole grains, nuts, and raw fruits and vegetables, shifting to a low-residue diet may be hard. But if you prefer white bread and pasta, don't mind canned fruits and vegetables, and are happy to snack on saltines and vanilla wafers, it may come naturally.
Remember, this isn’t a healthy way to eat for a long time because it skips many important nutrients.
Ask your doctor if he knows a nutritionist who can help make sure your diet is right for you and let you know if you need to take supplements.