User:Ngriffeth/Low-fiber diet

A low-fiber/low-residue diet is a diet whose goal is 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-fiber diet is often prescribed before and/or after abdominal surgery or cancer treatments.

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.

General guidelines
Almost all low-fiber/low-residue diets make the following recommendations:

Some diets recommend limiting servings of baked goods to 2 grams per serving.

Conditions that may require a low residue diet

 * Pre- and post- abdominal or intestinal surgery
 * Bowel inflammation
 * Crohn's disease
 * Diverticulitis
 * Ulcerative colitis
 * Radiation therapy to the pelvis and lower bowel
 * Chemotherapy
 * Preparation for and participation in space flight (as per the space toilet)
 * Preparation for a colonoscopy
 * Gastroparesis
 * Internal hemorrhoid surgery

Quantity of Fiber
A low-fiber diet is not a no-fiber diet. A recent review article recommends less than 10 grams of fiber per day. Other sources recommend that a patient on a low-fiber diet eat no more than 10-15 grams of fiber per day.

Nutritional Quality
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.

Colonoscopy
The most common preparaton for a colonoscopy is a clear liquid diet accompanied by laxatives. However, this may not be the most effective preparation. A recent 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, because of evidence that it performs at least as well for bowel cleansing and is associated with better patient satisfaction.

Crohn's Disease
Various guides to low-fiber diet suggest their use for short-term management of Crohn's disease, but there is little research to support this. . A recent review of the research found that a semi-elemental whey hydrolyzed protein (WHP) diet is superior for treatment of Crohn's disease.

Diverticulitis
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). A Mayo Clinic review from 2011 showed that a high-fiber diet can prevent diverticular disease.