Low fibre diet

The recommended UK fibre intake is 30g per day. A low fibre diet aims to reduce your fibre intake to approximately ≤10g per day. Foods classified as high fibre contain over 6g per 100g and should be avoided on a low fibre diet.

A low fibre diet is used in a range of medical conditions including gastroparesis, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), functional dyspepsia, chronic diarrhoea and patients who are at risk of bowel obstruction. It may help manage the following symptoms:

1. Minimise the risk of blockages in the gut in people with narrowing of the bowel.
2. Avoid excessive gas production
3. Help manage loose stools associated with diarrhoea
4. Reduce abdominal pain

It is important a low fibre diet is not followed for an extended period of time unnecessarily.

Your dietitian and consultant will discuss with you the ongoing low fibre requirements once your symptoms are reduced, or any risk from eating high fibre foods is minimalised.

There are two types of dietary fibre: soluble and insoluble. Manipulating the type of fibre in your diet may help improve symptoms, and in general, a low fibre diet contains more soluble than insoluble fibre.

Soluble fibre

Absorbs water to become a gel like substance that is digested by bacteria in the gut. This type of fibre can help with symptoms of both diarrhoea and constipation.

Foods rich in soluble fibre include:

• Oats (should be cooked)
• Pulses; beans, peas and lentils (should be well cooked)
• Fruit without peel
• Some vegetables such as parsnips, carrots, aubergine, spinach, squash, baked sweet potato, turnips, broccoli and courgette.

Insoluble fibre

Does not dissolve in water, but it absorbs water like a sponge and swells up. It is not broken down by our digestive processes and it is excreted in the stools. Foods rich in insoluble fibre include:

• Wholegrain/wholemeal bread
• Wholegrain Cereals (e.g. Weetabix, Shreddies, All bran)
• Wholegrain Rice and pasta
• Skins of vegetables, pulses and some fruits
• Citrus fruit pith
• Pips
• Seeds and nuts
• Stringy vegetables (e.g. Green beans, celery, leeks)
• Muesli

Sources of soluble or insoluble fibre can be isolated and sold as fibre supplements. Fibre supplements may also be prescribed for constipation, for example as laxatives or bulking agents such as Fybogel. If you have been placed on a low fibre diet, you would typically need to stop these medications, and you should discuss this with your doctor or dietitian if indicated.

How you eat and how you prepare and cook foods can also improve symptoms. These tips should be used while following a low fibre diet.

Small and frequent meals

Small and frequent meals spaced throughout the day may be better tolerated than larger meals.

Drink enough fluids

It is essential to drink enough water through the day. Between 8 and 10 glasses a day is recommended, and this should be spaced out throughout the day.

Eat slowly and chew your food well

Chewing your food thoroughly will help break it down and make it more easily digestible by your gut.

Check that your teeth and gums are in good condition or if you wear dentures and make sure they fit well.

Try finely processed foods

Some people can tolerate foods high in fibre as long as they are well processed, so for example fine oatmeal but not whole oats. Likewise, pureeing vegetables into soups might make them easier to digest.

Cooking methods

Cook vegetables/potatoes until soft and easily mashed or pureed. Remove tough skins, stems, husks, pips, peel and pith from fruit and vegetables. Chopping, dicing and blending, as well as cooking fruits and vegetables, will damage the fibre structure and therefore be easier to digest.

Below is a table of foods that are suitable for a low-fibre diet, as well as those high fibre foods that should be limited.

Remember to avoid any foods that contain 6g or more of fibre per 100g.

Important: If your symptoms do not improve or you are losing weight on a low fibre diet then please contact your dietitian as soon as possible for further advice.

Drink options

Tea, coffee, fruit juices no bits, cordials, milk drinks, water etc.

National guidelines suggest having 5 portions of fruits and vegetables every day. Below are some smoothie and soup recipes to help increase portions of fruits and vegetables whilst keeping fibre content low.

If you do not feel you will be able to meet 5 portions per day it may be worth trialing a multivitamin supplement, which are widely available to buy from chemists/pharmacies, supermarkets and health food shops. (e.g. Centrum Advanced, Sanatogen Gold). Discuss with your dietitian if indicated.

Smoothies

Mango and Banana Smoothie

1 portion (3.6g fibre)

• 1 glass (160ml) Orange juice
• 1 small banana (80g)
• 2 slices of mango (80g), roughly chopped
• 30ml of water

Put all the ingredients in a blender and whizz for 1 min until smooth.

Avocado and Pineapple Smoothie

1 portion (3.1g fibre)

• ½ avocado (70g), peeled and roughly chopped
• ¼ cup fresh pineapple (40g), roughly chopped
• 150ml coconut water

Put all the ingredients in a blender and whizz for 1 min until smooth.

Beetroot, Apple and Ginger Smoothie

1 portion (3.2g fibre)

• 1 small raw beetroot (80g), peeled and roughly chopped
• 1 small apple(75g), peeled, quartered and chopped
• 1 tbsp. grated ginger (2g)
• 200ml water

Put all the ingredients in a blender and whizz for 1 min until smooth.

Spiced Peach and Yoghurt Smoothie

1 portion (2g fibre)

• 2 peach, canned in juice, roughly chopped (120g)
• 1 plain yogurt (125g)
• ½ tsp cinnamon, ground

Put all the ingredients in a blender and whizz for 1 min until smooth.

Soups

Roasted Red Pepper and Tomato Soup

5 portions, 5.3g fibre per portion

• 3 red peppers halved and de-seeded
• 1 white onion, unpeeled & halved
• 4 cloves of garlic, unpeeled
• 2 sticks of celery sliced & chopped
• 500g plum tomatoes
• 450ml Vegetable stock
• 2tbsp olive oil
• 2tbsp tomato puree
• 1tsp chilli flakes
• 25g butter
• salt & pepper

1. Pre heat oven to 200 0C/gas mark 4. Place the pepper & onion halves (cut side down) along with the plum tomatoes & garlic cloves into a baking tray & drizzle with the olive oil. Bake at the top of your oven for 30 mins or until the vegetables are roasted & tender.
2. Meanwhile, melt down the butter in a large pan over a medium heat and sauté the chopped celery for 4-5 mins. Not too hot, don't burn the butter.
3. Make up the vegetable stock adding the tomato puree & the chilli flakes. Mix well and then add to the sautéed celery. Remove from the heat.
4. When the baked vegetables are ready remove the peel from the onion and garlic cloves roughly chop them and add them to the pan along with the plum tomatoes. Place back on to a low to medium heat and use a hand blender or put in a food processor until smooth.
5. Season to taste and gently simmer until the soup is at a comfortable edible temperature.

Chicken and vegetable Soup

8 portions, 2g fibre per portion

• 1 medium diced onion
• 2 diced garlic gloves
• 2 tsp cooking oil
• 1000ml chicken stock
• 1 whole chicken
• 2 tsp dried ground cumin
• ½ tsp dried ground coriander
• 400g vegetables (for example skinless 100g sweet potato, 100g carrot, 200g butternut squash without skin - seasonal choices, frozen, tinned or leftovers

1. Fry onion and garlic in the oil in a large saucepan for 5 minutes until soft.
2. Add the spices and fry for a further 1 minute, stirring continuously.
3. Add the chicken, and the remainder of the ingredients to the saucepan bring to the boil and then simmer for approximately 120 minutes.
4. Take the chicken out and leave to one side to carve.
5. Blend the soup using a food processor or hand blender until smooth.
6. Add the chicken to the soup and serve.

Fish Chowder

5 portions, 1.9g fibre per portion

• 2 rashers of back bacon all fat removed
• 400g fresh haddock cooked and flaked
• 1/2 pint of tomato juice
• 2 potatoes peeled and diced
• 1/2 pint of fish stock (no vegetable bits)
• Salt and pepper
• Bay leaf
• 2 cloves
• ¼ pint skimmed milk

1. Dry fry, grill or oven cook the bacon, dice.
2. In a saucepan add fish, bacon, potatoes, tomato juice, stock and seasoning, bay leaf and cloves.
3. Simmer gently for 30 minutes.
4. Add the milk and remove the bay leaf and cloves.
5. Reheat gently until hot and serve.

If you have been provided with a physical copy of this page, please enter your dietitian's name below.

Name of Dietitian:

Address:

Department of Nutrition and Dietetics, 3rd Floor East, 250 Euston Road, London, NW1 2PG

Direct line: 0203 447 9289

Switchboard: 020 3456 7890

Extension: 79289

Fax: 0203 447 9811

Email: uclh.DieteticsTeam@nhs.net

Website: www.uclh.nhs.uk