You won’t hear this advice often: Leave fiber out of your diet. It’s the opposite of all dietary recommendations for good health. It’s also a strategy for sensitive guts called the low residue diet (also known as a low fiber diet). “The purpose of the low residue diet is to reduce roughage that generates cramps, gas and other symptoms,” says Dr. Wilson Jackson, a gastroenterologist based in Harrisburg, Pennsylvania.
The Issue With Fiber
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Fiber is the indigestible component of plants we eat – such as whole grains, legumes, vegetables, fruits, nuts and seeds – and it plays a crucial role in gut health. “Eating high-fiber foods leaves a residue in the gastrointestinal tract that adds bulk to the stool, draws liquid into the bowel and pushes stool out,” explains Katrina Hartog, a registered dietitian and senior director of clinical nutrition at Lenox Hill Hospital in New York City.
Eating high-fiber food is also associated with:
Despite the benefits, digesting fiber can irritate the GI tract in someone with a sensitive gut, causing:
- Gas. Bacteria generate gas as they break down fiber. “The gas will stretch out and affect pressure sensors in the gastrointestinal tract, which can lead to cramps,” Jackson says.
- Speedy transit times. Fibrous foods move through the GI system faster than nonfibrous foods. “That can be painful, especially if you couple that with an inflammatory condition,” Jackson notes.
- Fluid buildup. “When undigested molecules rumble through the GI tract, there are faster shifts in fluid than normal, which can cause diarrhea,” Jackson says. “The molecules pull fluid in faster than it can be pulled out.”
Low Residue Rescue
The low residue diet offers a break from fiber-induced GI distress. The diet drops dietary fiber to 8 grams per day from the normal 25 to 38 grams of fiber recommended for generally healthy people. Low fiber intake helps ease GI tract irritation and reduce stool frequency and bulk.
To reach low fiber levels, you’ll have to eliminate just about all fiber-rich foods from the menu including:
- Whole grains, such as whole-grain cereals, pasta and bread.
- Raw fruit and raw vegetables.
- Legumes such as kidney beans, lentils and peanuts.
The Academy of Nutrition and Dietetics also recommends avoiding the following foods on the low residue diet, since they can cause GI distress:
- Dairy products, such as milk, cheese, yogurt or any food that contains dairy products (such as sauces with cream).
- Fatty meat, such as steak, sausage or bologna.
- Seafood with a rubbery texture, such as shrimp.
What’s on the Menu
The low residue diet features easy-to-digest foods that won’t irritate your GI tract. The choices include:
- Refined grains instead of whole grains. Refined grains have been processed, which removes the fibrous (and most nutritious) portions of the grain. Examples include white flour or anything made with it (like white bread, tortillas or pasta), white rice and puffed (white) rice cereal.
- Soft, well-cooked fruits and vegetables. “Remove the seeds and skins of fruits and vegetables, which have a lot of fiber, and then cook the foods for a long time. The cooking process will break down some of the fiber,” Hartog says. (Canned vegetables are especially soft.)
- Lean proteins. “Most proteins will work if they’re tender and don’t have a lot of fat – like eggs, chicken breast or cod,” Hartog says.
- Lactose-free, low-fat dairy foods. These foods do not contain lactose, the sugar many people have a hard time digesting. You can find lactose-free cow’s milk or drink plant-based milks such as almond or rice milk.
- Soup. You should eat soups with clear broth (not cream-based broth), well-cooked vegetables and protein.
What does a day of meals look like on the low residue diet? You might start with scrambled eggs and white toast for breakfast; have a cup of chicken noodle soup and half a tuna sandwich on white sourdough bread for lunch; a snack of saltine crackers; and then chicken breast, boiled potatoes or carrots and canned green beans for dinner.
In addition, you’ll need to drink lots of water and avoid beverages with too much sugar. “Sugary juices can run through the system too quickly and cause loose stool,” Hartog says.
Low Residue Diet Candidates
The low residue diet is intended for people with certain GI conditions. They include:
- Diverticulitis. Diverticulitis is an acute infection of diverticula or little pockets in the wall of the colon.
- Ulcerative colitis or Crohn’s disease. A flare-up of one of these conditions throws off GI health.
- Infection of the GI tract. This is often caused by food poisoning from bugs such as Salmonella or E. coli.
- Cancer. This includes people experiencing cancer of the GI tract or GI discomfort due to certain cancer treatments (such as radiation therapy) or cancer surgery.
- The post-operative period. Digestion may be disrupted after GI surgery.
Low Residue Diet Risks
While the low residue diet may help ease GI symptoms, it still comes with some risks. For example:
In the short term, you can avoid potential risks by:
But the low residue diet isn’t meant for the long term. “For acute issues, we’d recommend being on the diet for five to seven days and then adding fiber back in. But it’s all patient-specific,” Hartog says. “If you and I were on a low residue diet, you might be able to add back foods quicker than I would or vice versa.”
Long-Term Issues
In some cases, it may take longer than a week to get GI symptoms under control. That may be safe for some people. “If you take a well-nourished person with a Crohn’s disease flare, they can safely sustain the low residue diet for three months, presuming they’ll get back on a regular diet,” Jackson says. “But if you maintain this diet for years on end, there are deficiencies that can develop, and you’ll need to find other ways to get healthy foods into your diet.”
That can be especially challenging for people with GI cancer whose treatment may last for many months.
In those cases, Jackson suggests slowly adding healthy, fibrous foods back in your diet and breaking them up with a food processor or blender. “For example, take kale, put it in a blender and then drink it. You can do the same thing with an apple. You won’t have a lot of the side effects that normally come with those foods,” he says.
But sustaining any type of restrictive diet is difficult. Don’t hesitate to ask for help. “Get in touch with a dietitian or use internet resources with well-researched recommendations and ways to manage your condition,” Jackson says. “And remember to keep your doctor in the loop about how you’re feeling.”