Idea Transcript
Diet & Beverage Suggestions for Short Bowel Syndrome This diet is from the patient guidebook, "A Patient’s Guide to Managing a Short Bowel.” To order a free copy, go to: http://www.shortbowelsupport.com. The “good choices” in this handout are more easily absorbed and tend not to increase stool output as much as those in the “avoid” column. Some general tips: For those with some colon remaining, a lower fat, higher complex carbohydrate diet is recommended. For those with jejunostomies and high output ileostomies, a higher fat, lower complex carbohydrate diet is recommended. o See sections on carbohydrate and fat below so you know what we mean by this. Chew your foods well to help break them down. Avoid concentrated sweets and beverages such as desserts, sweet drinks/tea, fruit juices, etc. Eat smaller meals, more often – up to 6-8 per day. Limit beverages with meals. Instead, sip allowed beverages between meals (see list below).
If you are struggling to meet or maintain the weight at which you feel healthiest, consider meeting with a Registered Dietitian to develop an individualized meal plan.
More information on Nutrition in SBS is available at: www.GInutrition.virginia.edu (click on Patient Education Handouts and scroll down to Short Bowel Syndrome): Snack Ideas for patients with Short Bowel Syndrome Articles from the Journal Practical Gastroenterology to read or share with your physician
www.GInutrition.virginia.edu
1
CRP 7/2014
Good and Not-So-Good Food Choices for Short Bowel Syndrome GOOD CHOICES
AVOID
Complex Carbohydrates
Bread and Grains
Cereals
Cracker/Chips
Starchy Vegetables
Sliced breads Pita bread Naan bread Rolls Bagels, English muffins Plain waffles or pancakes Corn bread, plain muffins Plain banana, carrot or zucchini bread – not really sweet Tortillas – flour (whole wheat or white), corn Pasta, macaroni, noodles Rice - white, brown or wild Biscuits (without gravy) Bread sticks Bread stuffing Unsweetened cereals (with milk or eaten dry as a snack) such as: Cheerios®, Corn Flakes®, Rice Krispies®, Rice Chex®, Spoonfuls, Special K®, Kix®, puffed rice or puffed wheat Hot cereals: cream of rice or wheat, grits, oatmeal Crackers: saltines, club, soda, Matzo, Goldfish®, etc. Pretzels Bagel snack crackers or chips Rice cakes Corn or potato chips, reduced fat potato chips Potatoes Sweet potatoes, Yams Plantain Baked French fries Butternut squash, Pumpkin squash
www.GInutrition.virginia.edu
2
Donuts Sweet rolls Pop-Tarts® Pastries (see also dessert section) Pancakes or waffles with syrup or jam/jelly
Sugary cereals such as: Honey Nut Cheerios®, Frosted Flakes®, Cocoa Puffs®, Fruit Loops®, etc. Flavored hot cereals such as maple or apple cinnamon oatmeal, etc.
Granola bars, flavor-coated popcorns (Cracker Jacks®).
Those without a colon may do better limiting high fiber snacks such as popcorn.
Creamed vegetables. Some people (particularly those without a colon) may do better limiting legumes (such as lima beans, kidney beans, black beans, pinto beans, refried beans, etc.).
CRP 7/2014
GOOD CHOICES
AVOID
Fruits
Bananas Limit to 1 cup per day: Unsweetened canned fruits (applesauce, pears, peaches, mandarin oranges, apricots, cherries, plums, etc.)
Dried fruits Fruit canned in syrup Fruit juice, fruit drinks Watch out for high fructose corn syrup in drinks (for example, Capri-Sun®, canned fruits in syrup, etc.)
Non-Starchy Vegetables
Meat, Fish, and Poultry
Dairy and Soy
Cooked carrots, squash, zucchini, eggplant, turnip or beets Tomatoes, tomato sauce
In small amounts: Leafy greens (romaine, spinach, red lettuce, collard greens, kale, etc.) Green, red, or yellow pepper Protein Choices Poultry (chicken or turkey) Beef (flank steak, tenderloin, ground beef, meatloaf, etc.), Pork (ham, Canadian bacon, pork chop, etc.) Fish, fresh or canned Shellfish (clams, crab, lobster, scallops, shrimp, etc.) Game (duck or pheasant, venison, buffalo/bison) Regular cheeses (American, cheddar, Swiss, Monterey Jack, mozzarella, feta, Parmesan, etc.) Cottage cheese or ricotta Plain yogurt, yogurt sweetened with artificial sweeteners Plain cow’s milk, soy milk, or rice milk Buttermilk Tofu
www.GInutrition.virginia.edu
3
Creamed vegetables Broccoli Brussels sprouts Onions, leeks
Fried meats, fish, or poultry Raw meats, fish or poultry of any kind
Highly sweetened yogurts or kefir Chocolate or other flavored milks Flavored soy or rice milks (including vanilla) Cream, half and half
CRP 7/2014
Nuts and Nut Butters
GOOD CHOICES Chew well: Peanuts, almonds, cashews, pecans, walnuts Peanut, almond, cashew, sunflower seed, or soy butters Fat Choices Oils, salad dressing (full fat), Miracle Whip® Butter or margarine Cheese, cream cheese Avocado, Olives Sesame paste (tahini) Bacon Coconut (shredded)
AVOID Nutella , flavored nut butters, nut butters with jam or jelly mixed in ®
Sweetened cream cheeses (strawberry, honey nut, etc.) Honey butter, flavored nut butters Cream, half and half
Miscellaneous / Seasonings
Salt, pepper, herbs, spices Dill pickles Soy sauce, Worcestershire sauce, vinegar Tabasco or hot pepper sauce Splenda®, Equal®, Sweet ‘N Low®, etc. Unsweetened cocoa powder
White or brown sugar Maple or other syrups, honey, molasses Jams and jellies Chocolate or other flavored syrups, Nutella® High fructose corn syrup, corn or Karo® syrup Sugar alcohols (sorbitol, xylitol, mannitol) in "sugarfree" products such as jam, jellies, Jell-o®, and candy
Desserts (In Very Limited Amounts)
Animal crackers (not iced) Graham crackers Gingersnaps Vanilla wafers Angel food cake Shortbread Plain pound cake Plain cake donuts – no icing/sugar sprinkles Marshmallows
www.GInutrition.virginia.edu
4
Cake (especially iced), snack cakes (Little Debbies®), cookies, pie, brownies Danish, PopTarts®, donuts Ice cream, sherbet, popsicles Pudding, sweetened gelatin Candies, fruit snacks, etc.
CRP 7/2014
GOOD CHOICES
AVOID
Fluids and Hydration
Oral Rehydration solutions o Ceralyte®, DripDrop, “WHO” formula, Pedialyte® (or store brand equivalents, etc.) o See below for homemade ORS recipes Soups, broth If allowed: 6 oz Lactaid® milk If allowed: less than 4 oz coffee, tea, ice tea Limit water
Greater than 4 oz coffee, tea, ice tea per day Flavored or sweetened coffees or teas, hot cocoa, Ovaltine®, Nesquick® Fruit juices or fruit drinks (watch out for high fructose corn syrup in drinks), KoolAid®, Tang® Sodas (all kinds), sweetened tea, Sugar free beverages Alcohol Supplements such as Boost®, Ensure®, etc.
Fermentable Oligo-, Di- and Monosaccharides and Polyols (FODMAP’s): Limit yourself to only 2-3 small portions (1/4 cup) of these foods per week initially. If not well-tolerated, or if you have a stoma and these foods come out looking the same as when they went in, you may do better avoiding these foods.
Apples, pears, oranges, pineapples, melons Onions, leeks, asparagus, artichokes, cabbage, Brussels sprouts Broccoli, cauliflower Corn Beans (limas, pintos, black-eyed peas, edamame, etc.)
www.GInutrition.virginia.edu
5
CRP 7/2014