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Martha's low residue diet

Phoebesnow
Posts: 453
Joined: Apr 2011

Hi Martha,

 

I am interested in exactly what you are eating and about what size portion.  I have not had the success that you are having with thenlownresidue diet.  I have just had another partial blockage and itnwasnextremely painful.    I am also interested in what you are drinking and how much.  I really appreciate your help.

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mp327
Posts: 3114
Joined: Jan 2010

I'm sorry you have experienced another partial obstruction.  I know how painful it is.  I hope you are feeling better.

As for the low-residue diet, first off, small portions are key.  Eating smaller meals more often throughout the day is much better than eating 3 large meals.  I would stick with a portion of 1/2 cup of most foods--it's very important not to overload your system.  Also, it is important to drink enough water.  I would say that the 8-8oz. glasses per day is a good rule to follow.  I do drink tea in the mornings and count that as part of my fluids.  I am a very small person and it's hard for me to drink 64 oz. of water a day, but I try to get close. 

As for what I eat:  Yogurt, cottage cheese, pudding, ice cream, sherbet, cheese, chicken, fish, ground turkey, eggs, bananas, Soy milk, protein drinks, English muffins, white bread, white rice, white pasta, cornflakes, cream of wheat or rice, white potatoes, applesauce, canned mandarin oranges.  From the information I've read, canned peaches and apricots are okay. 

I made turkey meatloaf a few nights ago and have been eating leftovers of that, which have been easily digested.  Soups are good (homemade), using potatoes, broth or milk, a small amount of onion and celery for flavor.  You can eat it as is or whiz it in the blender to make it even more digestible.

Some foods to definitely avoid:  Raw fruits and veggies, including any kind of greens.  Beans/legumes, which can cause lots of gas.  Cooked veggies should be thoroughly cooked and not tough or fibrous (such as lower parts of broccoli or cauliflower).  However, since you've just experienced an obstruction, I wouldn't recommend eating any veggies right now.  Broccoli has been a nemesis for me lately, however, I ate a few bites of it last evening with no bad effects.  Definitely stay away from any type of seeds, nuts or peanut butter.  Obviously, some types of berries are full of seeds, as is kiwi also, so those should be avoided.  I can imagine that eating popcorn right now would put me back in the hospital--I think that one is a no-brainer.

The one thing I have learned is that processing any fresh fruits or veggies in a blender or food processor DOES NOT change the fiber content whatsoever, so anything high fiber will remain high fiber, no matter how much you blend it.  Choosing low fiber foods to begin with is a must.  I found good information on the internet on the BC Cancer Agency website and the Queensland Government website.  There are many others.  Keep in mind that some things can be contradictory from one website to another.  I guess you just have to use your best judgement in those cases.  If something sounds like it might not be safe, I wouldn't eat it.

This diet is not intended to be long-term or permanent, so at some point both you and I will have to begin gradually adding more foods back into our diet.  Right now, I'm a bit fearful of that.  However, it is hard to get all necessary nutrients from such a diet.  Multi-vitamins and supplements can help and are recommended on some of the sites. 

If you have any more questions, let me know.  I'm still finding my way through this as well, but I'll try to help you in whatever way I can.  I hope you can avoid another obstruction (and me too!).         

Marynb
Posts: 1134
Joined: Aug 2012

Martha,

Can you tell me a little more about symptoms of blockage? I have been having some trouble this week. Pains, bloating, etc. Is this caused by treatments?

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mp327
Posts: 3114
Joined: Jan 2010

I can only describe the symptoms I personally experienced but would be most happy to.

1)  Gut pain--Mine was located up high in my abdomen, not to the left or right, but right in the middle.  It got so bad that it doubled me over.

2)  Nausea and vomiting--this happens because what goes down cannot go past the blockage and must come up.

3)  Cramping, similar to severe gas pains.

4)  Complete cessation of bowel movements (total obstruction) or much reduced output (partial obstruction).

5)  Hyper bowel sounds, which are normally produced when bowels are working correctly and moving food/stool through intestines.  Hyper indicates the bowels are working hard to move things without success.

6)  Heartburn.

7)  Abdominal distention, bloating and a feeling of fullness.

8)  Lack of hunger.

I had no fever at any time.

The first episode happened on a Sunday night about 3 hours after my evening meal.  Vomiting made me feel much better.  I did not have another episode until the following Tuesday night, again about 3 hours after my evening meal.  I made the mistake of going to bed around 10 p.m. and I think lying down made things worse.  At midnight, I was on my way to the ER.  Intestinal obstructions can be seen on a CT scan, which was ordered for me.  The obstruction was described as "partial" and in my small intestine, but down low in my belly.  The reason the pain felt higher than that was because of the backup of food "north" of the area of blockage. 

If you have a mild episode, I would not recommend eating or drinking anything for a few hours to see if it clears on its own.  In really severe cases, you need to get yourself to the ER.  Ruptures can happen and are very serious, as all the bacteria and fecal matter in your intestines is released into your abdominal cavity, requiring emergency surgery.

The above symptoms were those I experienced.  There may be other indications of a bowel obstruction, I just don't know.  I hope this info is helpful to you.

Marynb
Posts: 1134
Joined: Aug 2012

Thanks much. Sounds to me like this is what is going on with me. I am going to see what develops in the next 24 hours, sticking only to warm broth. I had major abdominal surgery after treatment for anal cancer, so this could be a contributing factor. I hope this is all that it is. Always aware that there could be mets from neuroendocrine cancer. I really don't want to go to the hospital. Ugh.

Btw, why would spinach be out? I have been eating lots of it the past 2 weeks.

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mp327
Posts: 3114
Joined: Jan 2010

I'm not sure why spinach is on the list of foods not to eat.  I will say, though, that the times I have eaten spinach, either raw or cooked, in the past, I have suffered from constipation and abdominal discomfort.  When is the last time you ate it? 

It's quite possible that your abdominal surgery is contributing to your symptoms, i.e. scar tissue.  I hope you can get some relief by adjusting your diet.  Keep us posted!

Marynb
Posts: 1134
Joined: Aug 2012

I have eaten spinach every day for a week. Ugh. Hopefully, that is it. Who knew?

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mp327
Posts: 3114
Joined: Jan 2010

That is probably a good bet.  Hopefully, you will feel much better real soon!

 

Marynb
Posts: 1134
Joined: Aug 2012

I have eaten spinach every day for a week. Ugh. Hopefully, that is it. Who knew?

Marynb
Posts: 1134
Joined: Aug 2012

Thank you so much for the information about blockage. I think this is what is happening to me, so I have switched to your diet. My pains are much better today...not yet gone. I will stick with this diet for the rest of the week and see if that does the trick. I am hoping this is all it is.

Thanks a lot!

Mary

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mp327
Posts: 3114
Joined: Jan 2010

I'm very glad to hear you are feeling better!  I think all fingers are pointing to the spinach!  Hopefully, your pain will completely subside once you have given your bowels a break from all the fiber.  My lunch was strange today--an English muffin topped with a sliced hard-boiled egg topped with low fat cottage cheese.  I have had to get creative to keep from getting bored. 

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RoseC
Posts: 513
Joined: Jun 2011

Hmmm, an English muffin with a hard-boiled egg and cottage cheese - actually, that sounds rather delicious!

Glad things are looking up, Marynb.

Annie Belle
Posts: 2
Joined: Mar 2013

 This is very helpful information.  Thank You So Much!!!

LaCh
Posts: 533
Joined: Dec 2012

MP327... Why do you think you had a small bowel obstruction if it wasn't irradiated?  Did you have some underlying small bowel issue unrelated to anal cancer?  The last thing on my mind is some small intestine issue; my focus is at the extreme end of the tube, if you know what I mean (if you can even call "focus" because I'm actually not thinking about that too much anymore either). 

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mp327
Posts: 3114
Joined: Jan 2010

According to my radiation oncologist, part of my small bowel was most likely in the field of radiation.  Check out this diagram and you can see that much of the small intestines sit low in the abdominal cavity.  

http://www.webmd.com/digestive-disorders/digestive-system

My treatment began with a larger treatment field than just the tumor area and included atleast part of my pelvic region.  After a certain number of treatments, the field was reduced in size twice, the last reduction focusing on the anal area only.  I believe this is how pelvic radiation for anal cancer is normally done so that any cells that may have migrated outside of the tumor site are zapped.  The radiation can cause adhesions or scar tissue which can cause blockages.  This could have been the cause of my obstruction, but that was never really determined.  Intestinal bugs can also cause inflammation which can result in blockages. 

LaCh
Posts: 533
Joined: Dec 2012

Yeah, i had the same series of treatments, irradiatin of the entire pelvic girdle and it's contents (pelvic and inguinal lymph nodes and unfortunately, everything that sits inside the pelvic girdle) followed by a smaller field of the same and ending with irradiation of the tumor only. I was told that the only unwanted intestine that could be irradiated would be the large bowel, ascending, transverse and descending and that if I maintained a full bladder, it would push the small intestine out of the field.  When you mentioned the location of your blockage, high, center of the abdominal cavity,  thought, If I were a worrier, this would worry me (I generally don't worry about things that haven't happened) since I couldn't see a correlation between the radiation treatments (as I understand them) and the location of your blockage. That said, I've come to accept that the information shared with me by my doctors was a tiny fraction of the information not shared with me, a topic that I commented on in another blog heading. In any case, I was just curious.  Thanks for the explanation. 

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mp327
Posts: 3114
Joined: Jan 2010

You're welcome.  My rad onc said it would be next to impossible for the entire small intestine to be moved out of the radiation field.  In the 4 1/2 years I've been on support websites, I don't think I've ever heard of someone else having a blockage post-treatment, except for one person whose intestines (I don't remember if it was large or small intestines) "fused" together in one location.  I don't recall what her treatment was, but it seems to me that in that case surgery would be necessary. 

To update everyone, I am doing quite well these days and have gotten a little braver when it comes to diet.  I have begun eating very small amounts of well-cooked fruits and veggies, but  nothing raw yet.  I am still eating a lot of soft foods, which include yogurt, cottage cheese, and soups, although I no longer put soup through the blender, instead just making sure all ingredients are those that are tolerable and cut into very small pieces.  I am eating meat with no issues (not beef, as I rarely eat beef), fish, chicken and turkey.  I feel tons better than I did a few short weeks ago.  I bought a Nutri-Bullet, based on the endorsements I saw here from several of you, and am enjoying experimenting with all kinds of combinations in my smoothies.

I ran a 5K race on Saturday and my only issue was my creaky left knee in which I have osteoarthritis.  I finished 2nd. in my age group.  Saturday was my 4 1/2 year mark post-treatment, so I thought what better way to celebrate it than running a race!

I want to thank all of you who were concerned for me while going through the issues with the blockage.  Thanks for all the good thoughts and prayers! 

LaCh
Posts: 533
Joined: Dec 2012

I was told that my intestines, large and small, were never in the field, but as I said, who really knows...  my trust in the veracity of what I was told, across the board, is somewhere between zero and none.  (case in point: I was also told that there's no radiation scatter, that my chest cavity and head received no radiation whatsoever, and yet the treatment rooms are below ground so passersby at street level aren't exposed and when the treatments are in progress, two, large, heavy lead doors slide shut. So, it's hard to square "no unwanted exposure to me," in a room without protection for my head and torso with all the safety measures put in place for everybody else. It's just another "story" that doesn't add up for me (just like "a PET scan is safe but stay away from other people for 7 hours because it isn't safe for them."  Things like that leave me scratching my head and lead me to distrust everything that I'm told.  Anyway, good luck with a continued recovery.... Things seem on track.  

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mp327
Posts: 3114
Joined: Jan 2010

I agree, who really knows where all that radiation ends up.  As for me, I am currently doing well and I thank you for the good wishes!

Phoebesnow
Posts: 453
Joined: Apr 2011

As myndr explained to me, he can control where theradiation entered but not the exit. And that the radiation continues towork inside my body for 9 months to 1 year.  

 

P.s of course I have copies of my medical records.  Stage is not listed.  Size of tumor only and pictures from colonoscopy , pet, ct.

 

I have never heardthat you need to stay away from people for 7hours afte pet scan.  

LaCh
Posts: 533
Joined: Dec 2012

Can't conjecture on what someone else received but I was injected with a radioisotope, secluded in a small isolated room for an hour while it diffuces through my body, scanned, instructed to leave the office immediately so as not to expose the waiting room patients and told to stay away from people for 7 hours, which is the half-life of the radioisotope that was used.  Dunno about other scans, other people.  If the radiation works for 9 months to a year, I wonder why I;ve been recommend to have scans and/or biopsies in 5-6 months.  I'll have to rethink my 6 month biopsy follow-up plan, especially if it could result in a false positive.  Information: it's crucial, and sadly lacking. 

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mp327
Posts: 3114
Joined: Jan 2010

I was never told to avoid people for 7 hours after the scan, nor have I ever been told to follow a low carb diet for a couple of days prior to the scan.  However, I was always told not to exercise 24 hours prior and to drink lots of fluids afterwards.

Marynb
Posts: 1134
Joined: Aug 2012

Congratulations on running your race! You are doing amazingly well. I am glad you bought the Nutribullet. I really love it. I have eliminated the spinach and have switched over to kale for now. I am feeling better, not great. I do think I had some sort of a blockage. One of my tumors was in the small intestine, so it is probable. One day at a time!

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mp327
Posts: 3114
Joined: Jan 2010

Thank you!  I am feeling so much better these days.  As for the Nutribullet, I am still experimenting with different combinations of ingredients, just making sure that they are all good for me.  My husband has even been making smoothies for his breakfast in it, so it has been worth the price.  I happen to love kale and it has more nutrients in it than spinach, although spinach is good for us too.  I primarily use kale in soups.  It does sound like you had some kind of a blockage.  The diet definitely helps to rest the bowels.  I am getting a little more brave with what I eat and have been craving a salad like crazy.  Also, I am missing my steel-cut oatmeal in the mornings.  I may give both of these things a try later this week, even if in small amounts.

I hope you continue to feel better! 

jcruz
Posts: 279
Joined: Jan 2013

I'm eating pretty much the same way as Martha although I do allow myself a small amount of creamy peanut butter on my morning toast.  I'm following some guidelines from both Mayo Clinic (http://www.mayoclinic.com/health/low-fiber-diet/my00744) and Norwthwestern Memorial Hospital (http://www.nmh.org/ccurl/84/948/lowfiber-diet07.pdf).  And I'm also browsing a book about IBS to pick up other information.

I had to start following a low-fiber diet as I began weaning off the pain meds and discovered what my foods body was truly capable of handling and what foods might cause a disaster.

 

Phoebesnow
Posts: 453
Joined: Apr 2011

Thank you so much for outlining everything so clearly. I can now see where I was going wrong.  Peanut butter, bottoms  fibrous veggies were going in the soup, everday a sweet potato, beans once or twice aweek,and smoothies.  I think corn tortillas are a problem also, but not tortilla chips.

 

Do u think hummus would be a no?  Garbanzo beans puréed.

 

Because of my ataxia, I cannot have wheat, flour, gluten, whey, yeast or soy and rice, pasta or any derivative of these products.

 

I knew about the spinach from that blockage and consequently gave up lettuce, cabbage, tomatoes.  I guess there will be no need for a garden this year.

What about chocolate,  I have been eating a flour less chocolate cake from trader joes.

 

Again thank you.

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mp327
Posts: 3114
Joined: Jan 2010

I'm glad you were able to identify some trigger foods from the info I gave you.  I hope you will check out some websites that will give you additional information, as I'm just passing on what I've learned so far. 

I would say that anything with corn in it would not be good.  However, I have been eating some tortilla chips occasionally and had no problems after the last time I ate them.  I think hummus would not be a good choice--pureed beans would have the same amount of fiber.  I love hummus too, but have given it up, at least for now.  Spinach is definitely out.  That stuff used to stop me up even before I had the obstruction. 

According to the info I have, chocolate is fine as long as it doesn't contain fruit or nuts.  Dried fruit is not recommended.  One of the attacks I had came after eating a handful of raisins, which used to be a frequent snack for me.

As for the ataxia, that creates an additional challenge for you.  Not being able to eat any of the things you've listed cuts out a lot of the foods allowed on this diet.  I'm sorry you are in that predicament.

I just ate some of my homemade applesauce for lunch--waiting to see what happens!

Phoebesnow
Posts: 453
Joined: Apr 2011

So happy the cake will be ok.  It's nice to have something that's almost like cake or bread.  Yes I will look at the websites.  Thanks again. I'm interested to know how the applesauce plays out.

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RoseC
Posts: 513
Joined: Jun 2011

Great advice!

One thing (about hummus) - I'm eating it every day and it's been helping a lot. I eat it with a slice of pita bread to make a complete protein (not that I know what a complete protein is, doh, but I read that the combination of the two makes one). Must say though, I'm four and a half years out and it's possible that the hummus might not be a good idea for those who recently completed treatment. Might want to try it though - it's got protein in it and if one can tolerate it, it's delicious. It can be gassy though, so might want to start with a little and let the body get used to it.

Another thing - taken from a book for those with IBS - eat only soluble fiber on an empty stomach. Soluble fiber consists of (I'm giving a list from the book):

Rice, pasta, oatmeal, cornmeal, fresh white breads (not whole wheat), barley, rice or corn cereals, flour or corn tortillas, soy, quice, carrots, yams, potatoes, squash, rutabagas, parsnips, beets, squash, pumpkin, mushrooms, chestnuts, avocados, bananas, mango, papaya, applesauce

(Taken from 'The First Year IBS' by Heather Van Vorous)

Eating only soluble fiber on an empty stomach did wonders for me - much less urgency, no diarrhea (as long as I stick to the diet). I also take Metamucil every day. Such a joy to be able to go out every day and not have to worry about bathroom problems!

 

Phoebesnow
Posts: 453
Joined: Apr 2011

I picked up your advice on the soluble fibre on another thread.  Things started to improve for me right aWay.  Then I started to go crazy again eating veggies and beans andeverything went downhill fast.  Keep us posted on these tidbits.

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RoseC
Posts: 513
Joined: Jun 2011

Yes, I did the same thing last week. Everything was going so well that I added in a few things that I shouldn't have - oh well, live and learn! Glad the info helped - I can't believe what a difference it made for me. Wish I had known about it (or done more research) earlier on!

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mp327
Posts: 3114
Joined: Jan 2010

Thanks for your good information.  You are right, hummus is a great source of protein and I used to eat it regularly.  However, it's not recommended for those who have had a recent bowel obstruction.  Resting the bowels is recommended after such an episode and high fiber foods, such as any beans, are not good for that.  Things you've listed that are okay after bowel obstruction are pasta, white breads, flour tortillas, potatoes, mushrooms, bananas and applesauce.  I did not find any of those other foods listed under the column "You can eat this" on my information.  However, it probably depends on the severity of symptoms.

That is good information about eating soluble fiber on an empty stomach.  Thank you for posting that!  I'm glad that is working for you!

As for Metamucil, that is definitely not recommended in cases of bowel obstruction, according to the information I have. 

RoseC's picture
RoseC
Posts: 513
Joined: Jun 2011

Thanks Martha - I had lost sight of the original question in the thread and was responding to diet changes only, wasn't thinking in terms of blockage. Thanks!

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RoseC
Posts: 513
Joined: Jun 2011

Thanks for the websites - I like that they give a suggested menu - I'm terrible at putting all the different things together.

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