January 29, 2018
Fibre is good for us, keeping our digestive system working well, our hearts healthy and helping to lower risk of diabetes and certain cancers. It’s one of the reasons that fruit, vegetables and wholegrains – which are rich in soluble and insoluble fibre – are so beneficial. But sometimes the gut just can’t cope with fibrous foods. Inflammation from Crohn’s disease or as a result of surgery, or procedures such as colostomy or ileostomy, may mean that foods containing fibre cause severe pain and may obstruct the gut, which is incredibly serious. You may be advised to eat a low-residue diet to prepare you for an investigative procedure, or after a period without eating a normal diet. Very fatty foods can also be difficult to digest.
The words ‘low residue’ send chills down my spine, as they take me back to an unhappy time in my teens when I had to spend weeks at a time in hospital. On the ward, I was on the receiving end of the type of care I later vowed never to dish out, if you can excuse the pun. The standard menu was poor enough, but when my gut was particularly traumatised and I was unable to tolerate fibre or meals high in fat, the food put in front of me was dreadful. The less I ate, the weaker I became. Without the energy to stay awake, I became less inclined to eat anything. It’s a downward spiral I see so often and that I try to remedy in my own patients with a new approach to food and nourishment, low residue or not.
Low-residue diets keep fibre to an absolute minimum. Unfortunately, that means many foods we associate with being healthy are a no-no, as are any skins and pips that you might normally eat on fresh fruit and vegetables. But despite what most hospital menus may suggest, there are many delicious foods you can still enjoy, and which will provide the nourishment and comfort you need. Root vegetables, such as carrots, parsnips and potatoes, can be slow-cooked so they’re wonderfully soft. If you casserole them with lamb shanks, bay leaves and rosemary (these herbs are woody, so you’ll need to remove them before eating), you’ll get a melt-in-the-mouth stew that will tempt you back for more.
For intense, herby flavour, blend basil until it becomes an essence and use it to infuse extra virgin olive oil. You could then toss white pasta in the herby oil. Or drizzle it over a soft risotto made with arborio rice. Or try one of our special low-residue soups, which are so delicious everyone will be wanting a bowlful.
A close friend is currently coping with a stoma, which we hope will be a temporary solution to her recent bowel surgery. As well as bringing her a flask of soup when I visit, I’ve been taking some tasty, low-residue treats. She loves the jellies I make with sieved fruit juices, and most recently she’s craving crème fraîche pana cotta, which we serve with raspberry juice made from sieving frozen raspberries. With some imagination and passion for food, a low-residue diet can be just as delicious as it is soothing.
Low-residue: foods to avoid
Wholemeal or granary bread
Brown rice and pasta
Pulses and grains, such as lentil and quinoa
Peas, sweetcorn and celery
Smoothies and fruit juices with bits