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Dietary strategies for IBD: Low Residue

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Quality Rating

Criteria for starring system: 

  • Incorporates appropriate microbiome strategies
  • Incorporates appropriate gut healing strategies 
  • Inflammation reduction is a priority
  • Long-term symptom reduction
  • Easily implemented
  • Reduces disordered eating patterns

Caveat for starring system: This system is our opinion based on the available research at this time. We reserve the right to modify our recommendations as new literature is published and we learn more about the complexities of IBD. Review our recommendations with an appropriate amount of discretion and understand that oftentimes there is not a one size fits all approach for every situation.

Low Residue Diet

Overview: Although there is not one agreed upon definition of a low residue diet, it has traditionally aimed to decrease stool volume. The diet aims to reduce stress on the digestive system by reducing fiber intake which reduces the amount of residue in the colon after digestion. Because fiber slows down movement of food through the digestive tract, lowering fiber intake reduces the amount of stool (because fiber bulks stool)

  • Very limited studies in IBD without a clear definition of what a low residue diet is. Your doctor may suggest this type of diet in the instance of a stricture, before or after surgery, during a flare, before an endoscopy, to treat diarrhea, or even indefinitely after diagnosis. 
  • Reduces or eliminates: whole grains, beans, legumes, all fruits and vegetables except bananas and peeled potatoes, raw fruits and vegetables, fruit and vegetable skins, nuts, seeds, coconut, flax, fruit and vegetable juices with pulp, prune juice, fibrous meats, and dairy products. 
  • Aims for <10-15 g fiber/day making it difficult to feed and nourish a healthy microbiome, ingest enough vitamins and minerals from food, and reduce risk of future flare or narrowing of the bowel. 
  • Very similar to a low-fiber diet, in fact many studies define their parameters as a low-fiber diet, but some also restrict other residue forming foods like dairy and fibrous meats. 
  • Imposes unnecessary restrictions that may lead to lowered diversity in the gut microbiota, increase chances of flare, and potentially lead to worse health outcomes.
  • Source: https://med.virginia.edu/ginutrition/wp-content/uploads/sites/199/2014/06/Parrish-July-15.pdf

Meets criteria for: 

  • Short-term symptom reduction

Does not meet criteria for: 

  • Incorporates appropriate microbiome strategies
  • Incorporates appropriate gut healing strategies
  • Inflammation reduction is a priority
  • Easily implemented
  • Reduces disordered eating patterns