Low-Residue and Low-Fiber Diets in Gastrointestinal Disease Management

Abstract

Recently, low-residue diets were removed from the American Academy of Nutrition and Dietetics' Nutrition Care Manual due to the lack of a scientifically accepted quantitative definition and the unavailability of a method to estimate the amount of food residue produced. This narrative review focuses on defining the similarities and/or discrepancies between low-residue and low-fiber diets and on the diagnostic and therapeutic values of these diets in gastrointestinal disease management. Diagnostically, a low-fiber/low-residue diet is used in bowel preparation. A bowel preparation is a cleansing of the intestines of fecal matter and secretions conducted before a diagnostic procedure. Therapeutically, a low-fiber/low-residue diet is part of the treatment of acute relapses in different bowel diseases. The available evidence on low-residue and low-fiber diets is summarized. The main findings showed that within human disease research, the terms "low residue" and "low fiber" are used interchangeably, and information related to the quantity of residue in the diet usually refers to the amount of fiber. Low-fiber/low-residue diets are further explored in both diagnostic and therapeutic situations. On the basis of this literature review, the authors suggest redefining a low-residue diet as a low-fiber diet and to quantitatively define a low-fiber diet as a diet with a maximum of 10 g fiber/d. A low-fiber diet instead of a low-residue diet is recommended as a diagnostic value or as specific therapy for gastrointestinal conditions.

An Examination of Diet for the Maintenance of Remission in Inflammatory Bowel Disease

“…Although the low-residue diet is prescribed for short-term use, in clinical practice, patients often follow the diet long-term. The primary purpose of a low residue diet is to reduce the frequency and volume of stools and reduce the risk for intestinal obstruction [89]. In the literature, there have been discrepancies as to the actual composition of low-fiber and/or low-residue diets.…”

“…In the literature, there have been discrepancies as to the actual composition of low-fiber and/or low-residue diets. A low-residue diet requires the elimination of whole grains, legumes and all fruits and vegetables (except for bananas and skinless potatoes), dairy and fibrous meats [89]. This is not the same as a low-fiber diet which excludes only insoluble fiber.…”

“…A prospective study in subjects with active CD ( n = 70) that compared a low-residue diet to an unrestricted diet found no differences in outcome including symptoms, need for hospitalization, need for surgery, new complications, nutritional status, or postoperative recurrence [42]. Due to lack of evidence, there appears to be no reason to restrict residue from the diet, however anecdotally CD patients with obstructive symptoms and strictures report improvement in symptoms when following a diet reduced in fiber (total daily fiber intake < 10 g) [89,90]. …”

Enfermedad diverticular: nuevas perspectivas en el tratamiento dieto-terapéutico

“…La digestión de la fibra comienza en la boca y abarca diferentes órganos, además de glándulas que procesan la matriz alimentaria con el objetivo de transformar las macromoléculas en sus constituyentes, sin embargo, algunas partículas no logran ser digeridas en el intestino delgado y son fermentadas en el colon 48 . Estas partículas pobremente asimiladas por los seres humanos se denominan fibra 49 , en este sentido el Comité del Codex sobre Nutrición y Alimentos para usos Dietéticos Especiales, es claro en definir a la fibra dietética como polímeros de carbohidratos con cierto grado de polimerización (GP) [unidades monoméricas (azúcares individuales) no inferiores a 3, que no se digieren ni se absorben en el intestino delgado] 48 . Es decir, un GP no inferior a 3 pretende excluir mono y disacáridos.…”

Nutritional Therapy for Inflammatory Bowel Disease

“…While a low-fiber diet excludes only insoluble fiber, a low-residue diet requires exclusion of not only all vegetables, fruits, whole grains, legumes, but also dairy products and fibrous meat [79]. A basic idea behind these diets is that they reduce the volume and frequency of stools as well as the risk of intestinal obstruction.…”