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Ultimate Guide to the Low Residue Diet (Low Fiber)

Evidence Based

If you’ve been told to look into a low residue/fiber diet, then we know you have questions.  For a starters, what is the difference between the low residue diet vs low fiber diet vs bland diet?  And just as importantly who should actually try it?  We’ll look at all of this, plus exactly what foods you can and can’t eat on the diet, in this definitive guide to all things low residue.  Let’s go!

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What is it? Yes & No Foods Typical Meals Is It Easy To Do? Why Try It? Cautions Summary & Verdict
Researched & Written by
Bailey Franzen MS, RDN
Bailey Franzen MS, RDN
Registered Dietitian Nutritionist
Carolyn Quijano MS, RDN
Carolyn Quijano MS, RDN
Registered Dietitian Nutritionist

Edited by Digest Life team

Last Updated: 7 April 2021

What is the Low Residue (Low Fiber) diet?

What’s a Low Fiber Diet?

A low fiber diet is a poorly-defined diet prescription recommended by healthcare providers for certain conditions affecting the gastrointestinal (GI) tract. The diet restricts fiber — a carbohydrate type that can’t be broken down by the body for energy. Fiber remains intact while passing through the digestive tract.

Good fiber sources include plants such as fruits, vegetables, beans, nuts, seeds, and whole grains. While the amount of fiber allowed on a low fiber diet is not specified, education materials and studies evaluating the diet generally allow for 8-10 grams per day.

Though a low fiber diet helps manage certain disease states, it is mostly prescribed based on professional opinion or consensus. For some intended uses, the diet has not been studied enough to assess its therapeutic value.

What’s a Low Residue Diet?

The term “residue” refers to any food substance that stays in the intestinal tract without being digested, which adds to the bulk of stools.1 For the most part, residue is associated with dietary fiber. Still, all foods can contribute to intestinal residue build-up to some degree.2 Cells sloughing off in the intestines, microorganisms, and gut secretions can also cause increased residue and stool output.1

To date, there is no standardized low residue diet. Partly because it’s challenging to calculate the exact volume of residue produced from digesting foods.2 Also challenging are differences from person to person in bowel function and gut microbes, which can cause variance in output.2 For these reasons, the low-residue diet was removed from the nutrition care manual in the United States.1

Why Restrict Fiber or Food Residues?

Because fiber and residues lead to bulkier stools, this may increase how often you have bowel movements. Usually, this is a good thing but may not be what you’re going for before or after a gut procedure or if you’re in the throes of a flare-up of an underlying bowel disease. In such cases, you may be given professional advice to restrict dietary fiber. Fiber can also be fermented by helpful gut microbes, which is usually great. Still, the gas produced in the process may cause some discomfort for already sensitive guts.

When Is the Diet Recommended?

A low fiber diet is sometimes recommended for:

  • Cleansing the bowel
  • For GI disease flare-ups
    • Crohn’s disease, Ulcerative colitis, and Diverticulitis
  • Bowel Strictures and for Prevention of Bowel Obstruction
  • Gastroparesis
  • In cases of chronic constipation non-responsive to fiber and laxatives
  • After Intestinal Surgery
  • After Pelvic Radiation
  • For high-output stomas
    • e.g. Ileostomy; Colostomy

How the Diet is Commonly Practiced — The “Bland” Diet

Aside from using a low fiber diet to cleanse the bowels or to treat high-output stomas, a low fiber diet is often used when trying to promote “bowel rest.” This typically is recommended when the bowels are sensitive due to an underlying disease flare-up or after a recent bowel surgery. For that reason, it’s not uncommon for a low fiber diet to also come with other non-fiber related restrictions such as lactose, fatty foods, and potentially irritating spices.3

In most cases, the diet takes on elements of what’s called a “bland” diet. Bland diets restrict the usual fibrous foods but also may limit fried foods, spices, acidic fruits (e.g., lemons, limes, oranges, grapes, etc.), non-lean meats, dressings and sauces, alcoholic beverages, and vegetables that cause excessive flatulence (cabbage, cauliflower, onion, and so forth).4

It’s also commonly recommended for meats to be cooked until soft and tender and for fruits and vegetables to be peeled and softened through cooking to ease digestion.3

Quick Summary

  • A low fiber diet is sometimes recommended by healthcare providers for specific conditions or circumstances affecting the GI tract.
  • The diet is not well defined, but in practice often restricts fiber intakes from 8-10 grams per day
  • Traditional indications for the diet include:
    • Cleansing the bowels
    • Flare-ups of Crohn’s disease, Ulcerative colitis, and Diverticulitis
    • Bowel strictures for prevention of obstruction
    • Gastroparesis
    • Chronic constipation non-responsive to fiber and laxatives
    • After intestinal surgery or pelvic radiation
    • For high-output stomas
  • Dietary residue refers to any food substance that stays in the intestinal tract adding bulk to stools.
  • The low residue diet is not standardized and no longer is part of the nutrition care manual in the United States.
  • The low fiber diet is commonly practiced with additional restrictions aimed at reducing the work or irritation of the bowels.
  • Additional restrictions might include choosing soft-cooked meats, fruits, and vegetables and avoiding acidic foods, gas-forming foods, irritating spices, and condiments.

What foods can you eat on the diet?

Starchy and Non-Starchy  Vegetables

Notes Yes No
Choose well-cooked vegetables. Avoid raw and undercooked vegetables and remove skins and seeds. Carrots, all potato varieties, cooked green beans, strained vegetable juice Peas, kale, spinach, mushrooms, okra, olives, pickles, onion, parsnips, peppers, cabbage, potato skins, sauerkraught, tomatoes, mustard greens, turnip greens, collards, beets, broccoli, brussel sprouts, cauliflower, corn

Fruits

Notes Yes No
Remove skin and seeds from all fruit. Cooked fruit may be better tolerated. Soft and well-cooked fruits without skins, seeds, or membranes. Canned fruit in juice: peaches, pears, or applesauce Dried fruits, raw fruit berries, coconut, avocado, canned fruit in syrup, canned fruit with mandarin oranges, papaya, or pineapple, prune juice, fruit skins.

Meat, Seafood, Protein Powders, and Meat Alternatives

Notes Yes No
Cook meats and seafood until tender and soft. Shredded or soft cooked chicken, beef, pork, lamb, flaky fish, and eggs. Meats should be chopped if you have a stricture or ostomy. Lunch meats, processed meats, skins, fatty meats with gristle, pork rinds, seafood with a tough, rubbery texture (e.g., shrimp, lobster), fried meats
Vegetarian meat – Choose soft varieties. Aim for less than 2 g fiber per serving. Tofu

(Firm tofu may be better tolerated and less gas-forming than silken tofu)

All vegetarian meats that have beans, corn, quinoa, etc., should be avoided.
Protein powders – Aim for protein powders that have less than 1 g fiber. Watch out for lactose, whey, casein if you have a sensitivity to milk products. All protein powders with less than 1 g of fiber All protein powders with more than 1 g of fiber

Legumes

Notes Yes No
These should be avoided entirely due to fiber content and possible gas production. N/a All beans and lentils

Examples: Chickpeas, kidney beans, black beans, pinto beans, black-eyed peas, red lentils, lima beans, hummus

Grains

Notes Yes No
Choose refined grains and grain products.

Aim for less than 2 g fiber per serving.

White rice, white flour tortillas, white bread, cream of wheat, grits, cold and hot cereals from refined grains (puffed rice; corn flakes, etc.) Any whole grain products

Examples: whole grain and high fiber cereals, whole grain tortillas, oatmeal, bran flakes, wheat bran, oat bran, brown rice, quinoa, kasha, barley, millet, whole wheat, shredded wheat, popcorn, grain products containing seeds or nuts.

Oils

Notes Yes No
Foods high in fat, such as fried foods, may cause GI distress. When cooking with oils, use moderately. All oils are low in fiber. When possible, choose fats from plants such as olive oil rather than solid fats from animal sources.

Dairy and Dairy Alternatives

Notes Yes No
Dairy may need to be avoided based on personal tolerance of lactose. All plain dairy products are low in fiber. Choose lactose-free dairy products if lactose intolerant.

Examples: reduced-fat milk, buttermilk, kefir, yogurt, cheese, and cottage cheese

Fortified alternatives: almond, cashew, coconut, or rice milk

Yogurts with fruit, seeds, granola added.

Avoid pea milk and soymilk (may cause diarrhea, gas, bloating, and abdominal pain)

Limit high-fat dairy products if they cause GI distress. Examples:

Whole milk

Half and half

Cream

Icecream

Sour cream

Nuts and Seeds

Notes Yes No
Avoid whole nuts and seeds. Smooth nut/seed butters in small amounts Whole nuts, seeds, or chunky nut/seed butters.

Herbs and Spices

Notes Yes No
Most spices and herbs should be tolerated if cooked and ground if necessary. Chilli powder, pepper flakes, cayenne, etc. may upset the stomach.

Sweeteners

Notes Yes No
Concentrated sweets can cause GI distress. Over-consumption of sugar alcohols causes diarrhea. Small amounts of sugar, honey, agave nectar, etc., as tolerated. Avoid non-nutritive sweeteners and sugar alcohols.

Examples of sugar alcohols: xylitol, erythritol, maltitol, isomalt, lactitol, mannitol, sorbitol

Sauces/Condiments

Notes Yes No
Sauces and condiments are generally low in fiber but should be used with caution depending on the ingredients. Use moderately as tolerated:

Soy sauce, mayonnaise, mustard, teriyaki sauce, ketchup

Hot sauce, salsa, spicy condiments, wasabi

Beverages

Notes Yes No
Some teas and juice may irritate the stomach. Caffeine can cause GI distress in some individuals. Water, some herbal teas Alcoholic beverages, soda, juices, caffeinated beverages

Adapted from: 3

What typical meals do you eat on the diet?

Breakfast Ingredients
Peanut butter toast
  • 2 slices white bread
  • 1 tbsp smooth peanut butter
  • ¼ cup applesauce
Snack Ingredients
  • 1 hard-boiled egg, salt to taste
  • Nutritional supplement (e.g., Ensure or fortified protein shake) lactose-free, less than 1 g fiber
Lunch Ingredients
Soup, crackers
  • 2 cups chicken broth
  • 3 oz chicken
  • ½ cup skinned white potatoes
  • ½ cup noodles
  • ¼ cup cooked carrots
  • 1 tbsp olive oil
  • Salt to taste
  • 5 saltine crackers
Snack Ingredients
  • 6 oz lactose-free vanilla yogurt
  • 2 puffed rice cakes
Dinner Ingredients
Fish, vegetables
  • 1.5 cups white rice
  • 6 oz white fish
  • 1 tsp butter
  • ¼ cup soft-cooked green beans

 

Calories 1,914
Total FIber 10 g
Total Fat 59 g
Total Protein 107g
Total Carbs  235 g

How easy is the diet to do?

This diet is not particularly easy to try as it requires close monitoring of your intake to ensure you don’t overdo fiber. While the standard American diet is typically low in fiber, it will likely surpass the 8-10 g often allowed on a ‘low-fiber diet.’ The diet requires refined carbohydrates like bread, rice, cereal, pasta, tortillas, and chips, all of which still have some fiber. So even when eating refined carbs, you will need to eat them in smaller amounts.

If you’re used to eating fruits and vegetables, that will add another obstacle to following this diet. The allowed serving size for these foods is relatively small. When we analyzed the diet, it was hard to include even half a cup of fruit or vegetables and stay within the designated fiber goal.

As we previously mentioned, a low fiber diet is almost always paired with guidelines for ‘easy digestion.’ This adds another layer to the ease (or unease) of following a low fiber diet. It is recommended that foods be cooked thoroughly until soft to allow for smooth digestion. Think baby food! Guidelines for easy digestion include avoiding any potential irritants–like spicy foods, which are easy to avoid.

To maintain nutritional adequacy while avoiding fiber to this extent will almost always require some supplementation–either through a protein shake or a multivitamin. Thankfully this diet is not meant to be long-term and is usually carried out in a hospital setting where supplementation is readily available.

Why do people try the low residue / fiber diet?

Inflammatory Bowel Disease (IBD)

Crohn’s disease (CD) and ulcerative colitis (UC) are the two diseases that fall under the umbrella of inflammatory bowel disease (IBD). The Academy of Nutrition and Dietetics and the American College of Gastroenterology recommends against high-fiber foods during acute IBD symptom flare-ups. They also advise against high-fiber foods if strictures or fistulas are present.5 In the case of strictures, it’s logical to avoid high fiber foods, which could potentially lead to bowel obstructions.5

It’s also thought that lowering fiber intake in the diet reduces the frequency of bowel movements, which may help induce IBD remission.1 Anecdotally, many patients also report worsened symptoms during an IBD flare when eating high fiber foods.5 For these reasons, following a low fiber diet until symptoms improve may be suggested.

It’s important to know that the recommendation for a low fiber diet during an acute IBD flare is weak and not backed by substantial evidence.5 It’s also only intended for when someone is experiencing active IBD symptoms, fistulas, or is at risk of bowel obstructions. A healthy diet with the recommended intakes of fiber is suggested after remission.

Summary

  • In the case of IBD, it is thought that a low-fiber diet may be helpful during an acute IBD flare or if fistulas or strictures are present.
  • A low fiber diet may lessen the frequency of bowel movements, potentially helping to induce remission.
  • A low fiber diet might also decrease uncomfortable symptoms during an IBD flare
  • The evidence to support a low fiber diet during an active IBD flare is weak
  • After disease remission is achieved, dietary fiber intakes are gradually increased back to that of a healthy diet

Gastroparesis

Gastroparesis is a condition where food remains in the stomach for a prolonged time due to weak muscle contractions of the stomach. This can lead to symptoms such as nausea, vomiting, bloating, feelings of fullness, regurgitations, and heartburn. Diet therapy for gastroparesis includes restricting dietary fiber, not eating large meals, and limiting fat intake.6 These are all factors that might delay the emptying of the stomach.

Summary

  • A diet made up of small frequent meals low in fiber and fat is recommended for gastroparesis. This helps to lessen dietary factors that slow stomach emptying.

Diverticular Disease

Diverticula are small bulging pouches that can form in the intestines, most often in the colon. The presence of diverticula means that a person has diverticulosis. When the diverticula are inflamed or infected, this is a condition called diverticulitis.

The professional consensus is to follow a low fiber diet during active diverticulitis flares to ‘minimize irritation.’ A high fiber diet from a mix of dietary fiber sources is recommended for the prevention of diverticulitis.7

Summary

  • A low fiber diet may be suggested to minimize irritation during active diverticulitis.
  • A high fiber diet from mixed sources is recommended for the prevention of diverticulitis.

Bowel Preparation

Bowel procedures such as colonoscopies, laparoscopic surgeries, and so forth require a clean bowel. While laxatives and clear liquid diets have been used traditionally to clear the bowels, more recent studies have looked at the use of low fiber diets for bowel preparation.

A pre-digested low fiber/low residue liquid formula called Peptamen was given as part of the bowel preparation protocol in one study. This formula achieved bowel cleanliness comparable to a standard clear liquid diet. Study participants receiving the formula also reported less hunger, better compliance, and better tolerance of the low fiber formula compared to traditional protocols.8

Summary

  • Drinking a low fiber predigested formula (Peptamen) is effective at cleansing the bowels and is better tolerated than more traditional protocols.

Chronic Constipation

One of the first-line treatments for constipation recommended by the American Gastroenterological Association (AGA) is to gradually increase fiber intakes from food and/or fiber supplements such as psyllium.9 Some people may benefit from these adjustments because dietary fiber increases stool bulk and frequency, potentially helping to relieve constipation.10

However, in some cases, there are underlying mechanical problems with the bowels, which lead to constipation. This can include slow gut movement (slow transit constipation) or problems with the functioning of the muscles for defecation (defecatory disorders/pelvic floor dysfunction). In these cases, dietary fiber is less helpful. 10

One study looked at the effects of a 2-week ‘no-fiber’ diet in people with chronic constipation. The study did not determine the underlying cause of constipation (e.g., a mechanical problem as opposed to diet and lifestyle-related constipation).11 After 2 weeks, study participants were asked to gradually increase fiber amounts to a level they found tolerable. The study found that constipation was reduced in chronic constipation sufferers by stopping or lowering dietary fiber intake.11

An important distinction is that the underlying cause of constipation was unknown. The AGA points out that pelvic floor disorders are most responsive to a therapy called biofeedback and are unlikely to respond to dietary fiber. Similarly, those with slow transit constipation sometimes require prescription medications or surgical intervention if they do not respond to diet or laxatives.9

Even still, changes to the diet, supplemental fiber, and laxatives are always tried first given the low cost of these interventions, along with their less invasive nature compared to other therapies and surgeries.

In chronic constipation that is unresponsive to dietary fiber or laxatives, lowering fecal bulk through a reduced fiber diet may be helpful.

Summary

  • Increasing dietary fiber and/or fiber supplements is one of the first-line recommended treatments for constipation
  • Some forms of constipation may be less responsive to fiber due to mechanical problems with the bowels.
  • For chronic constipation that is non-responsive to added fiber or laxatives, a reduced fiber diet may help to lessen constipation and associated symptoms
  • For those who are non-responsive to added fiber or laxatives, additional followup with a gastroenterologist is recommended to rule out the need for other treatments such as biofeedback therapy, prescription medications, or surgery.

Radiation Therapy to the Pelvis

Traditionally, low-fiber diets have been recommended for those undergoing radiation therapy of the pelvis to treat cancer. A lack of evidence was available to support this practice.12

Recently a study randomly assigned patients undergoing pelvic radiation to either a low-fiber diet of < 10g per day (n=55), a habitual fiber diet (n=55), or a high-fiber diet (n=56). Those following a high fiber diet had reduced gastrointestinal toxicity right after the therapy and at 1 year compared to those eating lower habitual fiber intakes. This suggests that fiber restriction is not warranted for those undergoing pelvic radiation and could potentially be harmful. More studies are needed.12

Summary

  • Traditionally low fiber diets have been recommended for patients undergoing pelvic radiation.
  • A more recent study found potentially beneficial effects of a high-fiber diet for those undergoing pelvic radiation compared against lower fiber intakes.
  • Reducing fiber intake during pelvic radiation is a practice that is not supported by preliminary studies.

After Intestinal Surgery

After intestinal surgeries, it used to be common practice to restrict all foods and fluids by mouth (nil per os).13 The idea behind this approach was to reduce the risk of nausea, vomiting, and infection and allow time for surgical incisions to heal without the stress of food.13

Evidence now suggests that early feeding 24 hours after surgery is associated with fewer complications, including a lowered risk of infection, improved surgical healing, and a shorter hospital stay.13,14

In one study, a “low-residue” diet started 1 day after colorectal surgery was associated with less nausea, faster return of bowel function, and a shortened hospital stay compared against a clear-liquid diet.1 The standard of practice now recommended by the Enhanced Recovery After Surgery (ERAS) protocol is to provide clear liquids immediately postoperatively once the patient is awake and can safely drink. On post-op day 1, the patient is given a clear liquid breakfast. From there, the diet is advanced as tolerated towards a regular diet.15

Following a bland or low fiber diet may be suggested to avoid potential gut irritants such as spicy foods and fibers. However, if foods are well tolerated and are not causing symptoms, the patient should be able to resume a regular diet without restrictions.

Summary

  • Evidence suggests that early feeding within 1 day of gastrointestinal surgery may be optimal.
  • One study which compared a “low-residue” diet to a clear liquid diet on day 1 after colorectal surgery found that a low-residue diet produced better patient outcomes than the clear liquid diet.
  • The Enhanced Recovery After Surgery (ERAS) protocol recommends a clear liquid breakfast on day 1 after colorectal surgery. If this is tolerated, the diet can be gradually advanced to a regular diet as tolerated.
  • A low fiber or bland diet may be suggested to minimize gut irritants, but diet tolerance determines if and when a regular (non-restricted) diet is suitable for the patient.
  • A low fiber or bland diet may be suggested to minimize gut irritants, but diet tolerance determines if and when a regular (non-restricted) diet is suitable for the patient.

Intestinal Stoma

A stoma made in the gastrointestinal tract, such as an ileostomy or colostomy, allows stool to be excreted when the body can no longer excrete stool naturally. Sometimes excessive fluid can be lost through an intestinal stoma. This high output is dangerous and can lead to dehydration, electrolyte imbalances, intestinal failure, and can even be fatal if not appropriately managed. 16

In high output situations, a low-fiber diet is recommended to slow down the rate at which food passes through the small intestines.16

Summary

  • A low-fiber diet is recommended to slow gut transit when there is high stoma output.

Any potential cautions before trying it?

You should only restrict fiber if you’ve been instructed to do so by a healthcare provider. Under most circumstances, fiber is incredibly beneficial.

Fiber helps to:

  • Keep probiotic gut microbes well-fed and thriving
  • Keep you regular
  • Protect heart and colon health
  • Helps with the management of several chronic diseases such as blood sugar control in diabetes.
  • Helps our gut microbes make beneficial compounds called short-chain fatty acids (SFCAs).
  • SCFAs may help to regulate our immune system and keep our gut barrier healthy.  Source: 17

You definitely don’t want to skip out on fiber unless it’s necessary. Also, keep in mind that, even if you need a low fiber diet temporarily, under most circumstances, you can transition back onto a regular diet rich in fiber if your personal tolerance allows.

Summary & Verdict

Admittedly, as dietitians, there are elements of the low fiber/low residue diet that even we have found confusing. We feel that evidence is lacking to support the diet’s use and restrictiveness under certain circumstances.

Aside from the general consensus that cooked foods are more easily tolerated, we were able to find sparse evidence supporting this. We found that cooking may lessen the already small risk of bowel obstructions by reducing the formation of obstructive masses called bezoars.18

We were also surprised to note that the diet would be so restrictive for even low fiber fresh foods such as cucumbers or seedless melons. In clinical settings, we would be unlikely to recommend all elements of the diet be implemented at once unless there were appropriate medical indications.

Key Takeaways:

  • The low fiber diet is poorly studied for most indications. It’s prescribed on the basis that a lower fiber diet will produce less stool output and potentially less bowel irritation for sensitive guts.
  • The diet is commonly restricted to 10-8 grams of fiber per day, however no firm guidelines have defined a low fiber diet.
  • The term “low-residue” is also not well-defined and was removed from the nutrition care manual in the United States.
  • We feel the diet is likely to place restrictions above and beyond what may be needed at times, given that fiber alone is often not all that is restricted.
  • As dietitians, we would be cautious before recommending all suggested restrictions that usually accompany a low fiber diet. We prefer a more tailored approach depending on each patient’s symptoms and clinical presentation.
  • We would also be quick to liberalize the diet as soon as a patient appeared capable of tolerating a regular fibrous diet.
  • It is important for anyone prescribed a low fiber diet to work with a professional to ensure the diet is not carried out for longer than is necessary and to avoid the risk of malnutrition.

References

  1. Erika Vanhauwaert, Christophe Matthys, Lies Verdonck, Vicky De Preter, Low-Residue and Low-Fiber Diets in Gastrointestinal Disease Management, Advances in Nutrition. 2015; Vol 6 (Issue 6) Pages 820–827, https://doi.org/10.3945/an.115.009688
  2. Sorathia AZ, Sorathia SJ. Low Residue Diet. [Updated 2020 May 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: URL Accessed 1/18/2021
  3. Academy of Nutrition and Dietetics Low-Fiber Nutrition Therapy handout for client education. Accessed 1/18/2021
  4. Weir SBS, Akhondi H. Bland Diet. [Updated 2020 Aug 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: URL Accessed 1/18/2021
  5. Sonali Palchaudhuri, MD, Lindsey Albenberg, DO, James D Lewis, MD, MSCE, Diet Recommendations for Hospitalized Patients With Inflammatory Bowel Disease: Better Options Than Nil Per Os, Crohn’s & Colitis 360. 2020; Vol 2 (Issue 4) doi:https://doi.org/10.1093/crocol/otaa059
  6. Camilleri, M, Chedid, V, Ford, AC orcid.org/0000-0001-6371-4359 et al. Gastroparesis. Nature reviews Disease primers, 2018; Vol 4 (Issue 1). ARTN 41. 41-. ISSN 2056-676X doi: https://doi.org/10.1038/s41572-018-0038-z
  7. Gill SK, Rossi M, Bajka B, Whelan K. Dietary fibre in gastrointestinal health and disease. Nat Rev Gastroenterol Hepatol. 2020 Nov 18. doi: 10.1038/s41575-020-00375-4.
  8. Tikfu Gee, Limi Lee, Ngoh Chin Liew, Shu Yu Lim, Nur Suriyana Abd Ghani, Robert G. Martindale, Efficacy of low residue enteral formula versus clear liquid diet during bowel preparation for colonoscopy: a randomised controlled pilot trial, Journal of Coloproctology, 2019; Vol 39 (Issue 1) Pages 62-66, ISSN 2237-9363, https://doi.org/10.1016/j.jcol.2018.10.003.
  9. Bharucha A.E. Pemberton J.H. Locke G.R. American Gastroenterological Association technical review on constipation. Gastroenterology. 2013; Vol 144: Pages 218-238 DOI:https://doi.org/10.1053/j.gastro.2012.10.029
  10. Mari A, Mahamid M, Amara H, Baker FA, Yaccob A. Chronic Constipation in the Elderly Patient: Updates in Evaluation and Management. Korean J Fam Med. 2020;Vol 41(Issue 3): Pages 139-145. doi:10.4082/kjfm.18.0182
  11. Ho KS, Tan CY, Mohd Daud MA, Seow-Choen F. Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms. World J Gastroenterol. 2012; Vol 18( Issue 33): Pages 4593-4596. doi:10.3748/wjg.v18.i33.4593
  12. Linda Wedlake, Clare Shaw, Helen McNair, Amyn Lalji, Kabir Mohammed, Tanya Klopper, Lindsey Allan, Diana Tait, Maria Hawkins, Navita Somaiah, Susan Lalondrelle, Alexandra Taylor, Nicholas VanAs, Alexandra Stewart, Sharadah Essapen, Heather Gage, Kevin Whelan, H Jervoise N Andreyev, Randomized controlled trial of dietary fiber for the prevention of radiation-induced gastrointestinal toxicity during pelvic radiotherapy, The American Journal of Clinical Nutrition, 2017; Vol 106 (Issue 3), Pages 849–857, doi:https://doi.org/10.3945/ajcn.116.150565
  13. Silk DB, Gow NM. Postoperative starvation after gastrointestinal surgery. Early feeding is beneficial. BMJ. 2001; Vol 323( Issue 7316): Pages 761-762. doi:10.1136/bmj.323.7316.761
  14. Dag A, Colak T, Turkmenoglu O, Gundogdu R, Aydin S. A randomized controlled trial evaluating early versus traditional oral feeding after colorectal surgery. Clinics (Sao Paulo). 2011; Vol 66 (Issue 12): Pages 2001-2005. doi:10.1590/s1807-59322011001200001
  15. Cavallaro P, Bordeianou L. Implementation of an ERAS Pathway in Colorectal Surgery. Clin Colon Rectal Surg. 2019; Vol 32( Issue 2): Pages 102-108. doi:10.1055/s-0038-1676474
  16. Adaba F, Vaizey CJ, Warusavitarne J. Management of Intestinal Failure: The High-Output Enterostomy and Enterocutaneous Fistula. Clin Colon Rectal Surg. 2017; Vol 30(Issue 3): Pages 215-222. doi:10.1055/s-0037-1598163
  17. Lisa L. Strate, Arden M. Morris, Epidemiology, Pathophysiology, and Treatment of Diverticulitis. AGA, 2019; Vol 156 (Issue 5): Pages 1282-1298 doi: https://doi.org/10.1053/j.gastro.2018.12.033
  18. Plataras C, Sardianos N, Vlatakis S, Nikas K. An unusual cause of small bowel obstruction in children: lentil soup bezoar. BMJ Case Rep. 2014; doi:10.1136/bcr-2013-203316