Dietary advice following bowel surgery

NHS Borders

Produced by the Department of Nutrition and Dietetics at the Borders General Hospital, NHS Borders.

"Information given on this site is not meant to take the place of a talk with your doctor or health worker."

Advice

After your surgery it can take a few days for the bowel to start working again and return to normal function. The area can be sensitive and as you may not have eaten for a while smaller meals may be easier to digest. You can gradually begin to reintroduce foods as you feel comfortable. Good nutrition is extremely important for your recovery and this booklet will help guide you towards returning to a healthy balanced diet following your operation. Your surgeon will advise you on when to progress to each stage.

Tips

Eat little and often. Smaller meals with additional snacks may be easier to manage
Eat slowly and chew your food wellDrink plenty of fluids but avoid drinking too close to meals and sip only during meals/when eating
Avoid spicy and fried foods initially

Stage 1

For the first day after your surgery it is recommended that you choose liquids and smooth puddings only as your body is still adapting to digestion. If you can tolerate milk this is a good source of protein and energy.

Stage 2

Stage 2 involves progressing towards more solid foods. You should aim to take small portions of soft, low fibre foods as they can be easily digested. Fibre containing foods are normally recommended as part of a healthy balanced diet. However, for the first week or two after bowel surgery a low fibre diet may be better tolerated.

If you are managing to eat these foods with no signs of vomiting, stomach bloating or discomfort you may choose to introduce more foods and increase portion sizes as you feel comfortable.

Stage 3

During stage 3 you will begin to return to your normal diet. Once you are tolerating stage 3 for a few days, you can slowly start to introduce more fruit, vegetables, wholegrain bread and higher fibre cereals such as porridge, and wheat biscuits.

Wait two weeks of tolerating stage 3 before introducing lentils, pulses, split peas, beans or barley into your diet, unless you have been advised to avoid these foods completely.

During the early stages after you surgery your Doctor or dietitian may recommend a ‘supplement drink’. This is a nourishing drink to provide you with additional nutrition following your procedure. Your dietitian will advise you if these are necessary and how long you should take these for.

If you have had recent weight loss or reduced dietary intake prior to surgery you should ask to speak to a dietitian. This diet is intended for short term use only – if you are struggling to progress through the stages or have not returned to normal diet after ~1 month please seek further advice from your Doctor or dietitian.

Foods to choose and foods to avoid - the list is not exhaustive and menus are for guidance only.

	Foods to choose	Foods to avoid
Stage 1	Tea/coffee Milk Smooth & creamy yoghurts Custard Jelly Ice cream Diluting juice Consommé Bovril Cup-a-soup	All vegetable soups (especially pulses/lentils/splitpea/ broth) All fruits and vegetables Foods containing bran and oats
Stage 2	Rice krispies/cornflakes White bread & rolls Plain sponge Pancake Plain scone Plain biscuit Cream crackers Boiled/mashed potatoes (no skins) Fish, chicken, mince (no onions) Scrambled egg or plain omelette Chicken or tomato soup Milk Smooth yoghurts Cheese Milk puddings (custard, semolina, rice pudding) Tea/coffee Hot chocolate Bovril Diluting juice Cup-a-soup Seedless jam, shredless marmalade Boiled sweets/mints	All cereals containing oats or bran Wholemeal, wholegrain granary or seeded bread Skins of potatoes All fruit and vegetables Any soup with lentils, pulses, broth Nuts Dried fruit
Stage 3...
	Cereal, crackers, biscuits & starchy foods Rice krispies/cornflakes Porridge, Ready Brek White bread & rolls Pancake Plain scone Plain sponge Plain biscuits Cream crackers Boiled/mashed potatoes (no skins) White pasta or noodles Meat, Fish & Eggs White rice Meat, chicken, fish Eggs; scrambled or plain omelette Quorn or Tofu Chicken soup Dairy Milk Hard, soft, cream or cottage cheese Cream Fruit yoghurt Fruit and Veg Soft ripe peeled fruit eg. apple, pear, peach, plum, banana Tinned fruit eg. mandarins, peaches, pears, pineapple, fruit cocktail (not prunes) or Vegetable based soup Most well cooked, peeled soft/mashable vegetables without seeds Desserts Milk puddings (custard, semolina, rice pudding) Ice cream Jelly Stewed fruit Sponge pudding Drinks Tea, coffee, hot chocolate Bovril Diluting juice Smooth fruit Juice (1 serving per day) Other Seedless jam Shredless marmalade Smooth peanut butter Honey Chocolate, sweets, crisps Gravy Sauces Wholemeal cereals and cereals containing bran,	Wholemeal cereals and cereals containing bran, dried fruit or nuts Wholemeal, wholegrain, granary or seeded bread Wholemeal pasta or noodles Brown rice Skins of potatoes Tough, gristly meat Fatty, processed or fried meats Yoghurts with pips, nuts or seeds Cheese with fruit or nuts Fruit with skins on or containing seeds Dried fruit Raw vegetables Vegetables with skins, seeds or husks Vegetables that may cause gas such as cabbage & beans Stalks of broccoli/cauliflower Any soup with lentils, pulses, broth Puddings with dried fruit, nuts, seeds or coconut Fruit juice with bits Marmalade with shred Jam with seeds Crunchy peanut butter

More advice

Information is intended for hospital use.

When ordering from hospital menus you should specify the stage you are on.

Sample Menu for Stage 2

Breakfast

cornflakes or rice krispies
wait about an hour & try 1 slice white bread & butter/margarine with seedless jam

Mid-Morning

glass of milk & plain biscuit (eg. rich tea/ginger-nut) or yoghurt or pancake/plain scone with butter/margarine & seedless jam

Lunch

chicken/poached fish/mince (no onions) with potatoes
wait 30-60mins then try pudding eg ice cream, milk pudding, plain sponge

Mid Afternoon

glass of milk & plain biscuit (eg rich tea/ginger-nut) or smooth yoghurt

Evening Meal

scrambled egg/plain omelette or
potatoes & chicken/poached fish
chicken or tomato soup

Supper

slice of white bread & butter/margarine or plain biscuits or bowl cornflakes/rice krispies

Sample Menu for Stage 3

Breakfast

cornflakes or rice krispies
1 slice of white bread & butter/margarine
apple juice

Mid-Morning

glass of milk & plain biscuit (eg. rich tea/ginger-nut) or yoghurt or pancake/plain scone with butter/margarine & seedless jam

Lunch

chicken/poached fish/roast meat/mince with potatoes/white rice/white pasta
sponge & custard, jelly & ice cream, milk pudding, plain sponge, stewed or tinned fruit

Mid Afternoon

glass milk & plain biscuit (eg rich tea/ginger nut) or fruit yoghurt or pancake/plain scone with butter/margarine & seedless jam

Evening Meal

scrambled egg/plain omelette
chicken/poached fish/meat with potatoes/white rice/white pasta
macaroni cheese
baked potato with cheese (no skins)
chicken or tomato soup only
sandwich made with white bread (chicken, cheese, ham, tuna, egg)

Supper

slice white bread and butter/margarine or plain biscuits or bowl cornflakes/rice krispies or cheese & crackers

Next review date: 31/07/2024

Author(s): Cairns L.

Author email(s): lynne.cairns@borders.scot.nhs.uk.

Approved By: Clinical Governance & Quality

Reviewer name(s): Cairns L.