Low Fiber Diet for Chemotherapy and Radiation Therapy

[David Baxter PhD]

Low Fiber Diet for Diarrhea
Katrina VB. Claghorn, M.S., R.D., L.D.N., OncoLink.org
Last modified: June 15, 2018

The fiber in food provides the roughage or bulk that stimulates the bowel. It is generally recommended that you consume at least 25 grams of dietary fiber a day to promote good bowel health. The major sources of dietary fiber are fruits, vegetables, whole grains, nuts, seeds and dried beans.

However, a common side effect of radiation treatment and many chemotherapies is diarrhea. If you experience treatment-related diarrhea, you should follow a low fiber diet and limit your intake of dietary fiber to about 10 grams a day. A low fiber diet is better tolerated with diarrhea because it will not stimulate the bowel as much and it will be easier to digest.

Food Group	High Fiber Foods to AVOID	Low Fiber Foods ALLOWED
Fruits	Raw fruits Dried fruits	Bananas Applesauce Canned fruits Cooked fruits without skin or seeds Fruit juices without pulp
Vegetables	Broccoli, Brussels sprouts, cabbage, cauliflower, corn, peas, peppers, radishes, and spinach Raw vegetables	Vegetables not on avoid list. Best tolerated: asparagus, green beans, carrots and summer squash Peel, seed and cook vegetables until they are soft
Breads & pastas	Whole wheat and whole grains Brown rice Cracked wheat and tabouli Cornbread Any bread with dried fruits or nuts	Bread products made with refined white flour Choose products that have less than 2 grams of fiber per serving Pasta/noodles make with refined flour White rice White rice cakes Graham crackers
Cereals	Whole grains Bran Shredded wheat Granola and muesli Any cereal with dried fruits or nuts	Cold cereals - Rice Krispies, Corn Flakes, Cheerios, Special K, Golden Grahams, Rice and Corn Chex Hot cereals - Oatmeal, Cream of Rice, Cream of Wheat, Farina and Grits Choose cereals that have less than 2 grams of fiber per serving
Nuts	Whole nuts and chunky nut butters	Smooth nut butters
Dried beans & legumes	Lentils, lima beans, chick peas, kidney beans and black beans, etc.
Meat, poultry, fish and eggs		All allowed
Milk and milk products		Allowed unless lactose intolerant
Miscellaneous	Any foods that contain corn (including popcorn and tortilla chips), seeds, nuts, coconut or dried fruit	Marshmallows

Food labels list grams of fiber
To find out how much fiber is in a serving of a food use food labels. Look for "Dietary Fiber" in the list of nutrients. Choose foods that have 2 grams or less of dietary fiber per serving.

Soluble fiber
Soluble fiber is a type of fiber found in some foods. Soluble fiber absorbs fluid and can help relieve diarrhea. Foods high in soluble fiber include:

• Fruits: Applesauce, bananas (ripe), canned fruit, orange and grapefruit sections
• Vegetables: Boiled potatoes
• Breads & pastas: White rice (see congee soup recipe below), tapioca, pearl barley and products made with white flour
• Cereals: Oatmeal, cream of rice, cream of wheat and farina

Other foods that can contribute to diarrhea

• Fatty, greasy and fried foods
• Spicy and highly seasoned foods
• Caffeinated foods and beverages e.g. coffee, tea and chocolate
• Milk and milk based drinks
• Avoid chewing gum, as well as sugar free candies and gums that contain sugar alcohols such as sorbitol or mannitol

Foods best tolerated when diarrhea is severe
Eat bland and easy to digest foods such as chicken, fish, eggs, puddings, mashed potatoes, noodles, rice, yogurt, cottage cheese, cream of wheat, farina, smooth peanut butter, white bread, bananas, applesauce, canned fruit and well cooked vegetables. Eating 5 to 6 small meals/snacks throughout the day is often better tolerated than eating 3 large meals.

Congee Soup – Chinese rice soup
¾ cup white or sushi rice
2 ½ cups chicken or vegetable broth
Salt to taste
Combine rice and broth in a pot and bring to a boil. Lower the heat and half cover the pot. Cook at a slight boil. Stir occasionally and scrape the bottom to prevent rice from sticking. Simmer 1 ½ to 2 hours. Cook until the grains burst and become thick – oatmeal consistency. Season with salt for taste. Can flavor as desired e.g. ginger, soy sauce or sesame oil.

Sample menu
This is a sample meal plan to follow if you have diarrhea. It is low in dietary fiber and high in soluble fiber.

Breakfast	Lunch	Dinner
6 oz orange juice (no pulp) 1 cup Rice Krispies cereal 1 cup 2% milk 1 medium banana Decaffeinated coffee	1 cup chicken rice soup 3 oz sliced turkey breast 2 slices white bread 1 tsp mayonnaise	4 oz salmon 1/2 cup white rice 1/2 cup asparagus 1 dinner roll 1 tsp butter 1/2 cup fruit sorbet
Snack	Snack	Snack
1 slice white bread toast 1 tablespoon peanut butter 1 tsp jelly	2 rice crackers 1 oz cheese 1/2 cup applesauce	1 cup vanilla yogurt

Nutrients

• Calories 1946
• Protein 101 gm
• Fat 54 gm
• Dietary fiber 10 gm