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Low Protein
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Low Residue

Table  3-4.-Sample  Low  Protein  Diet-Continued High  Residue The  high  residue  (high  bulk,  high  fiber, high  roughage)  diet  is  indicated  in  atonic  con- stipation,  spastic  colon,  irritable  bowel  syndrome, and  diverticulosis.  This  diet  encourages  regular elimination by stimulating muscle tone, creating softer  and  larger  stools  that  are  more  easily propelled  through  the  colon.  This  reduces  the pain   and   cramping   that   accompany   spastic colon  or  irritable  bowel  syndrome. The patient is given a regular diet, with the inclusion of high residue foods. The main sources of fiber are whole grain breads and cereals, bran cerals, fresh fruits, and vegetables that are raw or  cooked  until  tender.  Whole  grain  breads  and cereals  that  contain  wheat  bran  have  a  greater laxative  effect  than  fruits  and  vegetables, because  the  bran  acts  to  absorb  water  within the   colon   creating,    a  bulk  effect.  At  least one  serving  of  100  percent  wheat  bran  cereal is recommended daily. Raisin Bran, Bran Flakes, Shredded   Wheat,   and   Oatmeal   may   be   used occasionally,   but   they   contain   less   than   half the  amount  of  fiber  in  All  Bran  or  Bran  Buds. Fresh  fruits  and  vegetables  with  edible  skins, such  as  apples  and  grapes  are  higher  in  fiber content  than  canned  fruits  or  vegetables  and  their juices. Dietary intake of refined sugars and starches should be decreased, as they are poor sources of fiber. Limit white flour products, refined cereals, pies,  cakes,  and  cookies. Fluids are increased. Too little fluid in the diet may cause dehydration and lead to constipation. The patient must drink at least 8 glasses of water or   other   fluids   daily,   particularly   when   con- suming  the  recommended  amount  of  bran. Drinking too much alcohol, coffee, cola, tea, and soft drinks can irritate a sensitive colon and can cause dehydration. If possible, use decaffeinated coffee. One or 2 glasses of water in the morning helps to stimulate peristalsis. Excessive  intake  of  alcohol,  beverages  con- taining caffeine (coffee, tea, colas), chili powder, dried  beans,  fruits  with  seeds  and  skins,  nuts, pepper,  popcorn,  and  strong  spices  may  cause irritability. These foods should be individualized to the patient. When  one  is  progressing  from  a  low  residue diet  after  an  acute  infection  or  diverticulitis, increase  fiber  in  the  diet  gradually.  Start  by adding 1 serving of 100 percent bran cereal and 3  servings  of  whole  grain  bread  to  the  low  residue menu pattern. Gradually increase the amount of raw  vegetables  and  fresh  fruits  to  at  least 4 servings per day. 3-11

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