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Revisiting bowel ob...
 

Revisiting bowel obstructions and no fiber diet advice  

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madrikh52
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August 23, 2019 9:41 pm  

Hello everyone, I'm not sure when I last posted here but I had another bowel obstruction in March. Hospitalization, NG tube and then the "human draino" to finally flush me out. I really hate the "nothing by mouth" part. You know it's rough when hospital food starts smelling good!

Anyway, I see that this topic came up again recently and I agree with Eric's advice to speak with a dietician. I have done that, and even though she works at our local cancer center, she wasn't too concerned with the low fiber diet, but to me it equals an unhealthy diet. (As an aside, I was having a rough day recently and told my husband I really wanted a doughnut. He said "well at least it's low fiber". Sheesh.) The GE doctor I had during this last episode said I have narrowing in  2 places so will always be prone to obstructions. Sigh. I have had a juicer since my first obstruction 3 years ago and juice almost daily, hoping that at least I will be getting the nutrients of the fruits and vegetables, if not the fiber. I still worry about it though. If I eat a small salad or something else with high fiber, I worry about a blockage. If I avoid fiber and eat "low residue" foods, I worry about not getting proper nutrition. A low fiber diet does not seem like a good diet to avoid a recurrence of colon cancer. 

Any thoughts?

Thanks,

Marci


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Fred
 Fred
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August 24, 2019 5:33 am  

After my blockage in July, doctors gave me different diet advice from zero fiber  to the normal range of 20+grams daily. The no fiber diet seemed too extreme for me as I love fruits and vegetables and like you, don't think it's too healthy. So I decided to add fiber gradually starting with low fiber fruits and vegetables such as watermelon, cantaloupe, peaches etc. I removed all the peels and seeds if any and ate onkly small amounts at first. I built up to the low fiber stage of about 12-15 grams daily nad that worked well. Being paranoid about causing another blockage I eat slowly and chew everything well.  I have expanded to eat some of the peels and so far so good. I plan to keep increasing to reach about 20grams. The other day I was speaking to an Integrative Nutritionist and she suggested that I may benefit from Visceral Manipulation as it has shown to be helpful in prevention of recurring blockages. I had never heard but she explained that it involves massaging the internal organs by a trained practitioner. I am wondering if you or any fellow ostomates have heard of or have had Visceral Manipulation?


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August 24, 2019 6:23 am  

Marci, welcome back...I get repeated blockages and had struggled what to eat to avoid and to be healthy at the same time. I grew up believing that fibre was our way to scrub our intestines and help avoid disease and I still believe it. Thru the years I see that cancer picks it host with no rhyme or reason to the process.  To help avoid my chronic blockages I began the process with elimination lol,...literally...I kept a list of results of everything I ate.  Different from the journal when things go wrong. I listed gas, flavour, cravings, preferences and what I ate, texture & what it looked like after digestion. If I could identify it, then I chewed my food longer. I allowed myself some of everything. All things in moderation became my goal, allowing me the foods I enjoyed.

I learned how to cook differently. I loved raw vegetables, but they caused pain and gas, blockages and more pain. I swore I new the layout of my intestines based on what I ate and was sure I had rearranged them sometimes. To eat the veggies I love, I cook them just past the tender crisp stage, in a seam basket letting them get soft but not mushy (yuk) still needing a good chew to break down and to let me taste the flav. they had as crisp. I tested them in the cooking process in a steam basket, with a fork, not a knife. Forks allowed for a little longer cooking time, a knife made them too hard yet for my guts. I eat a wider variety of veggies more now then I did before things got testy, because I cook them slightly different.

If your meat eater, choosing different styles of the same meats you enjoy can make the difference.  Try eating more fish, and different kinds cooking them all differently as well. Cooking certain cuts of meat longer and maybe in a crock pot can help break down. After avoiding the salads I loved to eat  in a big heaping plate for so long, I now eat them, not as heaped, but with the fresh veggie cut thinner or a thicker grate for something like raw carrots. I add some couscous to the top of it and mix it all in as I eat thru it. Greek salads are my fav. so I use couscous or quinoa as the base, add lettuce on top  and add the olives, "thin" cut veggies and cheese to that, then dressing on top. The  lettuce usually disastrous for me, with couscous or quinoa, buffers the zone, making me feel as full as a heaped plate and preventing the watery output.  Brown rice or wild rice are great cold too. I slice sticks of asparagus in thin slices, zucchini, red peppers, cut differently means I can eat them and break them down raw.  Mixing the soft and harder fibre in each bite. 

Eric taught me something not so long ago. "Put your fork down to chew your food in between bites."  It makes a difference in how well I chew my food,  it takes me longer to eat, but it seems, I enjoy it all the more. 

 Adding nuts to the top of a salad adds roughage too, as well as dried cranberries or...? All good for you and a tablespoon or two go a long way. The real secret is to chew the life out of them. Nuts to a powder, crispy chunks to a smooth juice.  Make sure you drink plenty before, during and after, a meal.  All in moderation. 

If I eat something like loaded nachos, they can be dangerous to me, I like the cornmeal taste, but since I add a back up texture, it makes it so I can eat them, in moderation again. After a meal of nachos, meatless, I toss the veggies in some of the flav. pack. I will have about 2/3 cup of yogurt, and up my fluids after a meal. Same with a plate of spaghetti, or lasagna, not as big a portion, adding a salad and fresh thin cut veggies, eating this "with" the meal not before or a after, then yogurt for desert and then a glass of fluid a few times in the hour after.

Snacks are great with frozen strawberries, you can bite right into them frozen in place of a popsicle & instead of ice cream and I freeze smaller portions of yogurt containers, wash and reuse, zap 15 seconds. Satisfying and good for you. I added melons to my diet, a softer fibre, apples chewed longer make the difference.  Experiment. Notes were vital. I also challenge myself to keep try diff. veggies prepped diff. ways. Have fun with it.  All the best!

Sorry for the length but this is a huge topic really. 

Linda


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VeganOstomy
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August 24, 2019 2:29 pm  
Posted by: @madrikh52

The GE doctor I had during this last episode said I have narrowing in  2 places so will always be prone to obstructions.

This, unfortunately, creates more of a challenge for you since it's no longer about what you eat.

Do you know what food or what amount of food it took to cause your last blockage? I wonder if you could use that as a guideline (obviously, you won't want to get near the amount/type of food that caused it). 

Posted by: @madrikh52

[the dietician] wasn't too concerned with the low fiber diet, but to me it equals an unhealthy diet.

If they aren't concerned, and have at least demonstrated that you can still get all your nutrition from a low-fiber diet, then embrace it as much as you can. Low or high fiber diets can both be unhealthy if you aren't paying attention, but I think it's more important to prevent those blockages than to stress out about the fiber content in your food. 

That's not to say you still can't enjoy "high fiber food", you may just need to further modify how they are prepared, although I would still be cautious. 

Just your friendly neighborhood ostomate.

~ Crohn's Disease ¦ Ileostomy ~


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madrikh52
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August 24, 2019 4:49 pm  

Thanks Fred, Linda and Eric for your help. 

I am fortunate to have a massage therapist who is trained in Visceral manipulation, so working with her regularly does help a lot. Like many of you, I frequently get partial blockages, so it's hard not to worry.

I will try adding more steamed veggies. I did eat a nectarine last night and chewed it to death and had no problems. 

Honestly I think stress plays a role too.

I know that I cannot tolerate coconut (milk and oil is fine), too many raw foods or nuts, flax seeds and I have to be careful about mushrooms by cooking and chewing them thoroughly. I also can't drink smoothies. I will keep gathering information and I am keeping food journal as well.

Thank you again for this helpful input!


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sjlovestosing
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August 24, 2019 7:21 pm  

Hi madrikh52,

Having had colon cancer, I understand your concern. Stress was probably a major reason for my cancer as it lessens the effectiveness of a our ability to fight off the cancer cells in our bodies.

Regarding your diet, I think you need to introduce foods slowly and one at a time to see if you can tolerate them. Try eating a diet filled with anti-inflammatory food. These include blueberries, strawberries, beets, carrots, etc. You can look up a list of foods that are on the anti-inflammatory list on the Internet. There is also a book called The Cancer-Fighting Kitchen by Rebecca Katz, which has a complete list of these foods, information about them, and a whole bunch of wonderful recipes. Take care and God bless.

Stella


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Dona
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August 24, 2019 8:01 pm  

Hi Marci,

Good nutrition is a struggle. Especially with blockage issues. Maybe try smoothies made with things that are not stringy ( I have to omit pineapple) I eat lots of melon and bananas. No coconut for me either!

I chop up spinach, microwave it and then add it to the vegetable soup I fix all the time. Lots of cooked veggies , beans, etc. If you like tomato soup, you can also add chopped steamed ( or microwaved) spinach to that.  I also love carrot juice.  And V8 is a go to for lots of us. Go slow.

A cookie every now and then ( or donut) doesn't hurt either.

Onset of severe Ulcerative Colitus Oct.2012. Subtotal colectomy with illiostomy July 2015; Peristomal hernia repair ( Sugarbaker, mesh, laparoscopic) May 2017.


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madrikh52
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August 24, 2019 11:34 pm  

Thank you Stella and Dona.

I'm getting a lot of good ideas and reminders here.

Marci


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LK
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September 1, 2019 10:41 am  

Hello Marci...I drink a lot of fruit smoothies and love to and greens to them.  The great thing about smoothies is the softer fibre that does go thru the narrowed areas. Narrowing I found out more recently is one of my beasts as well,,,and explained many blockages. Amazing what shows up in an MRI verses even a scope. I will buy bananas on cheep and ripe and smash with some lemon juice and freeze labeled in zip bags portioned out by the side of my hand and take quickly from there before they thaw. Strawberries frozen buy the sliced ones, they fit better in a magic bullet, less air between fruit meaning more fruit. I start with 1/2 the supplied cup if full of  a mix of fruits, usually bananas, blueberries and mango(?) papaya, there both yellow.  ...I have even added frozen cucumbers (sliced) to mine and some small chunks of ginger. This freezing prevents a lot of waste, so be sure you label and date your bags. Fruits frozen are often very flavorful and sweet.  I also add Turmeric a couple shakes to each drink for the anti-inflammatory affects. Too much will make it bitter. The melon fruit are fab. for this effort.

Fred...I did not realize there was a name for it then, but about 2 years ago, my GP showed me how my guts were likely laid out inside of me and encouraged a gentle massage when the pain was bad to help to move things along some, I now do this almost every night. GENTLE being the key word. I find when I have bad  bloating that this helps tremendously to move it along with turning on my sides also.  No pun intended but follow your guttural instinks...(sp? I know.)..that was on purpose, and eat what you like when it comes to food, you will enjoy eating more.  The moderation thing is important. I have very unfriendly guts and the smoothies and the massage have both been beneficial. Check out the anti-inflammatory list, it is helpful. Veggies in a smoothie add their own flare right up there with some herbs like basil and mint. Have fun with it and wrote down what you add for several times then you can copy a good mixture. As dona says.. spinach go great too and some kale. When I sense my guts are changing for what ever reason, I will make a whole blender of  a smoothie and drink that over 2 days. I have avoided a blockage now for over a year...and that is a mile stone for me. Best f luck to you all.

Linda


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