Diet & Beverage Suggestions for Short Bowel Syndrome

Diet & Beverage Suggestions for Short Bowel Syndrome (SBS)

 

This diet is from the patient guidebook, A Patient’s Guide to Managing a Short Bowel.  To order a free copy, go to: https://www.shortbowelsyndrome.com/sign-up.

More information on Nutrition on short bowel syndrome is available at www.GInutrition.virginia.edu.

  • Look for Patient Education and scroll down to Short Bowel Syndrome.
  • Look under “Nutrition Articles” from the journal Practical Gastroenterology, which you can read or share with your physician.

 

 

Some general tips:

  • If you have some colon remaining, a high complex carbohydrate diet is recommended.
  • If you have a jejunostomy or high output ileostomy, a higher fat diet is recommended.
    • See sections on carbohydrate and fat below so you know what we mean by this.
  • Chew ALL food well to help break it down for digestion.
  • Avoid concentrated sweets and beverages such as desserts, sodas, sweet drinks/tea, fruit juices, sweet coffee drinks, etc.
  • Eat up to 6-8 smaller meals per day.
  • Limit beverages with meals. Instead, sip allowed beverages between meals (see list below).

 

The “good choices” in this handout are more easily absorbed and tend not to increase diarrhea as much as those in the “avoid” column. 

 

 

COMPLEX CARBOHYDRATES

Breads and Grains

Good Choices

Avoid

 

  • Sliced breads
  • Bread stuffing
  • Pita bread, Naan bread
  • Tortillas (flour [any kind] or corn)
  • Plain banana, carrot, or zucchini bread (not real sweet, and no icing)
  • Plain waffles or pancakes
  • Corn bread, plain muffins
  • Bagels, English Muffins, Rolls
  • Pasta, macaroni, noodles
  • Rice (white, brown, or wild)
  • Biscuits (without gravy)
  • Breadsticks
  • Donuts
  • Sweet rolls
  • Pop-Tarts®
  • Pastries (see also dessert section)
  • Pancakes or waffles with syrup or jam/jelly- Both sugar free and regular

 

Cereals

Good Choices

Avoid

 

  • Unsweetened cereals (with milk or eaten dry as a snack) such as:  Cheerios®, Corn Flakes®, Rice Krispies®, Rice, Wheat, & Corn Chex®, Special K®, Kix®, puffed rice or puffed wheat
  • Hot cereals: cream of rice or wheat, grits, oatmeal
  • Sugary cereals such as: Honey Nut Cheerios®, Frosted Flakes®, Cocoa Puffs®, Fruit Loops®, etc.
  • Flavored hot cereals such as maple or apple cinnamon oatmeal, etc.

 

Crackers/Chips

Good Choices

Avoid

 

  • Crackers: saltines, club, soda, Matzo, Goldfish®, Ak Mak, Wasa, etc.
  • Corn or potato chips, reduced fat potato chips
  • Bagel snack crackers or chips
  • Rice cakes, rice crackers
  • Pretzels (without flavoring)
  • Granola bars, flavor-coated popcorns (Kettle corn, Cracker Jacks®).
  • Those without a colon may do better limiting high fiber snacks such as popcorn.

 

Starchy Vegetables

Good Choices

Avoid

 

  • White potatoes
  • Sweet potatoes, Yams
  • Plantains, Yucca
  • Butternut squash, Pumpkin squash
  • Baked French fries
  • Creamed starchy vegetables like corn.
  • Avoid legumes (such as lima, kidney, black, pinto, refried, lentils, etc.) if they bother you. Chew them WELL if you eat them.

 

FRUITS

Good Choices

Avoid

 

  • Bananas
  • Limit to 1 cup per day: Unsweetened canned or fresh fruits (applesauce, pears, peaches, mandarin oranges, apricots, cherries, plums, etc.)
  • Dried fruits
  • Watch out for high fructose corn syrup in drinks (for example, Capri-Sun®)
  • Fruit canned in syrup
  • Fruit juice, fruit drinks

 

NON-STARCHY VEGETABLES

Good Choices

Avoid

 

  • Cooked carrots, squash, zucchini, eggplant, turnip or beets
  • Tomatoes, tomato sauce

In small amounts:

  • Leafy greens (romaine, spinach, red lettuce, collard greens, kale, etc.)
  • Green, red, or yellow pepper
  • Creamed vegetables
  • Onions, leeks
  • Broccoli
  • Brussels sprouts

 

 

 

PROTEINS

Meat, Fish, Poultry

Good Choices

Avoid

 

  • Poultry (chicken or turkey)
  • Beef (flank steak, tenderloin, ground beef, meatloaf, etc.)
  • Pork (ham, Canadian bacon, pork chops, etc.)
  • Fish, fresh or canned
  • Shellfish (clams, crab, lobster, scallops, shrimp, etc.)
  • Game (duck, pheasant, venison, buffalo/bison)
  • Fried meats, fish, or poultry
  • Raw meats, fish or poultry of any kind

 

Dairy and Soy

Good Choices

Avoid

 

  • Regular cheeses (American, cheddar, Swiss, Monterey Jack, mozzarella, feta, Parmesan, Gouda, etc.)
  • Cottage cheese or ricotta
  • Cream cheese
  • Plain yogurt, yogurt sweetened with artificial sweeteners, kefir
  • Plain milks, buttermilk
  • Unsweetened soy, rice, or almond milk
  • Tofu
  • Sweetened yogurts or kefir
  • Frozen yogurt
  • Chocolate or other flavored milks
  • Flavored soy or rice milks (including vanilla)
  • Cream, half and half

 

Nuts and Nut Butters

Good Choices

Avoid

 

  • Peanuts, almonds, cashews, pecans, walnuts, pepitas, sunflower seeds, etc.
  • Peanut, almond, cashew, sunflower seed, or soy butters

 

  • Nutella®, flavored nut butters, nut butters with jam or jelly mixed in
  • Honey butter, flavored nut butters

 

FAT CHOICES

Good Choices

Avoid

 

  • Vegetable oils (sunflower, olive, walnut)
  • Salad dressing – limit to 2 tablespoons
  • Mayonnaise, Miracle Whip®
  • Butter or margarine
  • Avocado, Olives
  • Sesame paste (tahini), hummus
  • Bacon
  • Coconut (shredded) unsweetened
  • Sweetened cream cheeses (strawberry, honey nut, etc.)
  • Cream, half and half

 

MISCELLANEOUS/ SEASONINGS

Good Choices

Avoid

 

  • Salt, pepper, herbs, spices
  • Soy sauce, Worcestershire sauce, vinegar
  • Splenda®, Equal®, Sweet ‘N Low®, Stevia, etc.
  • Dill Pickles
  • Tabasco or Hot Pepper Sauce
  • Unsweetened cocoa powder
  • White or brown sugar
  • Chocolate or other flavored syrups, Nutella®
  • Maple or other syrups
  • High fructose corn syrup, corn or Karo® syrup, Molasses, Honey
  • Jams and jellies
  • Sugar alcohols (sorbitol, xylitol, mannitol) in "sugar-free" products such as jam, jellies, Jell-O®, and candy

 

DESSERTS (VERY LIMITED AMOUNTS)

Good Choices

Avoid

 

  • Plain (no icing/sugar sprinkles) cake donuts, Pound cake
  • Graham crackers
  • Gingersnaps, Vanilla wafers
  • Angel food cake
  • Shortbread
  • Marshmallows
  • Cake (especially with icing), snack cakes (Little Debbie’s®), cookies, pie, brownies
  • Candies, fruit snacks, etc.
  • Danish, PopTarts®, donuts
  • Pudding, sweetened gelatin/ Jell-O®
  • Ice cream, sherbet, sorbet, popsicles, frozen yogurt

 

BEVERAGES AND HYDRATION

Good Choices

Avoid

 

  • Soups, broth (chicken, beef, vegetable)
  • Oral Rehydration solutions: Ceralyte®, DripDrop, “WHO” formula, Pedialyte® (or store brand equivalents, etc.) See website for recipes under patient education at: www.ginutrition.virginia.edu
  • Limit water
  • If allowed: 4 ounces coffee, tea, ice tea
  • If allowed: 6 ounces Lactaid® milk
  • More than 4 ounces coffee or tea
  • Flavored or sweetened coffees
  • Sweet teas
  • Hot cocoa, Ovaltine®, Nesquick®
  • Fruit juices or fruit drinks (avoid high fructose corn syrup), Kool-Aid®, Tang®
  • Sodas (all kinds)
  • Sweet alcohol drinks
  • Supplements like Boost®, Ensure®, etc.