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.

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

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 your foods well to help break them down.
  • 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)

If you are struggling to maintain a healthy weight, consider meeting with a Registered Dietitian to develop an individualized meal plan. 

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

Chart

COMPLEX CARBOHYDRATES

Breads and Grains

Good Choices Avoid
  • Sliced breads
  • Bread stuffing
  • Pita bread
  • Naan bread
  • Tortillas – flour (whole wheat or white), corn
  • Plain banana, carrot or zucchini bread – not
  • really sweet
  • Plain waffles or pancakes
  • Corn bread, plain muffins
  • Bagels, English Muffins
  • Rolls
  • Pasta, macaroni, noodles
  • Rice - white, brown, or wild
  • Biscuits (without gravy)
  • Bread sticks
  • 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®, etc.
  • Corn or potato chips, reduced fat potato chips
  • Bagel snack crackers or chips
  • Rice cakes
  • Pretzels
  • 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
  • Potatoes
  • Sweet potatoes, Yams
  • Plantain
  • Butternut squash, Pumpkin squash
  • Baked French fries
  • Creamed vegetables.
  • Some people (particularly those without a colon) may do better limiting legumes (such as Lima, kidney, black, pinto, refried, etc.).

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®, canned fruits in syrup, etc.)
  • 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 chop, etc.)
  • Fish, fresh or canned
  • Shellfish (clams, crab, lobster, scallops, shrimp, etc.)
  • Game (duck or 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, etc.)
  • Cottage cheese or ricotta
  • Plain yogurt, yogurt sweetened with artificial sweeteners
  • Plain cow’s milk, soy milk, or rice milk
  • Buttermilk
  • Tofu
  • Highly sweetened yogurts or kefir
  • Chocolate or other flavored milks
  • Flavored soy or rice milks (including vanilla)
  • Cream, half and half

Nuts and Nut Butter

Good Choices Avoid
  • Chew well: Peanuts, almonds, cashews, pecans, walnuts
  • Peanut, almond, cashew, sunflower seed, or soy butters
  • Nutella®, flavored nut butters, nut butters with jam or jelly mixed in

FAT CHOICES

Good Choices Avoid
  • Oils, salad dressing (full fat)
  • Mayonnaise
  • Miracle Whip®
  • Butter or margarine
  • Cheese, cream cheese
  • Avocado, Olives
  • Sesame paste (tahini), hummus
  • Bacon
  • Coconut (shredded)
  • Sweetened cream cheeses (strawberry, honey nut, etc.)
  • Cream, half and half
  • Honey butter, flavored nut butters

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, Angel food 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
  • Ice cream, sherbet, sorbet, popsicles

BEVERAGES AND HYDRATION

Good Choices Avoid
  • Soups, broth
  • 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: less than 4 ounces coffee, tea, ice tea
  • 'If allowed:  6 ounces Lactaid® milk
  • More than 4 ounces coffee, tea, ice tea
  • Flavored or sweetened coffees
  • Sweet teas
  • Hot cocoa, Ovaltine®, Nesquick®
  • Fruit juices or fruit drinks (avoid high fructose corn syrup in drinks), Kool-Aid®, Tang®
  • Sodas (all kinds)
  • Sugar free beverages
  • Alcohol
  • Supplements like Boost®, Ensure®, etc.