Dear Dietitian: Small bowel obstruction

Dear Dietitian,

I recently had surgery to correct a small bowel obstruction. I have been following a low fiber diet, but now I've been instructed to transition to a high fiber diet. My question is how much fiber do I need and should I increase it all at once?

Betty

Dear Betty,

For readers who are not familiar, a small bowel obstruction (SBO) is just as it sounds; it's a blockage in the small intestine, and digested food cannot pass into the colon (large intestine). The obstruction is often caused by scar tissue known as adhesions. Sometimes SBOs resolve with rest and no food or drink by mouth, while others require surgery.

A low fiber diet is often prescribed after a bowel obstruction is corrected. This is because fiber passes through the GI tract unchanged and adds bulk to the stool. A low fiber diet helps the bowel rest and return to its normal function. This diet is temporary; then the patient is transitioned to a high fiber diet. We know that fiber is beneficial in keeping us regular and helps manage certain chronic conditions, such as high cholesterol and diabetes. There is some research to suggest that fiber may help protect us from certain types of cancer, but more studies are needed before a definitive statement can be made.

Fiber is found in plant foods: fruits, nuts, seeds, vegetables, beans, legumes, and whole grains. The American Heart Association suggests that we consume 25-35 grams of fiber each day, but most Americans get half that amount. The mantra to apply here is "Easy does it." Start with one to two servings of fiber-rich foods each day. Add a fruit at breakfast and a vegetable at dinner, which will give you about 8-10 grams of fiber. Then gradually increase fiber by 5-gram increments weekly until you reach the goal of at least 25 grams each day. For a list of high fiber foods, click here. It is important to drink plenty of water and/or decaffeinated beverages while increasing fiber intake in order to prevent constipation.

If you have gas or discomfort when eating these foods, consider taking an over-the-counter enzyme with the first bite. Since the body cannot break down fiber, it is digested by bacteria in the colon, which produces gas in the process. The enzyme actually helps break down some types of fiber. You may also consult your doctor or pharmacist about taking simethicone.

Enjoy your new diet, and if you have any questions, please write again.

Until next time, be healthy!

Dear Dietitian

Leanne McCrate, RD, LD, CNSC, aka Dear Dietitian, is an award-winning dietitian based in Missouri. Her mission is to educate consumers on sound, scientifically-based nutrition. Do you have a nutrition question? Email her today at [email protected]. Dear Dietitian does not endorse any products, health programs, or diet plans.