Reference

Foods and preparation

Every ingredient the book has checked against the leaflet it follows, and against the other hospital guidance it was compared with. Green foods need no special handling. Amber foods are allowed, but only prepared a particular way, or only by some hospitals and not others. Red foods are left out of every recipe.

This follows the leaflet this book uses and notes where other trusts differ. If your own dietitian or surgical team has told you something different for your situation, follow them — your team wins.

Bread, rice, pasta and cereals

FoodTierPreparation
White breadAllowed—
White bread with crusts removedAllowed—
White breadcrumbsAllowed—
Panko (white)Allowed—
Plain white bagelAllowed—
Plain briocheAllowed—
White pittaAllowed—
White flour tortillaAllowed—
Plain naanAllowed—
White-flour chapattiAllowed—
Plain or self-raising white flourAllowed—
CornflourAllowed—
SemolinaAllowed—
Fine or instant polentaWith care

Use the fine or instant grade only. Coarse or wholegrain cornmeal is off the list.

Hospitals differ: The leaflet this book follows does not name polenta. Refined maize products are allowed by St George's and Leeds.

White pastaAllowed—
Pastina (tiny white pasta)Allowed—
White egg or wheat noodlesAllowed—
Rice noodlesAllowed—
Udon noodlesAllowed—
White riceAllowed—
Arborio or carnaroli riceAllowed—
Pudding riceAllowed—
Potato without skinAllowed

Peel it and leave no skin on.

Instant mashAllowed—
ChipsAllowed—
Cornflakes or Rice KrispiesAllowed—
Plain biscuits (Rich Tea, shortcake, custard creams, wafers)Allowed—
Cream crackers or water biscuitsAllowed—
White-flour pastry (shortcrust, puff)Allowed—
Plain sponge cakeAllowed—
Plain sconeAllowed—
Wholemeal, brown, granary or seeded breadAvoid—
Oats, porridge, oatcakesAvoid

Hospitals differ: The leaflet this book follows and Leeds list porridge as avoid. St George's calls it medium. Milton Keynes lists oats as a stoma-output thickener. This book follows the leaflet and keeps oats out of the recipes.

Bran, Weetabix, muesli, granolaAvoid—
Brown rice or wholemeal pastaAvoid—
Potato skinsAvoid—
Wholegrain or seeded crackers, Ryvita, digestives, flapjacksAvoid—
PopcornAvoid—
Plain white breadsticks (grissini)Allowed—

Vegetables

FoodTierPreparation
CarrotWith care

Peel it and cook it until fully soft. Dice it small or mash it.

SwedeWith care

Peel it and boil it until soft. Mash it.

TurnipWith care

Peel it and boil it until soft.

ParsnipWith care

Peel it and remove the woody core. Cook it until soft and purée it.

Hospitals differ: The leaflet this book follows does not name parsnip. St George's allows it peeled and well cooked.

Butternut squashWith care

Peel it fully and scoop out all the seeds and fibrous centre. Cook it until soft and blend it.

CourgetteWith care

Peel it and scoop out the seeds. Cook it until soft.

MarrowWith care

Peel it and deseed it. Cook it until soft.

Cauliflower floretsWith care

Use florets only, with no stalk. Cook until soft.

Hospitals differ: Allowed, as florets cooked soft, by the leaflet this book follows and by St George's. It is on Leeds's avoid list. Stoma advice flags brassicas for wind.

Broccoli floretsWith care

Use florets only, with no stalk. Cook until soft.

Hospitals differ: Allowed, as florets cooked soft, by the leaflet this book follows and by St George's. It is on Leeds's avoid list. Stoma advice flags brassicas for wind.

Passata, tomato purée, sieved tomato sauceAllowed—
OnionWith care

Cook it until completely soft, then either purée it into the sauce or strain it out. Never leave it crunchy or in strands.

Hospitals differ: The leaflet this book follows lists "sausages with onions" as avoid and does not list onion itself as allowed. Several trusts allow well-cooked onion. This book uses onion only cooked to melting and then puréed or strained.

ShallotWith care

Treat it the same way as onion. Sweat it to melting, or leave it out.

LeekWith care

Use the white part only, sliced very finely, and cook it to melting, or sieve it out of a soup. Leek is stringy unless it is cooked this way.

Hospitals differ: Leek is not on the allowed list of the leaflet this book follows. St George's allows it well cooked.

GarlicAllowed—
CucumberWith care

Peel it and deseed it. Use it sparingly.

Hospitals differ: Raw salad is on the avoid list of the leaflet this book follows. Peeled and deseeded cucumber is medium at St George's.

BeetrootWith care

Peel it and cook it until completely soft, then purée it or sieve it. Never grate it raw.

Hospitals differ: The leaflet this book follows does not name beetroot. It is treated as a peeled root vegetable cooked soft, like carrot.

SpinachWith care

Cook it soft and purée it.

Hospitals differ: Spinach is not on the allowed list of the leaflet this book follows. St George's rates it medium, so allowed with care.

Raw vegetables and saladAvoid—
SweetcornAvoid—
CeleryAvoid—
MushroomsAvoid

Hospitals differ: The leaflet this book follows does not name mushrooms. They are on almost every other avoid and blockage list.

PeasAvoid—
PeppersAvoid—
Whole or chopped tomatoesAvoid—
Cabbage, kale, sprouts, spring greensAvoid—
BeansproutsAvoid—
Spring onionAvoid—
Olives and capersAvoid—

Fruit

FoodTierPreparation
Ripe bananaAllowed—
MelonWith care

Remove the skin and all the seeds.

Stewed appleWith care

Peel it, core it, and deseed it. Stew it until soft.

Tinned pearsAllowed—
Tinned peachesAllowed—
Stewed plumsWith care

Skin the plums and remove the stones.

Smooth fruit juice (no bits)Allowed—
Lemon or lime juiceAllowed—
Raspberries (sieved to a smooth coulis)With care

Blend it, then push it through a fine sieve and discard every seed. Use the smooth purée only, never the whole fruit.

Hospitals differ: Berries are on the avoid list of the leaflet this book follows, because of their seeds. A sieved purée is smooth juice, which the leaflet allows. Some hospitals would still say to leave berries out.

Strawberries (sieved to a smooth purée)With care

Blend it, then push it through a fine sieve and discard the seeds. Use the smooth purée only.

Hospitals differ: Berries are on the avoid list of the leaflet this book follows, because of their seeds. A sieved purée is smooth juice, which the leaflet allows. Some hospitals would still say to leave berries out.

Ripe mango (peeled, stoned, sieved)With care

Use it fully ripe. Peel it, cut the flesh from the stone, then blend it and push it through a sieve to remove any fibres.

Hospitals differ: The leaflet this book follows does not name mango. It is treated as a peeled, deseeded, sieved fruit.

Blackcurrant or elderflower cordial (smooth)Allowed—
Lime juiceAllowed—
Citrus segments, pith and zestAvoid—
BerriesAvoid—
Dried fruitAvoid—
PineappleAvoid

Hospitals differ: Pineapple has a fibrous core. It is cited in stoma and US guidance rather than in UK trust leaflets.

Coconut, desiccated or freshAvoid—
Fruit skins, pips and stonesAvoid—
Smoothies and juice with bitsAvoid—

Meat and poultry

FoodTierPreparation
Chicken (breast or thigh, skin removed)Allowed

Remove the skin and cook it until tender.

TurkeyAllowed—
Beef minceAllowed—
Braising beefAllowed

Trim off the fat and gristle. Cook it until fork-tender.

Lamb minceAllowed—
Pork (loin, fillet)Allowed

Trim off the fat. Leave out the crackling.

BaconAllowed—
Pancetta or guancialeAllowed—
HamAllowed

Trim off the fat and gristle.

Plain pork sausagesAllowed—
Tough, gristly or very fatty meat; crackling; skinAvoid—
Sausages with onion or herbsAvoid—

Fish and shellfish

FoodTierPreparation
SalmonAllowed

Remove the skin and check for pin bones.

Smoked salmonAllowed—
Tinned salmonAllowed

Remove the skin and any bones.

White fish (cod, haddock, pollock, hake)Allowed

Remove the skin and check it is fully boned.

Smoked haddockAllowed—
Tinned tunaAllowed—
PrawnsAllowed

Peel them and check for shell fragments.

Fish in white breadcrumbs or batterAllowed—
Fish in wholemeal breadcrumbsAvoid—

Eggs and dairy

FoodTierPreparation
EggsAllowed—
Whole milkAllowed

Hospitals differ: Milk is fibre-free everywhere. Radiotherapy and LARS advice can add a separate lactose restriction.

Skimmed milk powder (for fortifying)Allowed—
ButtermilkAllowed—
Double or single creamAllowed—
Crème fraîcheAllowed—
MascarponeAllowed—
Cream cheeseAllowed—
Hard cheese (Cheddar, Gruyère, Parmesan)Allowed—
FetaAllowed—
Sweetened condensed milkAllowed—
RicottaAllowed—
Clotted creamAllowed—
MozzarellaAllowed—
Smooth yoghurt (no bits)Allowed—
Ice cream (plain)Allowed—
CustardAllowed—
Yoghurt with fruit pieces, nuts or seedsAvoid—

Alternatives

FoodTierPreparation
TofuAllowed—
QuornAllowed—
Soya or oat-free plant milkWith care

Check the label for added fibre or husk.

Nuts and seeds

FoodTierPreparation
Nuts, all kindsAvoid—
Seeds, all kinds (sesame, poppy, chia, linseed, pumpkin)Avoid—
Peanut butterAvoid

Hospitals differ: It is on the avoid list of the leaflet this book follows. Smooth peanut butter is allowed by St George's, Oxford, Milton Keynes and Leeds. This book follows the leaflet and keeps peanut butter out of the recipes, and says so.

Chocolate and nut spreadsAvoid—

Pulses

Fats and oils

FoodTierPreparation
ButterAllowed—
Vegetable, rapeseed or olive oilAllowed—

Sugars and sweet things

Condiments and sauces

FoodTierPreparation
Tomato ketchupAllowed—
Pickles, chutney, relishAvoid—
Mustard powderAllowed—
Smooth mustardAllowed—
Wholegrain mustardAvoid—
VinegarAllowed—
Mayonnaise, salad creamAllowed—
Brown sauce, Worcestershire sauceAllowed—
Soy sauceAllowed—
Fish sauceAllowed—
MirinAllowed—
MarmiteAllowed—
Stock (chicken, beef, vegetable, dashi)With care

Keep it clear and strained, with no vegetable pieces.

Gravy (smooth)Allowed—
White sauce, cheese sauceAllowed—
Creamed or clear soupsAllowed—
Soups with vegetable piecesAvoid—

Flavourings

FoodTierPreparation
Ginger (infused and removed)With care

Slice it and simmer it to flavour the liquid, then remove every piece. It is never eaten.

Hospitals differ: Ginger is a spice, and the leaflet this book follows lists spices under avoid. Infusing it and removing every piece leaves flavour behind without any residue.

SaltAllowed—
Lemongrass (infused and removed)With care

Bruise the stalk and simmer it to flavour the liquid, then lift it out whole. Never chop it, and never eat it.

Hospitals differ: No leaflet names lemongrass. It is treated like an infused herb, which the stricter leaflets restrict when chopped.

Matcha (powdered green tea)With care

Use a teaspoon or less, sifted and whisked in fully. It is tea, not a spice.

Hospitals differ: No leaflet names matcha. The leaflet this book follows allows tea, and matcha is finely ground tea leaf with no residue at these amounts.

White wine (cooked off)Allowed—
Vanilla extract or pasteAllowed—

Herbs and spices

FoodTierPreparation
Ground black or white pepperWith care

Use a small pinch, finely ground, or leave it out.

Hospitals differ: The leaflet this book follows lists "herbs and spices" as avoid but "pepper" as allowed, in the same leaflet. St George's allows dried spices. This book treats a pinch of finely ground pepper as allowed, and says so.

Saffron (infused)With care

Steep a pinch in hot stock until the threads soften completely into the liquid.

Hospitals differ: Saffron is a spice, and the leaflet this book follows lists spices under foods to avoid. Some hospitals allow it.

Nutmeg, cinnamon and other ground spicesWith care

Use a small grating only, or leave it out.

Hospitals differ: It is on the avoid list of the leaflet this book follows. Dried spices are allowed by St George's and at Leeds stage 3.

Curry powder, five-spice, paprikaWith care

Use small quantities, finely ground, and leave it out if your team says so.

Hospitals differ: It is on the avoid list of the leaflet this book follows. Dried spices are allowed by St George's and at Leeds stage 3.

Herbs infused and removed (bay, sage, thyme sprig)With care

Simmer a whole sprig or leaf, then lift it out. Nothing is chopped, and nothing is left in.

Hospitals differ: Fresh herbs are on the avoid list of the leaflet this book follows and at Leeds. Infusing them and removing every piece leaves no residue.

Chopped fresh herbs (parsley, coriander, chives, basil)Avoid—
Chilli, fresh or flakesAvoid—
Whole spices left in the dish (cumin seed, mustard seed, cardamom pods)Avoid—

Drinks

Other ingredients

FoodTierPreparation
Gelatine (leaf or powder)Allowed—
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