The Gentle TableSimply delicious low fibre meals
Cooking for a narrowed bowel

A narrowed bowel

When the bowel is narrowed by a tumour or by scarring, the risk is mechanical, and the food rules change accordingly.

A stricture is a narrowed section of bowel. It can be caused by a tumour pressing into or growing around the bowel wall, or by scar tissue after surgery or radiotherapy. The opening is smaller than it should be, so food that would ordinarily pass without incident can slow, snag or lodge.

What the guidance emphasises

Texture above everything else. The concern here is not the abstract fibre content of a food but whether pieces of it survive chewing and stomach digestion intact. Skins, pips, husks, stringy stalks and the cell walls of mushrooms and sweetcorn are what physically accumulate at a narrowing, which is why those items appear on every avoid list compared for this book while the trusts still argue about herbs and cauliflower.

The most detailed UK protocol found in the research behind this book is a staged one. It moves from clear fluids to thin fluids to smooth or puréed low-fibre food and then to soft, sloppy low-fibre food, stepping up only after the bowels have opened regularly and without pain for several days, and stepping back down at the first sign of nausea, vomiting, bloating, distension or no motion for two days. Which stage you are on is a clinical decision, not a kitchen one.

What this book does

Everything here is cooked soft, and the smooth and sieved end of the book is where to look first. Recipes are tagged for a narrowed bowel when they are smooth or soft-sloppy, free of skins, pips and stringy pieces, and workable when appetite is small. Purées are sieved rather than only blended. Aromatics are infused and lifted out. Chewing thoroughly does as much as any of it.

How long

This is a temporary measure aimed at a specific problem, and how long it lasts depends on what is causing the narrowing and what is being done about it. Your team decides when to step back up and by how much, and the staged protocols above are designed to be walked in both directions.

New or worsening symptoms, including vomiting, severe or colicky pain, bleeding, distension or no bowel motion for more than two days, are for your medical team the same day, not for a cookbook.

Foods to know

Recipes for this situation

Sources

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