It’s clear that no single diet is suitable for everyone, there are just too many variables in Neuroendocrine Cancer. They are a heterogeneous grouping of cancers with different issues; and to a certain extent, different types and different circumstances can throw up different problems.  If you’re not careful, you can go into the ‘nth degree‘ on this subject, so tailored advice from a well-versed registered dietitian is always the preferred option.  I wanted to look at particular circumstances in this article as a low residue diet may be unsuitable for many Neuroendocrine Cancer patients. A low residue diet is sometimes called a low fibre diet.  For others, it might be something they encounter during procedures such as a Colonoscopy or before and after bowel surgery. It could also have some other utility and I’ll explain below. 

A well-balanced diet contains some fibre and that helps with digestion and absorption of nutrients and water. It also helps to bulk stools.  However, for those who have had bowel surgery, e.g. a right hemicolectomy together with the removal of some small intestine, diet can become an issue if any narrowing of the bowel occurs which will pose some risk if too much fibre (high residue) is consumed.

Anyone who is scheduled for a colonoscopy may have been instructed to go on a low residue diet which helps to ensure your bowel is clean for the procedure.  This is because the well-balanced diet mentioned above can leave behind ‘residue’ when preparing for a colonoscopy and makes seeing and performing the procedure harder.  I do remember being given this advice before having a Colonoscopy in 2008.

Those who have had bowel surgery may have been introduced to a low residue diet immediately after the procedure – this can give the bowel time to heal properly. After that, other foods can be gradually introduced.

After my own bowel surgery in 2010, I vividly remember my first real “solid” food after initially drinking nutritional liquids.  It was clear chicken-based soup followed by ice cream and jelly.  I then noticed my personal menu slowly change as they gradually introduced more foods.  Within a week, I remember being allowed to eat tender roast beef. For me it was a positive sign of healing. 

A low residue diet is not designed to be a permanent or long-term change.  However, if your bowel surgery (or other procedure) increased the risk of bowel obstructions, finding a middle ground between getting the right nutrition with minimum residue and bulking, might be one option.  In my own case, I did notice my earlier CT scans indicated some bowel narrowing due to mild colitis.  I guess the adjusted plumbing is also a potential risk area, e.g. I have an intestinal anastomosis, i.e. a new surgically created junction between the small and large intestine.  I also have mild to moderate diverticular disease spotted during a colonoscopy in 2008, I vividly remember the surgeon telling me to avoid seeds.  With all of this in mind, I found myself adjusting my own diet but still trying to maintain a high nutritional status and at the same time, enjoy the foods I like.  For example, I avoid seeds and fruit skins (both mentioned in low residue diets), I try to eat the leanest meat and I gradually moved from white bread to bread with some fibre (mostly an oat-based one). I started eating oatmeal (porridge) occasionally for breakfast and try to eat vegetables as part of the balancing act (but I cook these for longer than normal to make them easier to digest). I could go on, but you get the gist.  Basically, I am trying to eat a cut down version of a well-balanced diet looking at risks.  If I sense constipation, I normally row back a bit towards low residue until things are back to normal.  So, if you looked at a low residue diet sheet, you normally see two columns, things to avoid (generally high fibre) and things to eat (generally low fibre).  I pick and mix.  I’m not saying this would be right for you, but it is something that tends to work for me.  It’s also important to keep a food diary so that you can spot trends and then adjust as necessary.  So, for me, the low residue diet sheet is something I refer to when I’m feeling a bit sluggish in the bowel area. 

As I said above, a low residue diet is not designed to be permanent given the limited range of foodstuffs.  However, I guess people with severe issues may need longer-term guidance and specialist assistance – this is beyond the scope of this article. 

One thing which is generally accepted is the content of the low residue diet sheets handed out by hospitals.  I am attaching the low/high residue lists from my local hospital that might be a useful guide for some.  There are literally hundreds of examples online and there will be subtle differences in each one. The one attached is pretty basic and most online are similar – this is probably fine for most people, and it also comes from an authoritative healthcare professional source. 

You may be advised to follow a low residue diet after surgery. If you are unsure how long you need to follow a low residue diet or it has not been made clear why you need to follow this diet, please check with your relevant healthcare professional.