Download Nutrition

Nutrition
For pelvic radiotherapy
Radiation Oncology
Building 27
Salisbury Road
Camperdown NSW 2050
p. 02 9515 8057
f. 02 9515 8070
Table of Contents
I.
Introduction ................................................................................................. 2
Important Notice
II.
Reduced Fibre Diet ..................................................................................... 3
Dietary Fibre
Why I need a reduced residue diet?
What foods do I need to avoid?
Fluid Intake
III.
Food Guide .................................................................................................. 4
IV.
Suggested Menu ......................................................................................... 7
Breakfast
Morning tea
Lunch
Lunch
Afternoon tea
Dinner
V.
If you develop Diarrhoea ........................................................................... 8
If you develop watery diarrhoea
If you develop constipation after
treatment has finished
Introduction
The pelvic radiation treatment you are having may cause a change in bowel habits. It is
normal to experience some symptoms and it may be necessary for you to change some
of your eating patterns to minimise these symptoms.
Symptoms usually occur 2-3 weeks into your treatment and may continue for a week or
two after you have finished treatment. The symptoms vary from person to person and
some people do not experience any problems.
This guide contains information about the type of food you should avoid if you
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intake if you do not experience any symptoms.
This guide will enable you to maintain an adequate dietary intake for the duration of
your treatment and until the symptoms ease.
It is important that you maintain your weight during your treatment. If you are overweight, do not try to lose weight until you have finished your treatment. Speak to your
doctor or dietician about appropriate weight management.
If you would like any further information please ask to see the dietician.
Radiotherapy dietician:
Mars (Tuesday am)
Wendy (Thursday pm)
Important Notice
Information given within this document serves as a guideline only and should not replace health care professionals
Reduced Fibre Diet
Dietary Fibre
Dietary fibre comes from plant sources such as fruits, vegetables, grains, dried beans or
legumes, nuts and seeds. Although fibre is not digested by humans, it plays an active
role in promoting the health of the bowel and in ensuring a regular bowel motion.
Why I need a reduced residue diet?
Pelvic irradiation can cause temporary inflammation of the lining of the bowel. This can
make it difficult to tolerate certain foods because the intestine becomes more sensitive.
The changes can vary from person to person, and the symptoms you could experience
include bloating, increased flatus (wind), and sometimes diarrhoea. Fibre helps to
normalise the bowel, and not all fibre-containing foods need to be avoided. Use the
following list as a guide.
A reduced residue diet may help you tolerate your treatment, but it is only temporary,
until symptoms resolve. As your bowel habits return to normal, slowly introduce the
foods you have been avoiding. It is suggested that you do this over a week.
What foods do I need to avoid?
Some foods can irritate the sensitive bowel. These foods include those containing
fibrous structures that remain whole in the bowel, such as wholegrain cereals and skins
of fruit and vegetables. Spices and fatty, oily foods can also irritate the bowel and need
to be avoided. Refer to the list provided.
Fluid Intake
It is important to drink plenty of fluid, especially if you are experiencing diarrhoea. You
should drink at least 6-8 glasses of fluid per day (such as water, milk, clear broth,
cordials, soft drinks, sports drinks and jellies).
Food Guide
Breads and cereals
FOODS ALLOWED
FOODS TO AVOID
Porridge, semolina, Weet
Bix, Cornflakes, Special K,
Rice bubbles
Muesli and other cereals
containing nuts and dried
fruit. E.g. Sultana bran, Fibre
Plus, Sustain, All bran
White rice, white pasta
Brown rice and wholemeal
pasta
White, fine wholemeal bread, Spaghetti with onions,
rye bread, plain English
pepper/chillies or other spicy
muffins, crumpets, scones, seasonings
Pikelets, cake, biscuits (e.g.
Sao, plain salada, milk
arrowroot)
Coarse wholegrain bread
Bread/rolls with poppy
seeds, sesame seeds,
caraway seeds
Biscuits or cakes containing
dried fruit seeds, nuts,
coconut, whole grain
crackers
Milk and milk products
Milk, yoghurt, cheese, ice
cream (not containing nuts
and seeds)
Milk products containing fruit
skins, nuts or seeds
Meatfish, chicken, eggs
and tofu
Lean meat, chicken, fish,
Fish canned in brine, Drain
any oil from canned fish
Gristly, fatty and fried meat
Fried fish in batter
Highly seasoned meats e.g.
Curries/chilli-concarne,
chinese, thai, Indian foods,
pizza, meat pies, sausage
rolls, pasties
FOODS ALLOWED
FOODS TO AVOID
Vegetables
Cooked and peeled
vegetables including
potatoes, pumpkin, carrots,
tomatoes (seeded and
skinned), flower of broccoli
or cauliflower, zucchini,
mushrooms, spinach,
beetroot, tender lettuce,
cooked asparagus spears,
silver beet leaves
Vegetable seeds and skins,
onions, garlic, leeks,
cabbage, celery, brussel
sprouts, peas, tomato seeds
and skins, radishes, olives,
cucumber, sweet corn,
peppers, French beans,
green beans, avocados,
broad beans, dried beans,
split beans, lentils, chillies
and pickled vegetables
Fruit
Soft stewed or canned fruits
without skins and seeds,
peeled fruit e.g. apples,
pears, watermelon,
honeydew melon,
rockmelon, bananas,
peaches, apricots, and other
stone fruit, tinned fruit
All fruit skins and seeds,
pineapple figs, berry fruits,
strawberries, passionfruit,
kiwifruit, pomegranate,
grapes, oranges, mandarins,
grapefruit, dried fruit e.g.
sultanas, raisins, dates and
lemon peel
Beverages
Tea, small amounts of
It is best to avoid alcohol or
coffee, soft drinks, cordial, limit intake to small amounts
milk, milo, strained fruit juice,
vegetable juice
Strong brewed coffee
FOODS ALLOWED
Desserts
FOODS TO AVOID
Soft puddings, jelly, custard, Desserts containing nuts,
blancmange, ice cream and coconut, fruit skins or seeds,
other milk puddings
pastry, cake/muffins
containing dried fruit or
coconut
Condiments, spreads,
Honey, jam/jelly conserves,
sauces and miscellaneous tomato puree, vegemite,
marmite, plain chocolate
(small amount), jelly beans,
boiled sweets
Jam and jelly conserves
containing fruit seeds or
skins
Peanut butter
Soups without peppers or
spices
Chocolate containing fruit
and nuts
Soups without cream
Highly seasoned soups
(mulligatawny, laksa), cream
soups and broths containing
unsuitable vegetables
Pickles, wasabi, horseradish,
popcorn, mustard, relish
Nuts
Suggested Menu
Breakfast
x
Cornflakes with milk
x
x
Strained fruit juice
Poached egg on white toast or white rye toast with honey or vegemite
Morning tea
x
x
Cup of tea or coffee
Plain biscuit (arrowroot), plain scone or a plain toasted English muffin with
cheese
Lunch
x
x
White or rye bread sandwich with meat and cheese
Peeled apple
x
Glass of strained orange juice
Lunch
x
White or rye bread sandwich with meat and cheese
x
x
Peeled apple
Glass of strained orange juice
Afternoon tea
x
Milk shake with banana and ice cream, plain biscuit/scone or yoghurt without fruit
(vanilla)
Dinner
x
Pumpkin soup
x
Grilled chicken fillet
x
Peeled and steamed potato
x
Broccoli
OR
x
Pasta with tomato puree (no seeds) with allowed vegetables, stewed fruit and
custard or plain tea cake
If you develop Diarrhoea
If you develop diarrhoea that is uncontrollable speak to your doctor.
If you develop watery diarrhoea
x
Temporarily avoid large amounts of fruit and vegetables.
x
You may have diluted fruit juice, peeled pumpkin and potato.
x
Avoid cereals such as porridge and Weetbix, but you may have Rice bubbles,
Special K or Cornflakes.
x
Use only white bread and avoid wholemeal products.
x
Avoid milk. Use soy milk or lactose-reduced milk e.g. Pauls Lactaid. Choose low
fat yoghurt, and cheese and use very little fat in your cooking.
x
Eat small amounts often rather than 3 large meals e.g. 6 small nutritious snacks.
Avoid very hot or very cold food and drinks as these may stimulate the bowel.
If you develop constipation after treatment has finished
x
Drink at least 8 glasses of fluid per day.
x
Eat plenty of wholemeal cereals and plenty of fruit and vegetables (with the
skins) everyday. You should aim for 3 servings of fruit and 5 servings of
vegetables daily. Prunes and prune juice will help stimulate the bowel.
x
Eat regular meals and snacks
x
Try doing some light exercise, such as walking
x
Consult your doctor