Low-Fiber Diet After Multiple Surgeries: Seeking Advice

In August, I had diverticulitis which caused a ruptured sigmoid colon, emergency surgery with a Hartmann’s procedure, and I wound up with a colostomy. 
On the advice of doctors, I began to gradually reintroduce fibrous foods in mid-November, and by the 3rd week of December was back to eating my favorite vegetables in moderation. For the first few days of being back to a “normal” diet with fiber, I noticed pain in the abdomen, but figured this was my “new normal” with eating fiber again. Then, on Dec 21, the pain reared up and was unbearable. So back to the ER and another emergency open surgery, because the pain was actually a small bowel obstruction caused by adhesions/scar tissue and a hernia. But I can’t help but wonder if the bulky diet exacerbated it. 
I am now going to stay on a low fiber/residue diet, at least until April, when I have a consult about Ostomy reversal. 
Are any of you out there on low fiber diet for the long term? Any advice on this? Or on the prospect of another obstruction? Thank you. 

I tend to eat a low fiber diet because I have an ileostomy that is very finicky. Even if I eat cooked very soft carrots, they come right back out in my bag. I am also careful because a year ago I was in the hospital with a blockage and it was not fun. I think that was due to eating rice and cooked broccoli mixed together with cheese sauce. I think the rice was just too much for my ostomy to handle. So now I mostly stick to pasta, sandwiches with meat and cheese, no veggies, soup, and cheese pizza with no toppings. I do eat avocados sometimes on my sandwiches, but never lettuce or tomato. I am very conscious of what I am eating, what comes out in my bag, stuff like that. One time I ate peas and ended up with about 30 peas in my bag. I don't eat peas anymore. If they can come out in my bag like that, then they could get stuck in there. I like to say my ostomy is a pasta-tarian because pasta seems to be the only thing it likes. But I have expanded some to include things like crackers and hummus, cream of wheat, and cereal as long as there are no oats or nuts in it and no berries in it. I like Honey Nut Cheerios. There are no visible nuts in that. I like peanut butter and almond butter. So I have found that I can vary my diet some without including things like raw veggies and berries with skins and seeds. I eat mango a lot, peeled of course. I eat little fruit cups of pears, mango, peaches, and mandarin oranges. I eat applesauce, so I get my fruits in, just softened fruits, no skins. There are a lot of foods you can eat if you look around a bit.

 

I already commented at length in your other thread.

It's important to note that if you have a colostomy, your issues will vary from someone with an ileostomy. Someone with an ileostomy has no colon pulling out the water in their stool, so they are less prone to constipation. But they are much more prone to food blockages.

Many people with colons will become constipated with a low residue diet. In truth, I don't have that problem, but constipation seems to be very common, so I'd be remiss not to mention it. Constipation is a risk for developing a food blockage, and you are better off preventing it by eating fiber than taking laxatives to treat it.

I doubt that the nutritional issues will get too serious in a few months, so sticking to a low residue diet until April should not hurt you. But be very certain to discuss it with your doctor when you see him.

My aim is to help you distinguish between coincidence and cause. It is human nature to believe that if Y happens right after you did X, that X caused Y. A lot of the time it's true. But not always.

A personal example:

6 months before I was diagnosed with cancer, my doctor increased the dose of one of my medications. Within about a week, I started having a lot more diarrhea, loss of appetite, and abdominal cramping. All of these are known side effects of the medication. Both my doctor and I attributed it to my medication change, and I resolved to ride it out. About 4 months later, I was struggling, I had lost 40 pounds, and began to develop other symptoms. I felt poisoned and stopped taking all my medications. I blamed the medications for making me sick.

The symptoms did not improve. Eventually, I landed in the ER where a CT revealed a massive tumor that turned out to be rectal cancer. The cancer had caused all my symptoms. There can be no doubt, logically.

Cancer treatment relieved the symptoms, but I did not restart the medication that "started it all". I know in my head that it didn't make me sick, but I just can't do it.

I made an incorrect association, but moving past it is hard because I held the belief for so long.

If you stay on the low residue diet and have no more problems, it will reinforce the idea that fiber caused your problem. It will be that much harder to let go of the idea later on. At a minimum, hold the idea that fiber had no part in your mind until you talk to your doctor.

I have had an ileostomy for over 10 years and have never been able to introduce much fiber. So, I eat what I can tolerate.

I used to be. I was only allowed to eat orange-colored vegetables. In the hospital, I was given a lot of pureed food. I was no longer allowed to eat muesli, which I used to love. And I could only eat white bread.
Unfortunately, after more than 50 operations in the last 32 years, having many bowel obstructions, an intussusception (when part of the bowel folds into itself, which caused me to lose another 50 cm of small bowel), I developed a lot of adhesions. I was warned that the more operations one has, the more scar tissue you create. I have had a few times when they attempted to remove all or most of my adhesions, and the surgeons attempted to use gel-like substances to prevent the regrowth of my adhesions, but none of this was ever successful.
Eating started causing me so much pain, plus after losing my IV access, I have been told that I will not survive another operation, so it was decided that I needed a feeding tube - however, that did not work either, as the contents of my stomach would leak out, and the area around my PEG started becoming infected, so they had to pull my feeding tube out.
Now I no longer eat anything solid and live off nutritionally complete food (as I didn't absorb any food I ate, which caused me to struggle with malnutrition).
I have gotten to the stage where I no longer miss solid food, and here in New Zealand, the hospital pays for my food, as well as my medical equipment. However, sometimes I get sick of having only chocolate-flavored Fortisip (made by Nutricia), but as I do not like the other flavors they come in.

Living with Your Ostomy | Hollister

That is the way to do it. Eat what you know you can tolerate. Fiber is a hard one, knowing what to do and not to do. Knowing what works for you is important. If low fiber works for you then stick with that. 

What a horrific experience. Thank you for sharing, and best of luck to you.

I don't think well-cooked, well-chewed vegetables should be a problem. Thorough chewing and no raw vegetables are my best advice. One other comment: having a colostomy makes you more aware of what foods have not fully digested, but people without a colostomy just don't see the pieces of food mixed in with the stool that flushes down the toilet.

Hello Kayloo,

I had a permanent colostomy almost one year ago. I didn't fiber for months, and when I first did, there were many things that caused abdominal pain. I still have things that do, but by trial and error, I have figured out how to eat most things, but in much smaller portions.

I do well with berries, high-fiber bread (which I strongly suggest trying), and broccoli, cauliflower, Brussels sprouts, all in much smaller quantities. I still eat salad, but it produces a lot of gas, so I don't usually order it when I am out. My no-nos are mushrooms, beans (bad cramps), shrimp, and corn, which I love.

Try new things with just a few bites and see how you do. If all goes well, add an additional bite the next time. And... chew, chew, chew. I find if I grind up everything really well, I have better luck.

I am still in the discovery phase, and it takes a while. Be patient with yourself, and you can always reach out here if you need to vent.