Fiber Dilemma - High or Low?

So here is the dilemma,
I have had colorectal cancer, they got it all in remission. A stoma and stoma reversal and have been told by my oncologist I should eat a high fiber diet. I also have IBD Crohn's and have been told to eat a low fiber diet by my IBD consultant.

If I eat high fiber, I get lots of gas and bloating and pain. If I eat low fiber, I get constipation and need to take lactulose.
The stoma reversal was only 3 weeks ago and I don't want to put any undue pressure on my bowel. Any suggestions?
Sunny x

When I had one of my reversals, I was told high fiber. But yeah, I have Crohn's too and found myself in your predicament. I think you're only 3 weeks post-op, that's not long darlz. Your body is still knitting itself together again. Hope in time all this settles down for you. It's always a tricky thing with reversals and depends on the condition you have... seems like both are kinda right. Try a mixture maybe! Sorry, I can't be of more help. Our bowels are very stubborn at times. Hope someone here can give you more info. Cheers, mooza. By the way, I had a few reversals but my ileo is here to stay. Hate it, love it, just want to live without those emergency loo runs. Arghhhh! xx mooza

I think it is crazy for your oncologist to recommend a high fiber diet right after a reversal. Go with whatever your surgeon and/or gastroenterologist recommends. I've had colostomy to reversal back to permanent colostomy and each time I had to start out on a low fiber diet (bland and easily digested). As time passes, you can begin to add new foods slowly to see how your new plumbing will react.

I found low fiber tropical fruits with enzymes (mango, papaya, pineapple) helped a lot, as well as yogurt if you are not lactose intolerant. Rice, bananas, white bread, cream of wheat or rice, puddings - you get the picture. Eventually, I could tolerate quite a few fibrous foods, but never refried beans.

A good product to help with gas is Beano or the new equivalent by Gas-X. Good luck!

Thank you Pinky, very helpful.
I am mostly eating white rice, chicken, white bread, and drinking yogurt. I have really been missing my fruit and will be off out tomorrow to get some mangoes and pineapple.
Thanks again.

Watch out for the pineapple. Several people have mentioned having trouble with the strings.

Staying Hydrated with an Ostomy with LeeAnne Hayden | Hollister

I had a colostomy reversal earlier this year and have been fine with most foods from almost immediately - the colostomy was for diverticular disease.
In your situation, I reckon I'd start off with plenty of water, bio yogurts, small quantities of fresh fruit and vegetables, white meat, eggs, and fish but would introduce beans and pulses (likely to cause wind) gradually as you recover. Your gut has rested but remains delicate. I still enjoy nuts despite advice by some that we shouldn't. I think the answer is that we are all individuals, so go for the things that you know you can manage first and then start the experimentation!
Good luck!

PS Go easy with pineapple, it contains papain which breaks down meaty tissue (it tenderizes meat), and you will have a wound in your gut for some weeks!

Speaking of "fiber," there are at least two different kinds of that stuff. The "good" one for heart disease prevention is the so-called "soluble fiber." And then there is the bulk fiber, which is what I think almost everyone thinks of when they hear or use the word "fiber".

I like them both, and since I'm a lot more worried about heart disease than farting (gas pains), I eat them both.

With a colostomy, I don't have (and never did have) any trouble with those veggies that cause gas. Simethicone (which is prescribed as a relief for those same gas pains) does not prevent gas, it just makes the tiny little foamy bubbles form into larger ones so that they don't "get stuck" and allows it to pass through (can you say fart on this list?). I've only had gas pains a couple of times in my life, and simethicone really did work for me.

But back to the fibers. Metamucil (trademark name for psyllium) is a great soluble fiber and should be no more problem than orange juice (which also has a lot of soluble fiber).

The bulk fibers just fill up a colon and help keep things moving. If you have problems with stuff like that, then just try to avoid them. And, finally, just as "our" nurse says, pineapple (as well as papaya) has papain in it, which digests protein (which is why it "tenderizes" meats -- it digests the connective tissues in the muscle), so it just might be a good idea to limit the amount you eat right after surgery. Oh, and pineapple and papaya, if used in jello, will digest the jello, too.

I hope that has helped you just a tiny bit.

NT

Hey, it's Marjorie from the Odyssey trip. Would have sent you a message but I'm not a full member. Glad to hear you had your reversal. I think it does need time and you know if you eat something and you have pain that you're not ready for it. Good luck with everything. Seasons greetings.

Yes, I agree with avoiding fresh pineapple - the worst blockage I've had was due to the same. I found cooked (or canned) fruits to be much more digestible at first with both ostomies and with the reversal in between. I also ate coconut with my reversal - in fact, had been advised somewhere that 2 coconut macaroons in the AM would prevent diarrhea or numerous stools, and I found this to be true. I can no longer eat it with the permanent ostomy!

Soluble fiber can be just as bad as insoluble. For example, oranges contain soluble fiber but the membrane around the fruit is not and is also a blockage hazard. I've learned to slice the orange lengthwise to minimize the membrane.

Hope this helps.

Thank you all who helped with this dilemma, I am much the wiser now!
I did not know about the soluble / non-soluble issue.
Right now I am living on drinking yogurt as the antibiotics they have given me to stop this mesh rejection have given me a bad tummy.
Just hope I don't need to go back in and have the mesh taken out and the pig skin put in, which is what they say is the next step if I don't heal up soon.
All positive thoughts / prayers gladly accepted.
Sunny x