Information for patients after abdominal and stoma surgery 

Around 7 in 10 people who have stoma surgery will get a parastomal hernia. This is when there is a bulge near the stoma. This can develop gradually, increasing in size over time. The hernia happens because the tummy muscles are made weaker during surgery when the bowel is brought through the muscle to make a stoma.

Parastomal hernias can make managing the stoma tricky. They can cause:

• The stoma to not work as well.
• Pain around the stoma.
• Discomfort when moving about.
• Difficulty fitting the stoma pouch because of the shape of the stoma - this may mean the pouch is not secure.

What to do before surgery to prevent hernias

How to help prevent hernias after surgery

From 8 weeks after surgery

Health factors that contribute to hernias developing

Breathing to reduce intra-abdominal pressure

The benefits of protein

Log roll technique to get in and out of bed

Exercises

From 3-4 days post-surgery up to 8 weeks

Tummy tightening breathing deep core-back

• Lie on your back, on the bed, or floor with your knees bent.
• Take a deep breath in.
• As you exhale, draw your abdominal muscles down towards your spine and ribs towards your pelvis.
• Hold this contraction for 2-3 seconds while still breathing. Then release and repeat 5 times.
• Slowly build up to holding the contraction for 10-15 seconds and repeat 5-10 times.

Deep core side

• Lie on your side with knees bent.
• Allow your stomach to drop toward the floor.
• Take a deep breath in and exhale, drawing your abdominal muscles in and towards your back, pulling your ribs toward your pelvis, and lifting your tummy away from the floor.
• Hold the contraction for 2-3 seconds then release and repeat 5 times.
• Slowly build up to holding the contraction for 10-15 seconds and repeat 5-10 times.

Pelvic tilt

• Lie on your back, on the bed/floor with your knees bent.
• Press your lower back into the bed or floor.
• Rock your pelvis up towards your head, feeling a tightening in your tummy and bottom muscles, slightly pulling your ribs and pelvis together.
• Hold the contraction for a second and return to the neutral position. Repeat 5 times - build to 20 repetitions.

 

From 7 days post-surgery

Knee rolls

• Lie on your back on the bed or floor with your knees bent.
• Keep your knees and thighs together, exhale. Slowly drop your knees as far as is comfortable, rotating your pelvis and hips to one side.
• Keep your shoulders fixed to the floor as you roll. Inhale and breathe normally, and hold the position for a few seconds. Drop your knees a little to start with, and work on increasing this over time.
• Exhale and return your knees up to the starting position, use your core muscles to draw them up slowly. Repeat on alternate side 10-15 times.

Seated knee lifts

• Sit toward the edge of a chair with your back straight and unsupported (not leaning back).
• Engage your deep core, pulling your tummy toward your spine and breathe normally. Lift one foot from the floor a short distance, hold for 2 seconds
• then return foot flat to the floor.
• Repeat 10-20 times on alternate sides. You can increase the height you raise your foot from the floor over time.

Hip bridge

• Exhale and pull your tummy toward your spine, tilt your pelvis toward your head and lift your tailbone off the floor. Raise up a short way pushing from your heels, curling up through your spine.
• Breathe in and normally, holding the position for 2 seconds.
• Exhale and slowly lower yourself curling your spine back to the floor, relax and repeat 10-15 times.

 

From 6-16 weeks

Leg slides

• Lie on your back on the bed/floor with knees bent up and core pulled toward your spine.
• Exhale and slide one foot slowly away from you straightening your leg and breathe in. Exhale and slowly draw your foot back to the starting position. Keep control of the core by pulling it towards your spine. Repeat on alternate sides 10-20 times.
• As you get stronger you could increase the intensity by raising the opposite arm to leg up, and rotating it back past your head to your ear. Move the arm and opposite leg at the same time.

Knee circles

• Lie on the bed/floor or sit in a chair with your back straight and unsupported, exhale, pull your core towards your spine to engage your deep core, breathe normally.
• Exhale and lift one knee to 90 degrees (right angle), breathe normally keeping the core engaged.
• Circle the leg making a clear movement to one side, towards the chest, towards the opposite knee and to the back completing a full circle.
• Lower the foot back to the floor and repeat on the opposite side, alternating 10-20 times.

Hip bridge and inner thigh squeeze

• Lie on the bed/floor with your knees bent up and place a small ball or rolled up towel between your knees and hold firmly.
• Exhale and pull your tummy towards your spine, tilt your pelvis towards your head and lift your tailbone off the floor. Raise your body up, curling your spine off the surface, pushing from your heels until your body runs straight from your head to your knees.
• Breathe in and normally, holding the position for 2-5 seconds. Exhale and lower your body back to the floor curling your spine flat. Repeat 15-20 times.

Half superman with arms

• Start on your hands and knees, making sure hands are positioned under your shoulders, and hips over your knees.
• Pull your core to your spine to engage your deep abdominal muscles.
• Slide one hand away from you, keeping your arm stretched out, until your hand just leaves the floor. Hold the position for 2-5 seconds and slowly return your hand to the starting position. Always keep control of your core.
• Repeat on alternate sides 15-20 times.

Half superman with legs

• Start on your hands and knees, making sure hands are positioned under your shoulders, and hips over your knees.
• Pull your core to your spine to engage your deep abdominal muscles.
• Slowly slide your foot away from you until your leg is straight and your foot lifts away from the floor. Hold this position for 2-5 seconds keeping your core engaged. Slowly return your foot back to the starting position.
• Repeat on alternate legs 15-20 times.

Standing knee lifts

• Stand tall with your back straight and core pulled towards your spine. Hold onto the back of a chair with one or both hands for stability if needed.
• Exhale and slowly lift one knee up as far as is comfortable, breathe out and normally while holding the position for 2-5 seconds, maintaining control of your core. Exhale and lower your foot to the floor.
• Repeat on alternate legs 15-20 times.
• To make this a little harder and if your balance is good – raise both arms above your head and proceed to lift one knee at a time alternately.

From 14+ weeks

Continue the previous exercises alongside these.

Toe tap

• Lie on the bed/floor or with your knees bent up and engage your core, pulling your tummy to the spine. Exhale and pull one knee up to 90 degrees (right angle) followed by the second knee.
• Breathe in, and on exhale tap one foot down to the floor while keeping the opposite leg still. Breathe in as you bring the leg back up and repeat on the opposite side.
• Repeat 5 to 20 times on each side.

Full superman

• Start on your hands and knees, making sure hands are positioned under your shoulders, and hips over your knees. Pull your core to your spine to engage your deep abdominal muscles.
• Slowly straighten out your right leg and left arm until both your foot and hand are off the floor. Start by raising a short distance off the floor and increasing this over time, if not able to lift parallel with the body to start with. Control your pose keeping the core engaged and not overextending the arm or leg.
• Hold the pose for a few seconds, increasing this over time.
• Return your arm and leg slowly to the start position and repeat on the opposite side.
• Repeat 20 times.

Recommended reading

• The bowel cancer recovery toolkit by Sarah Russell.

Further information and support

• Breathing and Movements For People With a Stoma including a video
• Information about parastomal hernias from Colostomy UK
• Video of the log roll technique
• Coloplast charter Core 4 abdominal exercises

© North Bristol NHS Trust. This edition published December 2025. Review due December 2028 NBT003636

What is sarcoidosis?

Sarcoidosis is a condition where lumps cause granulomas develop in different areas in the body. Granulomas are made up of clusters or cells involved in inflammation. If lots of granulomas form in an organ, they can stop the organ from working properly.

What causes sarcoidosis? 

The exact cause of sarcoidosis is not known but it probably involves a mixture of genetic and environmental factors. It can run in some families. So far, a single cause of sarcoidosis has not been found.

What parts of the body can be affected? 

• Sarcoidosis can affect many different parts of the body.
• The lungs and lymph glands in the chest are most commonly involved, affecting 9 in 10 patients with sarcoidosis.
• Other parts of the body that are often involved are the  skin, eyes, and lymph glands elsewhere in the body.
• Joints, muscles, and bones are involved in 1 in 5 patients.
• The nerves and nervous system are involved in about 1 in 20 patients.
• The heart is involved in about 1 in 50 patients.

What are the symptoms of sarcoidosis?

The symptoms of sarcoidosis depend on which part of the body is affected.

They can include:

• cough
• feeling breathless
• red or painful eyes
• swollen glands
• skin rashes
• pain in joints, muscles or bones
• numbness or weakness of the face, arms, or legs

Patients with sarcoidosis may feel tired and lethargic (fatigued), lose weight, or have fevers and night sweats.

Sometimes, the symptoms of sarcoidosis start suddenly and don’t last long. In other patients, the symptoms may develop gradually and last for many years. Some people don’t have any symptoms at all and are told they have sarcoidosis after having a routine chest X-ray or other investigations.

How is sarcoidosis diagnosed? 

There is no one specific test to diagnose sarcoidosis. The doctors will take a detailed medical history from you and do a physical exam. You may also have the following tests:

• Blood tests – to check your liver and kidney function, and calcium levels. We may also check a marker in your blood called Angiotestin-Converting Enzyme (ACE) - this is sometimes higher in patients with sarcoidosis. 
• ECG - a tracing of the electrical activity in your heart. 
• Chest X-ray
• Lung function tests – to see how well your lungs work. They can also monitor how your condition is progressing. 
• CT scan – this will give us a detailed picture of your lungs. The patterns on these pictures
• helps us work out if the disease is active or quiet.
• PET-CT scan – this scan can look for areas affected by sarcoidosis that might not be causing any symptoms.
• Biopsy – we may wish to remove a small piece of tissue to confirm the diagnosis. Where the biopsy will be depends on the area of your body affected; we will discuss this with you.
  Sarcoidosis can affect many different parts of the body, so your doctor may ask other specialists (who specialise in the part of your body affected by sarcoidosis) to look after you as well.

The outlook

Sarcoidosis gets better without treatment in most patients (around 60%). In others, the condition persists and may require some treatment. A small group of patients develop a more serious form of the disease which is more aggressive. This may need long term treatment.

Sometimes symptoms may suddenly get worse - this is known as a ‘flare-up’. This may be triggered by stress, infections, a change in environment, or often something unknown. 

A much smaller group of patients develop permanent scarring of their lungs (called pulmonary fibrosis).

How is sarcoidosis treated?

Treatment may be required for patients whose sarcoidosis is causing severe symptoms or is preventing the affected organ(s) from working normally.

Medications

Steroids are produced naturally in the body by the adrenal gland. An additional steroid in the form of prednisolone can be given by your specialist to attempt to treat your sarcoid. 

They are usually given in tablet form but may be given by injection into a vein. If you take steroid tablets on a long-term basis, you should not stop them suddenly.

You will be given a ‘steroid emergency card’ which you should always carry with you.
Your specialist may also check if you need treatment against some side effects of steroids such as bone protection medication and anti-reflux treatment. 

Sometimes steroids may not be completely effective, or cause side effects. Other medications may be used, either alone or in combination, to help reduce the steroid dose. These are often called ‘immunosuppressive’ or ‘steroid- sparing’ medications. Methotrexate, Mycophenolate mofetil, and azathioprine are commonly used. We may use methotrexate on its own (without steroids) as a first treatment for some patients too.

Whilst you are taking immunosuppressant medication you will require regular blood tests to monitor your response to the treatment.

Clinical trials

You can ask about clinical trials which test new treatments. Joining is voluntary.

How can I help myself?

• Have your seasonal vaccinations (COVID-19 and flu) and the pneumonia vaccination (only once). 
• You may be eligible for benefits like PIP (Personal Independence Payment) if you need help with personal care or getting about.  
• Our specialist nurses runs a regular Pulmonary Fibrosis Support Group which is a space for discussion with other patients with similar lung conditions. Here we also aim to have presentations from a variety of guest speakers and charities.
• Keep active and do what you enjoy!

Resources

Sarcoidosis UK charity
SarcoidosisUK - Information, Support, Awareness & Research

Asthma and Lung UK
Asthma + Lung UK

Action for pulmonary fibrosis
www.actionpf.Home

Date published: 11 June 2026 Review due: 30 June 2029 PI number: BFT002701
 

The clinical service is staffed with 8 Consultant Haematologists for interpretation and advice.  The technical and clinical service is provided by Biomedical Scientists (BMS), Clinical Scientists (CS), Associate Practitioners (AP) and Medical Laboratory Assistants (MLA).  In 2024 the laboratory processed 600,000 full blood counts, 250, 000 HbA1Cs & 100,000 clotting requests, with 10% growth each year. Haemoglobinopathy testing is also undertaken, including sickle cell and thalassaemia (SCT) screening for the antenatal and newborn programmes.

The Blood Transfusion laboratory issued over 13,000 blood components and processed 50,000 group and save samples. It also supports the Adult Major Trauma Centre at NBT and provides blood components to two air ambulances for the prehospital setting.  

The department has been approved for BMS training by the IBMS and our Trainee BMS staff are trained in accordance with the IBMS and HCPC regulations. Our qualified staff (CS and BMS) are required to be registered with HCPC. The department is also accredited to train staff undertaking the STP and HSST programmes with the National Science Healthcare school.  There is active encouragement for staff to follow further education courses, such as MSc (Haematology) and management qualifications.

The Department has a dedicated Quality Manager who is responsible for maintaining accreditation and compliance to ISO 15189 and BSQR (https://www.nbt.nhs.uk/severn-pathology/quality/pathology-accreditation-status) . The department participates in all appropriate External Quality Assurance Schemes accredited to ISO 17043 (https://www.nbt.nhs.uk/severn-pathology/quality/external-quality-assurance) for which performance is closely monitored.

Clinical Head of Service
Dr Alastair Whiteway

Blood Sciences Services Manager
Mr Alan Noel

Blood Sciences Operations Manager
Mrs Ellen Roberts

Antenatal and Newborn Screening for Sickle and Thalassaemia (SCT)

Background:

Haemoglobinopathies are a group of inherited blood disorders that fall into two main categories: haemoglobin variants, such as sickle cell, and thalassaemias. If a person is a carrier of the sickle cell or thalassaemia gene it can be passed onto the baby. All pregnant people in England who have accepted screening will have laboratory testing for haemoglobin variants and thalassaemia. If the mother is found to be a carrier, screening may also be offered to the father. 

Haematology Department:

The department of Haematology provides a Sickle Cell and Thalassaemia (SCT) Screening service for antenatal patients in North Bristol and offers a confirmatory service for the newborn screening provided by Clinical Biochemistry. For further information on newborn blood spot testing please see the following page (newborn-screening).

The SCT screening provided by the laboratory follows the government’s published  handbook for antenatal laboratories and handbook for newborn laboratories which set out interpretation and reporting guidelines, including which types of sickle and thalassaemia carrier states to report.
SCT testing on antenatal patients is undertaken on whole blood samples taken at booking, preferably before 10 weeks gestation. This allows for prenatal diagnosis (PND) to be offered to at risk women and couples by 12 weeks + 6 days of pregnancy. Early detection of SCT through screening allows for personal informed choice, timely counselling, clinical monitoring and preparation for those patients identified as having an “at risk” pregnancy.

As well as the general sample labelling requirements, it’s also necessary for the patients’ family origin questionnaire (FOQ) to be completed either on the reverse of the antenatal form or by following prompts when requesting on ICE. Our UKAS accredited laboratory currently screens approximately 7,000 pregnant people each year and confirms results for approximately 500 babies for the newborn screening laboratory.

The SCT screening programme is provided in close collaboration with health care professionals throughout the region
 

Analysis:

Initial screening is performed on our primary analyser using capillary electrophoresis (CE). 

Abnormal samples are then reanalysed using isoelectric focussing (IEF). IEF separates the proteins into bands allowing our skilled biomedical scientists to identify the types of haemoglobins.    

Quality Assurance:

Turnaround times (TATs), standards and key performance indicators (KPIs) are used to continually monitor the performance of the laboratory service.

The laboratory is accredited by UKAS under ISO15189 registration number 8066 and participates in UK NEQAS Quality Assurance Scheme.

Screening laboratories must be able to release > 90% of antenatal results, interim reports and requests for repeat tests in < 3 working days in accordance with SCT screening standards.

Developments:

We report our rare, affected babies (those with suspected severe disease) on a named patient basis, and this is to the newborn outcomes solution (which reports to NCARDRS)

https://www.gov.uk/government/publications/sickle-cell-and-thalassaemia-screening-newborn-outcomes-system/sct-newborn-outcomes-system-overview#national-congenital-anomaly-and-rare-disease-registration-service-ncardrs
https://nww.mdsas.nhs.uk/Newborn/

All patient leaflets are held centrally and are available on the government website: 
https://www.gov.uk/government/collections/screening-in-pregnancy-information-leaflets#sickle-cell-and-thalassaemia

Laboratory Visits:

We offer half-day training sessions to midwives, health visitors, nurses, doctors and other allied healthcare professionals involved in the collection of samples. Please contact us to arrange a visit.

Please see below  for responses to our most recent survey

Key Contacts for Haematology Laboratory

Dr Sophie Otton
Clinical Lead for SCT & Consultant Haematologist 
Via Haematology secretaries - Telephone: 0117 414 8401

Reginah Visser
Principal Clinical Scientist 

Jemma Cable
Clinical Scientist

Grace Van Der Mee
Lead Biomedical Scientist

Helen Izzard
Senior Biomedical Scientist

Pathology Sciences Laboratory
Southmead Hospital
Westbury-on-Trym
Bristol
BS10 5NB
Email: NBTHaemoglobinopathyService@nbt.nhs.uk
Telephone: 0117 414 7121 / 0117 414 8356

Opening times: 9am - 5pm Monday - Friday excluding bank holidays.

Clinical advice & interpretation is available during working hours.

Q-Pulse Ref HA/WE/008 V3

Information for Healthcare Professionals

If babies are born before 32 weeks gestation or are admitted to a hospital specialist unit for other reasons, extra blood spot samples may be required to carry out the newborn screening tests. 

To ensure preterm infants are appropriately screened for CHT, all babies born at less than 32 weeks (less than or equal to 31 weeks + 6 days) should be offered a preterm repeat test at 28 days of age or discharge home, whichever is the sooner.

Babies less than 5 days of age should have a single circle bloodspot sample taken on admission/prior to blood transfusion to screen for SCD. The bloodspot card should be marked 'Pre-transfusion'.

Detailed instructions regarding sample collection from babies in specialist units can be found on pages 23-26 of 'Guidelines for Newborn Bloodspot Sampling'.

Access to Results

Designated clinicians will be informed immediately of any 'Suspected' results.

Certain healthcare professionals may access results via the Failsafe IT solution. If you are concerned that a baby has missed screening or that a sample has not arrived in the laboratory, please telephone or email us. Samples usually take several days to reach us in the post, although this is faster if a courier is used. One working day after they have been entered on our computer system they will appear on the failsafe shown as 'pending', these samples are undergoing analysis.

Please use the NHS number to search for babies, checking that the address shown matches your records as many babies have similar names, very similar dates of birth and surnames often change in the first few weeks of life.

Labelling the blood spot card

Points to remember:

• It is ESSENTIAL that the blood spot card is completed correctly with all the details of the baby whose blood is collected (including the NHS number). Samples received without an NHS number will not be processed.
• These details must be filled in BEFORE the heel prick is carried out, to make sure there is no chance of a mix-up.
• If there is an indication that any incorrect information may have been provided on a bloodspot card, you must inform the laboratory immediately.
• Do not assume that printed labels in the baby's child health record are accurate, it is important to check the details each time you use them.
• There is no need to indicate whether the baby is breastfeeding or bottle-feeding.

Information for parents

The NHS Newborn Blood Spot Test website includes information about each condition, FAQ's and links to further information.

The Screening Tests for You and Your Baby leaflet contains information about the blood spot screening test and the conditions it screens for. It is available in other languages.

Find out what happens to your baby's blood spot card.

Collecting the sample

A full guideline and quick reference guide are available here.

e-Learning for Healthcare has developed an e-learning module to support midwives and other sample takes in obtaining good quality newborn blood spot samples: https://www.e-lfh.org.uk/programmes/nhs-screening-programmes/

 of an acceptable quality sample, with correctly completed details. 

Transportation

The blood spots should be allowed to air-dry thoroughly, away from direct sunlight before placing in the transparent paper (Glassine) envelope provided (not plastic as this may cause the specimen to 'sweat') and sent, by first class post or courier on the day of collection, in a sturdy envelope.  If not possible, despatch within 24 hours of taking the sample. Despatch should not be delayed in order to batch cards together for postage.

 Clinical Guidelines

For guidance on hyperlipidaemia treatment guidelines and monitoring patients on lipid lowering therapy please see advice on Remedy

BNSSG Adult Vitamin D Prescribing Guidance

Blood Tests

Urine and Other Tests

• Biochemistry in Primary Care
• Clinical Updates
• General Biochemistry
• Endocrine investigations
• Toxicology and TDM
• Inherited Metabolic Disease

We are trialing Ambient Voice Technology in some Outpatient appointments 

From March 2026, we are running a 12-month trial of Ambient Voice Technology (AVT) in some of our Outpatient appointments. 

Ambient Voice Technology (AVT) is like having a smart helper that, with your permission, listens to you and your clinician’s conversation during your consultation, automatically turning the conversation into notes.   

This trial is starting with a small number of clinicians in Gynaecology, Urology, Neurology, Gastroenterology and Hepatology Outpatient clinics. 

If your clinic has the option to use AVT, you will be informed at the start of your appointment. We will only use AVT with your consent. If you choose not to consent to the use of AVT, your appointment will continue as normal. 

What is AVT?

AVT is a smart tool that helps your healthcare team take notes during your appointment. 

• It only listens to what you and your clinician talk about if you give consent, and it never records. 
• It captures your conversation in real time and turns it into notes and letters for your health record.  
• Your clinician checks everything to make sure it’s correct. 

You might have seen something like this if you’ve ever talked to your phone, used voice commands in a car, or asked a smart speaker to do something. 

What will happen if you say yes to AVT? 

• A microphone, mobile device, or laptop will listen to what you and your clinician say during your appointment.  
• Your appointment will feel the same, but your clinician won’t need to type as much – they can focus more on you.  
• The AVT captures your words into text straight away and creates a summary and clinic letter.   
• After your appointment, your clinician checks the notes and letters to make sure they are correct before adding them to your health record. 

Why are we trialing AVT? 

We want to see if AVT helps our patients and clinical teams. 

• It lets clinicians spend more time talking to you instead of typing notes. 
• It writes while you talk in real time, so your health records are more accurate and ready faster. 
• This could mean letters or referrals get sent to your GP or other healthcare services more quickly after your appointment. 

Your privacy is really important. At the start of your appointment, your clinician will tell you if AVT is an option. You can choose to have your appointment with or without AVT. 

Your information is always encrypted and securely handled meeting GDPR and NHS standards. Only authorised staff at the hospital access it.

Do you store recordings of my appointment?

Can I choose not to have AVT during my appointment?

Who can I contact if I have questions about AVT before my appointment?

More information

For details on how we collect, use and store personal information, including data collected via digital tools in outpatient settings, please visit our Privacy Policy and Data Protection webpage.

Introduction

You have been asked to follow a low insoluble fibre diet. This can help improve symptoms, give your bowel time to rest after surgery, or help prevent a blockage in your bowel. 

You may only need this diet for a short time. If your doctor says you need to follow it for longer than a month, we might suggest taking a daily multivitamin to make sure you get all the nutrients you need. 

If you have any questions or worries about this diet, ask your doctor or healthcare professional.

Types of fibre

There are different types of fibre in the foods we eat. The two main types are called "soluble fibre" and "insoluble fibre."

Soluble fibre

Soluble fibre mixes with water in your gut and turns into a gel-like substance that your gut bacteria can break down. It can help with both diarrhoea and constipation. Soluble fibre is usually safe for you to eat.

Here are some examples of foods with soluble fibre:

• Milled or ground oats, like Quaker Oat So Simple or Ready Brek.
• Fruit without the peel, seeds, or skin.
• Vegetables without the peel, seeds, or skin.

Insoluble fibre

Insoluble fiber is the "roughage" in our food. It does not get broken down by our body and helps make our stools bigger and easier to pass.

Here are some examples of foods with insoluble fiber:

• Wholegrain foods like brown or seeded bread, cereal, rice, pasta, and couscous.
• Skins of vegetables, fruits, beans, and pulses
• Pith, seeds, and stringy parts of fruits and vegetables.
• Nuts and seeds.
• Salad and leafy greens.

Removing insoluble fibre

Many foods, like some fruits, vegetables, beans, and lentils, have both soluble and insoluble fibre. To make these foods easier for you to eat, you need to remove the insoluble fibre.

Here’s how you can do that:

• Peel the skins and cook vegetables until they’re soft.
• Peel the skins and stew fruits until they’re soft.
• Peel and remove seeds, then blend vegetables into a smooth soup or sauce, or fruits into a smoothie.
• If you can’t peel or remove seeds, blend the fruit or vegetable and then use a sieve to strain out the “bits”.

Recommended foods and foods to watch

Meal ideas

Tips 

• High insoluble fibre foods include:
  • Nuts
  • Pips
  • Piths
  • Seeds
  • Skins on fruits and vegetables
  • Wholemeal/grain
  • Leaves
• If you cannot peel a fruit or vegetable, like raspberries, they’re not suitable - unless blended into a smooth consistency. Sieve any remaining bits out.
• Prepare a sauce as usual (e.g. with onions, garlic, peppers), then blend and sieve to remove large bits. Cook meat or meat alternatives separately, then add the blended sauce.
• Blend onions, garlic, and ginger, then freeze in portions using an ice cube tray to add to meals later.
• Batch freeze peeled vegetables to save time later.
• Onion, garlic, and ginger powder can be used instead of whole onions, garlic, or ginger.
• Salad alternatives:
  • Cooled white pasta with smooth pesto or a smooth tomato sauce (such as passata).
  • White rice or couscous with peeled and roasted root vegetables.
  • Peeled white or sweet potato salad with a smooth dressing.
  • Add protein like cheese (such as feta, halloumi) or egg.

© North Bristol NHS Trust. This edition published January 2025. Review due January 2028. NBT003820