DESPERATELY need dietary help for LOW-FIBER, LOW-FAT, HIGH-NUTRIENT diet! Please help me!

I desperately need dietary advice from anyone who has been in a similar situation...scroll down to skip history and get my specific dietary question.  Thanks!

I am experiencing only my 2nd severe flare-up with Crohn's, and have recently been released from a week long stay at the hospital.  I had been flaring for about a month, and was on antibiotics and steroids.  Nothing was helping, and my flare up was becoming worse seemingly daily.  A little over a week ago, I had to go to the ER with 103.3 fever and extreme pain.  They admitted me and over the course of the week ended up needing to give me a blood transfusion since I had been bleeding daily for a month with every bowel movement.  They also tried to control my Crohn's with a stronger steroid, antibiotics, the works.  Nothing was helping, and since I was scheduled to be getting my first dose of Remicade in a few days, they decided to give it to me in the hospital.  Within just 2 days my rectal bleeding had stopped and I started to feel better, so they released me.  I will be getting further Remicade soon.

My Crohn's personally is very very affected by fiber, so the whole time in the hospital and after I was released, I had been eating a very low fiber diet and feeling much better than before I went.  I've been drinking a boost in the morning for nutrients, plus I try to eat a lot of protein, and some fat for the calories.  My GI said to make smoothies with the boost, add some ice cream for calories, a banana for potassium/nutrients/light fat, etc.  I don't really eat any veggies or fruit (just while I'm flaring), unless they're low fiber like plain white soft potatoes. This was working excellently for me while in the hospital and after just being released, and along with the Remicade had turned my Crohn's from a nightmare to a simple annoyance of liquid (but no longer bloody and painful) stools. I was in heaven for a couple of days. (I was just released less than a week ago).

HOWEVER, in the week that I was in the hospital I lost 10 pounds, in addition to the 20 I had just lost in the month I was flaring before being admitted.  I am now a 22 year old female, 5'5", 110 pounds, sometimes as low as 106.  The past few days my stool has turned yellow and become horrible, cramping, gassy, painful, and frequent, diarrhea.  I am also having severe back pain.  GI says I'm severely malnourished and that this plus rapid weight loss can cause problems with the gallbladder and stones.  I had an ultrasound but am waiting for the results.  Looked up all this information and found out that I likely do have a gallbladder problem, which the symptoms are made worse most by FAT in the diet.  I am now in the dilemma of having to eat a LOW-TO-NO FIBER, LOW-TO-NO-FAT, and HIGH NUTRITION diet!  I have no idea what to eat.  Pretty much any fiber hurts my Crohn's (left side), any fat hurts my gallbladder (right side and back), and not eating will only starve me more.  I need to eat! I HAVE to drink the boost in the morning, that's no fiber but 4 g fat.  Fat-free yogurt seems to be good as it has nutrients but no fiber or fat.  I can tolerate egg whites only, the yolks are too fatty.  After that I'm lost.  I can't have the bananas or the ice cream the GI suggested to add calories, because the fat is now affecting me.

Does anyone have any suggestions as to meals I can make or buy that are fiber-free, fat-free, with some kind of nutrition to help me gain nutrients and/or calories?  I've been eating hard candies simply for the calories, and I'm sure all the sugar will eventually make me sick.  I can't sit around eating egg whites and fat-free, fruit-free yogurt all day!! I'm so bored with it that it makes me not hungry at all, and then I can't eat and become dizzy and faint, think I'm going to die of malnutrition but I just can't eat another stupid egg white.

PLEASE HELP!!!!

[boron]

Phone for results of ultrasound. You have to resolve your eventual gallbladder issue. Yellow diarrhea speaks for blockage within the bile system (probably from small stones or sludge). If ultrasound will be negative, get an order for a HIDA scan as soon as possible.

Carbohydrate/protein diet:
- low fat milk products (not only yogurts);
- soy juices or tofu (low-fat);
- polenta (look for low fiber, processed, "instant" polenta, cooking time 2-3 minutes)
- potatoes: do not cook them, but prepare them in the vapour. Cut them on small cubes, an put them onto the perforated plate over the pot with a boiled water - 10 minutes and you get delicios full-taste potatoes with all the potassium retained.

Search for a list of foods with mostly soluble fibers. Examples: rice, pasta, noodles. Maybe you can try with cooked bananas or apple sauce - these way fibers should be much easier to digest.

[IshtarLHP]

HI.  I am 43, 5'1", currently about 105 pounds (I should be about 130), about 6 years post gastric bypass-I was at 275 pounds- (they removed the Chron's damaged section of intestine during the surgery).  I have a good source for high quality protien powder (www.vitalady.com) and one of the good Drs supplied a pancreas gallbladder friendly diet and guidelines.  I am currently uninsured and waiting for either a lawsuit against the 1st hospital to come through or to get near the top of the waiting list for the county hospital (LA County) for a surgeon to remove the gallbladder, when its gone I can work on the other health issues.

Suggested Diet
Breakfast
Fruit : Orange juice (to acid unless its really freshly squeezed), stewed dried peaches or apricots, prune juice.
Cereal : Oatmeal, cream of wheat, wheatena, hominy, cream of barley, whle grain cereals, grapenuts, milk (NOT CREAM OR HALF AND HALF) and sugar, sparingly.
Bread : Toasted white bread, whle wheat bread, crackers, rolls, jelly or honey.
Beverage : Skimmed milk, postum, Kaffee Hag (I still don't know what it is), weak tea or coffee (decaf).  At least one glass of water.
Mid-Morning
Glass of milk (skimmed) or fruit juice.
Noon Meal
Soup : Chicken broth with rice or noodles, consumme, bouillon, broths.  Avoid grease or fat.  The gallbladder cannot distinguish between the "good fats" and the "bad fats".
Vegetagles : Choice of one starchy vegetable (potato, spaghetti, macaroni, rice) and one of two green vegetables (peas, spinach, squash, carrots, beets, tomattoes, green beans, lima beans - no butter sauce - .
Bread : Bread (as mentioned before) and small abount of jelly or honey.
Beverage : Weak tea or glass or skimmed milk.
Salads : Lettuce, celery (remove ribs) - no mayonnaise or oil dressings.
Mid-Afternoon
Same as Mid-Morning.
Evening Meal
First Course : Strained vegetable or thin soup without grease, or fruit juice
Meats : Broiled or roast lamb, white meat of chicken or turkey, squab, tender lean beef, broiled or baked white fish (perch, cod, flounder). AVOID FAT.
Vegetables : Same as lunch.  Any two.
Dessert : Any pudding free from egg yolk, cooked fruits, banana, pears, melon, water ices, angle food or sponge cake, gelatine or jello.
Bevrage : Same as breakfast.
Before Retiring
Same as Mid-Morning.

AVOID : Fats, greases,  salad dressings, oils fried food, gravies, butter, cream, rare meat (still haven't figured out this one yet), egg yolk, mackerel or blue fish, brains, sweetbreads, pastry, cookies, CHOCOLATE IN ANY FORM, corn, nuts, alligator pear, pork, backon, kidney, alsohol kohlrabi, cabbage, radishes, cucumbers, sauerkraut, turnips, broccoli, brussel sprouts, onions, navy beans, bananas (? apparent conflict here), avocados.

OKs : (in moderation, blah, blah, blah...) pineapple, soy products, tofu, tempeh, veggie sprouts (? another apparent conflict here), soy sprouts, soy milk (even the faux chocolate stuff).

I hope this helps.  I am adding and subtracting so it is still a work in progress- like the bananna and veggie sprout conflict.

In my own story I am search of a rabid shark type lawer willing to take this on contingency.  The 1st hospital had a wonderful social worker who had a bed and surgeon secured at a county hospital back in July, all of this would have been over, but a PA with delusions of grandeur cancelled the transfer and arranged for my discharge without a real Doctor ever seeing me.  Now, 3 months, 4 blood transfusions, and 3 hospitalizations though the ER, and over $100K in bills later, I still have a bad gall bladder, major pain issues and no end in sight.

Michelle,
I hope that this helps with your troubles,
Ishtar