What are the guidelines for a bland diet for patients?

Bland Diet Information for Patients

A bland diet consists primarily of easily digestible, low-fiber foods including bananas, rice, applesauce, and toast (BRAT diet), which is specifically recommended for managing gastrointestinal symptoms such as diarrhea. 1

Core Components of a Bland Diet

The BRAT diet forms the foundation of bland diet recommendations and includes:

• Bananas: Help thicken stool output and provide potassium replacement, which is often depleted during diarrhea 1, 2
• Rice: White rice is preferred as it helps thicken output and is easily digestible 1
• Applesauce: Provides gentle nutrition without irritating the digestive tract 1
• Toast/White bread: Low-fiber option that helps thicken stool and is well-tolerated 1

Additional bland foods that can be incorporated include:

• Mashed potatoes: Help thicken output and are easily digestible 1
• Pasta: Plain pasta without heavy sauces is well-tolerated 1
• Marshmallows or jelly: Can help thicken stool output 1

Eating Pattern Recommendations

Consume small, frequent meals instead of large meals to reduce digestive burden and minimize gastrointestinal irritation. 2

• Eat slowly and chew food thoroughly to aid digestion and reduce risk of irritation 2
• Avoid eating during acute symptoms of nausea or severe abdominal pain 1

Hydration Guidelines

Maintain adequate fluid intake of at least 1.5 liters daily, increasing intake if experiencing diarrhea or vomiting. 2

• Drink fluids 30 minutes before or after meals, not during meals 2
• Avoid carbonated beverages to reduce gas and discomfort 2
• Consider oral rehydration solutions if diarrhea is severe 1

Foods to Avoid During Acute Symptoms

Eliminate high-fiber, fatty, spicy, and processed foods during the acute phase of gastrointestinal symptoms. 1

Specific foods to avoid include:

• High-fiber foods: Fruit and vegetable skins, sweetcorn, celery, nuts (whole), and fibrous vegetables 1
• Fatty foods: High-fat meals, fried foods, and excessive animal fats 3
• Spicy foods: Can exacerbate abdominal pain and discomfort 3
• Processed meats: May worsen symptoms and are generally not recommended 1
• Dairy products: May need to be limited initially, though low-fat options may be better tolerated 1
• Coffee and alcohol: Can increase gastrointestinal motility and worsen diarrhea 1

Duration and Transition

The bland diet should be temporary, used only during acute gastrointestinal symptoms, with gradual reintroduction of a varied, nutrient-dense diet as symptoms improve. 1

• Non-evidence-based self-directed exclusion diets should be discouraged as they can lead to nutrient deficiencies 1
• Once symptoms resolve, transition to a varied diet including fruits, vegetables, whole grains, lean proteins, and healthy fats 1

Important Caveats

Monitor for protein deficiency, as bland diets are often low in protein; ensure adequate protein intake of at least 0.8 g/kg body weight during recovery. 4

• Prolonged restrictive diets can lead to malnutrition and micronutrient deficiencies 1
• If symptoms persist beyond 3-5 days on a bland diet, medical evaluation is necessary to rule out underlying conditions 1
• The bland diet is not appropriate for long-term management of chronic gastrointestinal conditions without professional dietary guidance 1