You ask the patient to take you through a normal day of eating (24-hour dietary recall).
She tells you the following information:
Breakfast: 2 pieces of gluten free sourdough toast, sometimes has jam or peanut butter on the toast
Lunch: Turkey sandwich on gluten free bread, dairy free cheese
Snack: Gluten free pretzels, peanut chocolate covered candies, trail mix
Dinner: Chicken and mashed potatoes
Dessert: Lactaid ice cream and peanut butter cup
Drinks: Soy milk, water, occasional soda
She notes that her diet is essentially the same everyday. She was previously eating more variety prior to her last bowel obstruction, but she was discharged home with instructions on following a low fiber diet and has successfully stuck with the diet for the last year. In addition, she has been told by other providers that gluten and dairy are inflammatory and therefore it is best to avoid them.
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