Gastroparesis is a chronic medical condition that affects how quickly food can pass through the stomach into the digestive tract. The speed is delayed and can cause symptoms of nausea, vomiting, and general discomfort after eating. Medication or surgery may be required to alleviate the symptoms in extreme cases.
Making dietary changes can help too. Certain foods move faster through the digestive system and will be easier to tolerate. A registered dietitian who specializes in gastroparesis can help you navigate these changes.
In this article, you’ll learn what foods you should eat or avoid, and why working with a dietitian can help you create long-lasting results.
Signs and Symptoms of Gastroparesis
The symptoms of gastroparesis are very similar to other digestive health conditions, and the severity will vary per individual. Most people who have gastroparesis will experience
- Feeling full at the start of a meal.
- Feeling full for hours after eating.
- Chronic bloating.
- Poor appetite.
To properly get diagnosed, a physician must assess your medical history and complete a few screening tests. These might be gastroparesis scintigraphy or a breath test. They both assess how quickly food is moving through your digestive system.
In some cases, you may also be required to complete an endoscopy, which is a long flexible camera the medical team uses to see better what’s going on inside your esophagus.1
What Causes Gastroparesis
In the past, scientists thought gastroparesis was caused by a blockage in the stomach which prevented food from passing through. Modern technology and imaging devices have disproven this theory. For anyone suffering from gastroparesis, any delay in food transit has nothing to do with a blockage or obstruction.2
Now gastroparesis is known to be a neuromuscular condition. There is a powerful communication channel between your gut lining and your brain. Gut functionality can decrease when the nerves in the upper intestinal tract are damaged.2
People who have diabetes are at high risk for developing Gastroparesis. Unmanaged high blood sugars can stick to tissues, essential organs, and delicate nerve endings - impairing how they operate. Impaired nerves in the gut can not communicate clearly with the brain, and motility slows down.
Other Risk Factors For Gastroparesis
- Esophageal surgery.
- A viral infection called viral gastroparesis.
- Narcotic medications slow down gut motility.
- Other health conditions which affect nerve function, including Parkinson’s disease. 3
- Ethnicity may increase your risk for gastroparesis.
A review completed in 2020 found that African American patients with diabetes were the most likely to develop diabetes-related gastroparesis. Knowing this information should stress the importance of tighter blood sugar control for different ethnicities, especially if they are more
vulnerable to medical complications.4
Unfortunately, there are no known cures for gastroparesis. But, dietary changes can significantly improve symptoms and improve quality of life. If modifying your diet feels overwhelming, consider working with a dietitian. They have expert nutrition training and evidence-based tools to help you regain your health control.
Some people will require medication to treat their gastroparesis. These drugs help increase the motility rate in your stomach and keep things moving. These medications are called prokinetics, and common brand names include domperidone and metoclopramide.
Other medications may also be prescribed to help manage symptoms that make it harder to eat, such as chronic nausea. Implementing dietary changes can help decrease the severity of your symptoms. You may even be able to come off medications if you start to feel better using diet strategies.
Always consult with your doctor first before stopping a medication.
Health Risks of Gastroparesis
It is hard to eat enough food and get enough variety when constantly feeling nauseous and sick. This opens you up for potential nutrient deficiencies and even malnutrition. When you are malnourished, it is harder for your immune system to function, and you become more vulnerable to illnesses.
Gastroparesis weight loss exceeding 5% of your total weight in the last 6-8 months is classified as severe. You may lose muscle mass, have a decreased metabolism, and be at higher risk for developing gallstones. Here are some examples to demonstrate how to do this calculation:
- A person has a starting weight of 165 lbs. In three months, they have unintentionally lost 10 lbs.
- (10lbs/165lbs)*100 = (0.06)*100 = 6% weight loss, which is classified as severe.
- Another person has a starting weight of 215 lbs. In six months, they have unintentionally lost 5 lbs.
- (5lbs/215lbs)*100 = (0.02)*100 = 2% weight loss, which is not severe.
A doctor should formally assess severe weight loss. Other underlying health conditions, such as thyroid disorders or cancer, could be at play.
What to Eat When You Have Gastroparesis
Symptoms can ebb between fine and terrible. When you feel your worst, stick with a liquid-only diet void of fiber and fat. Those two nutrients are tough to break down and can sit in your stomach longer than normal.
There are three main phases of a gastroparesis diet. You should graduate through each phase as your symptoms improve:
- Phase 1 - Liquids only.
- Phase 2 - Mostly liquids and soft foods.
- Phase 3 - Soft foods, adding more fiber and fat slowly.
Below is a sample meal plan for the Phase 3 diet, which is the maintenance phase. If you want to learn more about specific foods, check out this article.
- 1 cup of oatmeal made with water
- 1 tbsp of peanut butter
- ½ banana sliced
- ½ meal replacement
- ½ cup white rice
- ½ cup sliced chicken breast
- 1 cup of cooked red pepper, zucchini, and onion.
- Teriyaki sauce
- ½ cup 2% Greek yogurt
- 1 tsp of honey
- 3 oz serving of salmon
- 1 tsp of olive oil
- 1 tsp of parmesan cheese
- ½ cup sweet potato
- ½ cup baked eggplant
- 2 tbsp smooth tomato sauce
- Smoothie with 2% Greek yogurt, 1 fresh skinless peach, ½ cup fruit juice
- ½ cup 2% cottage cheese
- ½ cup canned pineapple (in water)
- 4-6 saltine crackers
- ½ can of tuna in water
- 1 tsp low-fat mayonnaise
- ½ cup tomato soup with fresh dill and 1 tsp of low-fat sour cream.
- ½ meal replacement
- 2 scrambled eggs
- 1 slice of white bread
- 1 tsp of margarine
- ¾ cup chicken noodle soup
- 2 egg omelet
- 1 slice of white bread
- 1 tsp of low-fat cheddar cheese
- Canned apricots (in water)
- ½ meal replacement
- ¾ cup clear vegetable broth
- 1/2 cup ramen noodles
- 1 boiled egg
- Canned peaches (in water)
- ½ cup 2% Greek yogurt
- ½ cup honeydew melon
- 3 oz chicken breast
- 1 tsp of olive oil
- ½ cup boiled squash
- ½ cup zucchini and mushrooms
- 2 tsp zero fat salad dressing
Do I need to Follow a Liquid Diet?
Yes, a liquid diet should be followed if you are experiencing ongoing vomiting. This is phase 1 of a gastroparesis diet. High-calorie liquid drinks, such as a meal replacement, may be helpful when oral food is less tolerated. The energy-dense beverages contain a high concentration of vitamins, and every sip offers a lot of nutrition.
You should not follow a liquid diet for longer than three days. There aren’t enough calories or nutrients to sustain your long-term nutritional requirements. If your vomiting hasn’t settled after three days, consult a medical professional and go to the hospital.
What is Residue?
Residue in the digestive world refers to fiber. Sometimes people recovering from a gut flare-up or surgery are instructed to follow a “low-residue” diet. This means keeping your fiber intake low (<10-15g/day) because fiber stimulates the gut when it should be healing. The concept is similar to a sprained ankle: stay off the injury it can heal.
The fiber requirements increase as you move through each phase of the gastroparesis diet. Only add more high-fiber foods to your diet if you can tolerate them. Popular options include fruits, vegetables, nuts and seeds, legumes, and whole grains. Blending high-fiber foods into a smoothie can help you meet your nutrient requirements, and a liquid can be better tolerated.
Long-Term Diet Suggestions
As you make diet changes, you’ll quickly see which foods agree with you and which don’t. Keep a running list of these items so you don’t have to reinvent the wheel whenever you are hungry and unsure about what to eat.
Here are some other long-term diet suggestions to keep in mind:
- Warm and hot foods than to be easier to digest than cold foods. Choose more soups, chilis, and stews over cold meals.5
- Chewing is an important part of digestion. Taking time to chew your food properly can break it down into small, more manageable pieces for your stomach to digest.
- Eat small meals more frequently throughout the day than three large meals. You will probably have fewer symptoms, and your hunger may return quickly after eating.
- Alcohol slows down your gastric motility and should be eliminated from the diet. This includes all beers, wines, and spirits.6
- Some probiotics may help lessen bloating, which can be a common symptom of gastroparesis.
Easy Snacks To Keep On Hand
Meal planning can help you stay on top of your diet, but sometimes we all need a backup plan. Here are some easy snacks to keep on hand:
- No sugar-added applesauce.
- A package of plain rice crackers.
- Low-fat pudding desserts (for days when your sweet tooth hits).
- Nut butter can be easier to digest than whole nuts and seeds.
- Saltine crackers or pretzels for a savory treat.
- Canned fruits (in water).
Dining out can be very hard since you have limited control over the ingredients. Here are some tips on how to make this experience easier:
- Always ask for sauces, dressings, and gravy on the side.
- Ask for a takeout container right away and store a portion of your food for later.
- Choose baked, broiled, or grilled over anything pan-fried or deep-fried.
- Ask for water with meals because the gas from carbonated beverages can make you feel full.
- Choose lean protein sources such as fish filet, chicken breast, eggs, and shrimp or scallops.
Work With A Gastroparesis Dietitian
Following a gastroparesis diet can be unlike any other food recommendations you’ve been given. It is restrictive and doesn’t always line up with other health conditions, such as diabetes (which promotes a high-fiber diet).
A registered dietitian specializing in gastroparesis can help you navigate this new way of living and help you build a sustainable plan. Together you can find foods and textures that will help you feel better without feeling deprived or missing your favorite foods.
Nourish Can Help
Nourish has a team of dietitians who are expertly trained, compassionate, and rooting for your success! All appointments are done virtually, and every dietitian is covered by insurance. Click here to learn more and book an appointment.
- Camilleri, M., Chedid, V., Ford, A. C., Haruma, K., Horowitz, M., Jones, K. L., Low, P. A., Park, S. Y., Parkman, H. P., & Stanghellini, V. (2018). Gastroparesis. Nature reviews. Disease primers, 4(1), 41.
- Camilleri, M., Parkman, H. P., Shafi, M. A., Abell, T. L., Gerson, L., & American College of Gastroenterology (2013). Clinical guideline: management of gastroparesis. The American journal of gastroenterology, 108(1), 18–38.
- Barboza, J. L., Okun, M. S., & Moshiree, B. (2015). The treatment of gastroparesis, constipation and small intestinal bacterial overgrowth syndrome in patients with Parkinson's disease. Expert opinion on pharmacotherapy, 16(16), 2449–2464.
- Duffey, K., Hannon, M., Yoo, J., Perkons, N., Intenzo, C., Moleski, S., & DiMarino, A. J. (2020). The impact of risk factors on gastroparesis at an urban medical center. Annals of gastroenterology, 33(3), 250–256.
- Sun, W. M., Houghton, L. A., Read, N. W., Grundy, D. G., & Johnson, A. G. (1988). Effect of meal temperature on gastric emptying of liquids in man. Gut, 29(3), 302–305.
- Grad, S., Abenavoli, L., & Dumitrascu, D. L. (2016). The Effect of Alcohol on Gastrointestinal Motility. Reviews on recent clinical trials, 11(3), 191–195.
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