GASTROPARESIS
Gastroparesis, or delayed stomach emptying, is a disabling motility disease. It happens when nerves to the stomach are damaged or stop working. When the main nerve (vagus) is not working properly, the movement of food is slowed or stopped. This disorder may cause:
- Nausea and vomiting
- Heartburn
- Bloating and belching
- Feeling full quickly
- Decreased appetite
- Weight loss
- Feeling tired
- Blood glucose (sugar) fluctuations
Gastroparesis interferes with your ability to grind, mix, and digest your food properly. These guidelines may help reduce the side effects:
- Consume small, frequent meals, four to six times/day
- Limit fiber foods to 10 grams (g)/day, avoiding:
- Foods such as cabbage and broccoli, which tend to stay in the stomach
- High-fiber foods, when you have severe symptoms
- Eat low-fat foods, and avoid foods high in fat—fats, including vegetable oils, naturally cause a delay in stomach emptying
- Choose nutritional supplements with ®, Glucerna®, Carnation® Instant Breakfast®, and Slim-Fast®)
- Chew food thoroughly; sometimes ground or pureed meats are tolerated better
- Do not lie down for at least 1 hour after meals
- Consume most liquids between meals
- Try to keep a daily routine—stress can bring on or worsen symptoms
- Pay attention to symptoms—sometimes taking a slow-paced walk can help
- Keep a food record of foods that cause distress, and try to avoid those foods
- Review all medications and over-the-counter products with your doctor—some medications can slow down digestion
- Focus on meals that have little odor, if food odors trigger nausea; try foods such as:
- Cold foods and cold sandwiches
- Foods that are grilled outdoors
- Avoid the following, which can irritate the lining of the stomach and result in acid reflux:
- Smoking
- Alcohol
- Caffeine
- Spicy foods
- Mint
- Keep your blood sugar under control, if you have diabetes, and let your doctor know if your blood sugar consistently runs higher than 200
Treatment of gastroparesis
Treating gastroparesis depends on the frequency and severity of symptoms. Four stages of treatment are outlined in this section, but work with your doctor and/or dietitian for specific recommendations.
Stage 1: Liquids
Liquids usually leave the stomach rapidly by gravity alone. Consume any tolerated liquids slowly throughout the day with plain saltine crackers.
Stage 2: Blenderized foods
You can puree Stage 3 and Stage 4 foods in your blender. You may need to add some liquid when blending solid foods.
Stage 3: Soft, low-fat and low-fiber foods
This stage starts to include a small amount of fat—
Stage 4: Solid, low-fat and low-fiber foods
This is intended for long-term maintenance. Fat is limited to 50 g/day, and fibrous foods are avoided, because you can not digest many plant fibers.
Foods for Stage 3
Food group | Recommended | Limit |
Breads or starches | Cream of Wheat®, pasta, white rice, egg noodles, and low-fat crackers | Oatmeal and whole-grain rice, cereals, and breads |
Fruits | Canned fruits without skins, apple juice, cranberry juice, grape juice, and prune juice | All fresh and dried fruits, canned fruits with skins, and citrus juices |
Vegetables | Vegetable juice and well-cooked vegetables without skins | All raw vegetables, cooked vegetables with skins, broccoli, brussels sprouts, cabbage, cauliflower, celery, corn, onion, peas, and sauerkraut |
Milk products | Yogurt, low-fat cheese, skim milk, and products made with skim milk | Whole milk, creams, and half-and-half |
Soups | Fat-free bouillon, soups made from skim milk, and broths with pasta, noodles, and allowed vegetables | Soups made with heavy cream or whole milk and broths containing fat |
Desserts and sweets | Hard candies, caramels, pudding and custards made from skim milk, frozen yogurt, fruit ice, gelatin, ice milk, jelly, honey, and syrups | High-fat desserts (cakes, pies, cookies, pastries, and ice cream) and fruit preserves |
Fats and oils | Any type of fat in small amounts | None |
Meats, eggs, and legumes | Eggs, peanut butter (2 tablespoons [Tbsp]/day) | Beef, poultry, pork, dried peas, beans, and lentils |
Foods for Stage 4
Food group | Recommended | Limit |
Breads or starches | All not listed in “limit” column | High-fiber, whole-grain breads and cereals |
Fruits | All fruits and juices not listed in “limit” column | Fruits with skins, raspberries, strawberries, blackberries, coconut, and figs |
Vegetables | Vegetable juices, well-cooked vegetables, and raw vegetables not listed in “limit” column, chewed well | Raw vegetables with skins, cabbage, broccoli, brussels sprouts, celery, and pea pods |
Milk products | Yogurt, low-fat cheese, skim milk, and products made with skim milk | Whole milk, creams, and half-and-half |
Soups | Any tolerated | None |
Desserts and sweets | Hard candies, caramels, pudding and custards made from skim milk, frozen yogurt, fruit ice, gelatin, ice milk, jelly, honey, and syrups | High-fat desserts (cakes, cookies, ice cream, pastries, and pies) and fruit preserves |
Fats and oils | Any tolerated, in small amounts | None |
Meats, eggs, and legumes | Eggs, peanut butter, poultry, fish, and lean ground beef | Fibrous meats (steaks, roasts, and chops), dried beans, peas, and lentils |
Sample meal plan for Stage 4
Breakfast
1 cup (C) Cream of Wheat
One slice white toast
1 Tbsp Peanut Butter
Morning snack
6 ounces (oz) low-fat yogurt
One half of a banana
Lunch
8 fluid ounce (fl oz) nutritional drink*
½ C pasta
1 Tbsp fat-free Parmesan cheese
1 Tbsp low-fat butter
Afternoon snack
½ C canned peaches
¼ C low-fat cottage cheese
Dinner
2 oz chicken or fish
½ C cooked squash
½-1 C mashed potatoes
Evening snack
1 C low-fat pudding or frozen yogurt
Total calories: 1630
Total fiber: 10 g
Total fat: 49 g
Total protein: 71 g
Beverages between meals
Choose from the following:
▪ Vegetable juice
▪ Crystal Light®
▪ Water mixed with fruit juice
▪ Nutritional drink supplements, if needed (examples: Ensure, Glucerna, Carnation Instant Breakfast, Slim-Fast)
References
Jackson Seigelbaum Gastroenterology. Gastroparesis diet for delayed stomach emptying. Available at http://www.gicare.com/pated/edtgs08.htm. Accessed September 29, 2008.
National Digestive Diseases Information Clearinghouse. Gastroparesis. Available at http://digestive.niddk.nih.gov/ddiseases/pubs/gastroparesis/ Accessed September 29, 2008.
Parrish CR. What to eat, idiopathics: food suggestions and tips for people who have idiopathic gastroparesis or delayed emptying of the stomach. Available at http://www.digestivedistress.com:80/main/page.php?page_id=27 . Accessed September 29, 2008.
