Gastroparesis

Gastroparesis means disturbed stomach motility, where the stomach loses it’s ability to empty into the duodenum. Symptoms range from mild to serious and can last for a shorter or longer period of time. Gastroparesis results in vomiting, epigastric pain, feeling of fullness and early satiety, abdominal distension and weight loss.

There is a lack of studies that examine what foods are better tolerated, so here we mention the most important guidelines for nutrition.

The volume of food – Avoid heavy meals. Abundant meals are slowly emptied from the stomach, thus it is very important to reduce the amount of food in a single meal. Eat more often and take 6-8 small meals throughout the day.

Food consistency – It is better to consume more liquids, soft and mashed foods. The blender can be used often. Semi-liquid foods will empty the stomach faster. Avoid foods that are solid and very fatty. In any case, the food eaten must be chewed well.

Fiber (from fruits, vegetables, grains) – Fiber may slow gastric emptying and quickly fill the stomach which leave less room for food that is better tolerated. Sometimes a bezoar forms – a mixture of fibers that is stuck in the stomach. For patients who have had a bezoar, it is very important to restrict fiber.

Fats – Fats can slow gastric emptying in some people, but most people tolerate fats in liquid meals. It is advisable to consume cow milk as well as plant derived milks, various milk drinks, milkshakes, and powdered nutritional supplements that are prepared with liquids. Unless fats cause problems, they should not be limited. Oils that are in liquid form are well tolerated and are excellent source of calories for those who have problems maintaining weight.

Maintaining weight – Patients need to set a target weight and eat enough calories to sustain it. Calories can be added to meals using powdered milk, it is good to replace low-fat milk with whole milk, and cream can be used to prepare soups, puddings, hot breakfast cereals, smoothies and milkshakes. Powdered supplements are a great source of calories and can be prepared with milk and juices.

Food choices – Always eat nutritious foods at the beginning of the meal, and then add “empty calories” such as candy, cakes, soft drinks.

Posture – Sit upright when eating, and also stay upright for at least an hour after the meal. It is desirable to take a walk after the meal.

Diabetes – For people with diabetes, it is important to keep glucose under control, which should not exceed 11 mmol/l. Elevated glucose levels can cause gastroparesis, therefore diabetic gastroparesis is not rare in untreated and badly treated diabetics.

Liquids – Consume adequate amounts of liquids, take medications with milk, juice or sweetened tea instead of water. Water is fine of course, but if the person needs to increase energy intake, it is better to choose caloric beverages: juice, fruit nectar, lemonade, sweetened tea, and even  soft drinks sometimes.

Source:
Gastroparesis diet tips. University of Virginia, Digestive Health Center. July 2014.