Gastroparesis

Gastroparesis means food empties too slowly from your stomach into your intestines. It is also often called “delayed gastric emptying.”

Gastroparesis affects each person in a different way. Food choices that may work for one person may not work for another. Consult with your dietitian to find foods that work best for you. They may also suggest supplements to help manage symptoms.

Causes

The most common cause is diabetes. Other causes may be abdominal surgery and nervous system diseases. Many medicines can also slow stomach emptying. In some people the cause is unclear.

Symptoms

• Feeling full soon after eating

• Bloating after a meal

• Nausea and vomiting

• Bad breath

• Weight loss

• Loss of appetite

• Abdominal pain

• Blood glucose that is hard to control
  

Treatment

Treatment depends on how severe your symptoms are. You may need to try one or more of these treatment options:

• Blood sugar control: Gastroparesis can result from or lead to poor blood sugar control. Ask your doctor if you need to check your blood sugars. High blood sugar levels can make symptoms worse.

• Medicines: Your doctor may suggest medicine which can help you feel better. Some medicines may be used
  to control nausea. Others can help the stomach empty more quickly. Ask your doctor for more information.

• Dietary and lifestyle changes: Changing your eating habits and food choices may prevent or decrease some of the symptoms. A dietitian can help you make these changes. You should also avoid or reduce alcohol smoking.
  

Nutrition Matters

The texture, volume, frequency, and make up of foods can affect how quickly or slowly they empty from your stomach. How you eat can also help. It may seem hard to eat a balanced diet when you don’t feel well, but nutrition is important.

Nutrition Tips

(Try the ideas in the order listed.)

1. Eat small meals often (about 6 small meals per day)

   • Larger meals cause the stomach to empty more slowly.

   • Smaller meals (1 to 1 ½ cups)mean you will need to eat more often during the day.

   • Eat healthy foods first before filling up on foods like dessert, high calorie drinks, etc.

2. Try more liquid or semi-liquid(blended or pureed) foods

   • Liquids empty the stomach easier than solids.

   • If symptoms get worse during day, try solid food meals in morning, switching to more liquid meals later in the day.

3. Choose low fat solid foods and limit how much fat is added to a meal.

   • A high fat meal takes longer to leave your stomach. Choose healthy, low-fat foods.

   • Limit fats added during cooking.

   • Liquid foods that contain fat (like a milk shake) do not slow down the stomach emptying. Do not limit these if you need more calories in your diet.

4. Try lower fiber foods.

   • A low fiber diet is 13 grams or less per day.

   • Fiber is found in plant foods like vegetables, fruits, and grains.

   • A high fiber diet may slow down stomach emptying.

   • Certain fibers are even harder to digest and can form a dangerous solid mass called a “bezoar.” Bezoars can lead to a blockage.

5. Chew foods well, especially meats.

   • If you don’t chew food well, the stomach has to work harder.

   • Chewing food tells the stomach to start digesting.

6. Try to move after eating.
   

   • If you can take a walk or get up and move around after eating, this will help the stomach to empty faster.

   • Sit upright for at least 1 hour after eating.

7. Try a liquid nutritional supplement.

   • These are good if you are unable to get enough calories from the food you eat and are losing weight.

8. Eat slowly, calmly and in a relaxed environment. Increased stress may make symptoms worse.

9. Do what works for you. Symptoms can change from day to day and from one week to the next.

10. Keep a food and symptom journal.

11. Write down what you ate, what time, how much and any symptoms.

12. This may help you figure out your problem foods.
    

Getting Enough Calories

If you struggle to eat enough, make sure everything you eat, and drink gives you some calories:

• Drink whole milk, 100% juice, low fiber smoothies, Gatorade®, sweet tea.

• Try Carnation Breakfast Essentials® or other supplemental drinks like Boost® and Ensure®.

• Add foods like dry milk powder, honey and other condiments, and use nutrition shakes in baking and cooking.

• Think about taking a daily multivitamin.
  

Try these foods:

Liquids and semi-solids (carbonated drinks may lead to bloating):

• Milk and milkshakes

• Creamy soups

• Smoothies

• Ice cream

• Puddings and custard

• Pureed Foods

• Liquid supplements

• Ensure®, Boost® Carnation Breakfast Essentials®
  

Fruits (fresh, frozen or canned):

• Applesauce

• Apricots

• Fruit juices

• Bananas (limit to ½)

• Cherries

• Grapefruit sections

• Fruit cocktail

• Mandarin oranges

• Mango

• Melon

• Nectarine

• Peach, peeled

• Pears, peeled

• Plums

• Pineapple

• Strawberries, small amounts

• Tangerines

Vegetables (fresh, frozen or canned; you may tolerate some better if cooked):

• Asparagus tips

• Cabbage

• Cauliflower

• Carrots

• Cucumber

• Eggplant

• Endive

• Lettuce

• Mushrooms

• Onions

• Peppers

• Potatoes, white, peeled

• Radish

• Tomatoes

• Sprouts

• Summer squash

• Sweet potatoes, peeled

• Zucchini
  

Protein

• Lean chicken

• Fish

• Lean cuts of beef

• Lean cuts of pork

• Eggs/Egg substitutes

• Tofu
  

Dairy

• Milk

• Low-fat cheese

• Ice milk/soft serve

• Light cottage cheese

• Yogurt (no nuts, granola, seeds)

• Pudding
  

Starches

• White pasta

• White bread

• Hard rolls

• Muffins*

• French bread

• English muffins, white

• Dry cereals**

• Crackers, soda, rice
  

Snack Foods

• Graham crackers

• Angel food cake

• Vanilla wafers

• Jello®

• Fruit

• Low-fat pudding

• Rice crispy bars

• Dry cereal**
  

*avoid muffins that contain bran, nuts and seeds
**2 grams of fiber or less per serving in cereal

Avoid these foods (some of these fruits and vegetables can cause bezoars):

• Apples

• Beets

• Berries (small amounts ok)

• Brussel sprouts

• Celery

• Coconut

• Figs, Date

• Broccoli (stems especially)

• Grapefruit

• High-fat meats

• High-fat desserts

• Leeks Legumes

• Nuts

• Oranges

• Persimmon

• Whole grain breads

• Whole grain cereals

• Legumes (any beans, peas and lentils

• Potato peelings

• Pumpkin

• Raisins

• Sauerkraut

• Seeds
  

Sample Gastroparesis Menu

Day 1

Breakfast

Low fiber toast with seedless jam
Scrambled eggs

Snack

1 cup low fat Greek yogurt
½ cup canned peaches

Lunch

Salad with soft lettuce, tomato, onion, deli turkey, low fat shredded cheese, and dressing

Snack

Nutrition shake like Boost®, Ensure® or Glucerna®

Dinner

Baked fish fillet
½ cup mashed sweet potato
1 cup cooked zucchini

Snack

½ cup low fat ice cream
½ cup grapes

Day 2

Breakfast

3/4 cup rice cereal with 1 cup low fat milk
1/2 banana

Snack

1/2 cup low fat cottage cheese

Lunch

1 cup low fat vegetable soup
1/2 tuna sandwich on low fiber bread made with light mayo or miracle whip

Snack

Graham crackers
2 Tablespoon creamy peanut butter

Dinner

Grilled chicken breast
1/2 cup white penne pasta
1/2 cup tomato sauce with mushrooms

Snack

1 low fat mozzarella string cheese
½ cup applesauce

Who to Call

If you are a UW Health patient and have more questions, please contact UW Health at the phone number listed below. You can also visit our website at www.uwhealth.org/nutrition.

Nutrition clinics for UW Hospital and Clinics (UWHC) and American Family Children’s Hospital (AFCH) can be reached at: (608) 890-5500.