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Gastroparesis: Guidelines, Tips, and Sample Meal Plan

Gastroparesis: Guidelines, Tips, and Sample Meal Plan

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
  • Avoid foods high in fat—fats, including vegetable oils, naturally cause a delay in stomach emptying
  • Choose nutritional supplements with <10 g of fat/8 fluid ounces (fl oz) for extra calories and protein (Ensure®, Glucerna®, Slimfast®, and Carnation® Breakfast Essentials™)
  • 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 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), trying foods such as:
    • Cold foods
    • 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 milligrams/deciliter

Treatment of gastroparesis
Treating gastroparesis depends on the frequency and severity of symptoms. Some patients may find liquid, blenderized, or soft foods are more easily digested. Some individuals can tolerate more fat and fiber in the diet than other people can. Work with your doctor and/or a registered dietitian or registered dietitian nutritionist for specific recommendations.

Liquids
Liquids usually leave the stomach rapidly by gravity alone. Consume any tolerated liquids slowly throughout the day with plain saltine crackers.

Blenderized foods
You can puree foods in your blender. You may need to add some liquid when blending solid foods.

Soft, low-fat and low-fiber foods
Include a small amount of fat—<40 g/day.

Solid, low-fat and low-fiber foods
This is intended for long-term maintenance. Fat is limited to 50 g/day. Avoid fibrous foods, because you cannot digest many plant fibers.

Food Guidance for gastroparesis—soft, low fat, low fiber

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 gastroparesis—solid, low fat, low fiber

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

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 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

Daily totals
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 (Ensure, Glucerna, Slimfast, and Carnation Breakfast Essentials)

 

References and recommended readings
Academy of Nutrition and Dietetics. Nutrition Care Manual®. Nutrition Care Manual Web site [by subscription]. www.nutritioncaremanual.org. Accessed February 10, 2014.

Fox J, Foxx-Orenstein A. Gastroparesis. American College of Gastroenterology Web site. http://www.acg.gi.org/patients/gihealth/gastroparesis.asp. Published August 2004. Updated December 2012. Accessed February 10, 2014.

National Digestive Diseases Information Clearinghouse (NDDIC). Gastroparesis. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health Web site. http://digestive.niddk.nih.gov/ddiseases/pubs/gastroparesis. Updated June 15, 2012.  Accessed February 10, 2014.

Parrish CR, Yoshida CM. Nutrition interventions for the patient with gastroparesis: an update. Practical Gastroenterology. August 2005:29-66. http://www.medicine.virginia.edu/clinical/departments/medicine/divisions/digestive-health/nutrition-support-team/nutrition-articles/ParrishArticle.pdf. Accessed February 10, 2014.

 

Review Date 2/14
G-0818

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