Food and gastroparesis

Gastroparesis means that the stomach’s emptying is delayed, which can result in symptoms of nausea, vomiting, bloating, abdominal pain and reflux. Dietary therapy therefore focuses on strategies and foods that speed up gastric emptying. As poor nutrition and weight loss can make gastroparesis worse, it is important to ensure you are consuming a balanced, nutritious diet with a regular eating pattern.

Your doctor can refer you to a Dietitian to prescribe a diet for your individual needs, but the following are some general recommendations for gastroparesis:

Eat small, frequent meals: By spreading out your food intake and ‘grazing’ throughout the day, you are less likely to become overly full which can lead to nausea and vomiting. Aim for around 6 entrée size meals per day. Fluids also take up space in the stomach, so try to drink most of your fluids between meals, rather than with meals.

Chew food well: The more work you do chewing your food means less work the stomach has to do to break the food down.

Remain upright for at least 1 hour after eating: Gravity will help speed up stomach emptying and reduce symptoms of reflux, heartburn and regurgitation.

Avoid high fat foods: Some people with gastroparesis may think they need to eat higher fat foods to stop them from losing weight, however it should actually be the opposite! Fat slows down stomach emptying, and sensitises the gastrointestinal tract, making symptoms worse. Choose low fat dairy products, avoid fried foods, take away, pastries, and rich, creamy sauces.

Limit bulky, high fibre foods: Foods high in fibre (especially insoluble fibre) also slow stomach emptying, and swell in the stomach, causing early satiety (fullness). Limit raw vegetables, fruit and vegetable skins, bran and unprocessed grains.

Avoid coffee, fizzy drinks and alcoholic drinks, which can make reflux worse and fill you up while providing minimal nutrients.

Eat a soft diet: Soft foods are easier for the stomach to digest. If you are having difficulty eating a normal diet, avoid tough meat, crunchy fruit/vegetables and fresh bread and instead select casseroles, soft-cooked vegetables, soft pasta, porridge, stewed fruits and dairy desserts like low fat yoghurt or mousse.

Some patients with severe gastroparesis will need to have a vitamised/pureed diet where most food is passed through the blender before eating, and others may even need to have a purely liquid diet made up of soups, smoothies and special nutrition supplements such as ‘Ensure’ or ‘Resource Protein’. If you feel your gastroparesis is severe enough to need a pureed or liquid diet, ask your doctor for a Dietitian referral to make sure you are getting adequate nutrients in your diet.

Diabetes: If your gastroparesis is caused by diabetes, improving your blood sugar control will help improve your symptoms. Avoid excessive dietary sugars, try to spread your carbohydrate intake evenly throughout the day, and aim to be physically active most days if you are able.

Vitamin and mineral supplements: As people with gastroparesis often need to restrict their diet, a vitamin/mineral supplement may be recommended to avoid the development of nutritional deficiencies. A general multivitamin such as Centrum ™ is a good start, but requesting that your doctor check your nutrient status or refer you to a Dietitian is important if you are avoiding a number of foods.

Other diets:

Non-medical professionals, well-meaning friends or some websites may advocate other diets for gastroparesis, including those that limit or cut out dairy, gluten, food chemicals, or FODMAPs (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols). While these diets may be appropriate for some individuals with additional food intolerances, they are not an effective treatment for gastroparesis, and can be overly restrictive. If you notice particular foods which trigger or worsen your symptoms, start a food and symptom diary and see a Dietitian to discuss this.

What if dietary changes don’t help?

Even after following all of the dietary guidelines recommended for gastroparesis, some patients are still unable to maintain adequate hydration and nutrition due to their symptoms. In this instance, patients may need fluids and nutrients delivered directly into their small intestine bypassing the stomach, through a feeding tube. If this is the case, your Doctor will refer you to a Dietitian to manage this feeding.