Digestive Health: Gastroparesis
What is gastroparesis?
Gastroparesis results in delayed or irregular stomach contractions, which can cause fullness, bloating, nausea, vomiting, loose stools or constipation.
Who does gastroparesis affect?
Gastroparesis occurs most often in people with diabetes. About 50% of people with long standing diabetes will have problems with gastroparesis. It can also occur as a result of other health problems, such as gastritis, reflux, gastric ulcer disease, after gastric surgery, after lung transplant, cystic fibrosis, smooth muscle disease, blockage of the GI tract and some neuropathologic conditions.
What are the symptoms?
You may have some or all of these symptoms:
- Early satiety (feeling full)
- Bloating after a meal
- Nausea
- Vomiting
- Weight loss
- Loss of appetite
- Depression
- Erratic blood glucose control
How is it treated?
Gastroparesis treatment depends on glycemic control (for those who have diabetes), medicines and nutritional therapy.
- Glycemic control: Maintain good glucose control to help prevent the diabetic neuropathy that causes gastroparesis. Checking your blood glucose daily and making changes in food intake and insulin help to achieve good blood glucose levels. High blood glucose levels can make gastroparesis worse.
- Medicines: Medicines that treat nausea and increase the rate at which the stomach empties include metoclopramide, tagaserad and erythromycin. These medicines may help correct or improve your symptoms of gastroparesis. Ask your doctor for more information.
- Nutritional Therapy: Nutritional management can prevent or decrease some of the symptoms. This may be achieved by changing the composition, consistency, size, volume and number of meals.
It takes one to four hours to empty your stomach after a meal. It depends on the amount and type of food eaten. A high fat meal takes longer to leave your stomach than a meal rich in carbohydrate or protein. Liquids leave the stomach more quickly than solids.
If you have gastroparesis, you should avoid high-fiber foods for these reasons:
- You are more prone to bezoar formations, which are compact masses of fiber that collect in the stomach or small intestine. Bezoars can cause obstruction. Common foods that can lead to bezoar being formed are apples, oranges, coconuts, berries, green beans, figs, sauerkraut, Brussels sprouts, potato peels, and persimmons.
- Fiber slows stomach emptying. This is mainly true of water-soluble fiber, such as pectin. Common foods high in soluble fiber to avoid include legumes, nuts, seeds, pectin (such as apple peels) and oat bran. Commercial psyllium products (Metamucil®, Citrucel®) are also high in water-soluble fiber.
Nutrition Recommendations:
- Eat frequent small meals (6-8 small meals per day): less bloating feeling, less early stomach fullness, and less chance of impaired nutritional status
- Choose foods that are semi-solid or liquid
- Choose a low fat diet (about 40 grams per day): may produce less delay in gastric emptying
- Gentle exercise after meals: may increase solid meal gastric emptying rates
- Choose foods low in soluble fiber: may decrease chance of bezoar being formed and result in quicker gastric emptying
- Avoid fiber supplements, e.g., Benefiber®, Citrucel®, Fibercon®, Metamucil® and Perdiem®.
- Chew foods well
- Sit upright for 1-2 hours after meals
- Liquid Nutritional Supplements may be advised, check with your dietitian or health care provider
A proper diet can help get rid of the symptoms of gastroparesis, maintain optimal nutritional status, and improve glycemic control.
Foods to Include in Your Diet:
Liquids and semi-solids: Since liquids appear to empty from the stomach during gastroparesis, a liquid diet may be better tolerated than solid foods. A full liquid diet, consumed in small amounts at frequent times may help maintain nutritional status. Pureed foods may also empty better than intact foods. Select liquids and semi-solids which provide a number of nutrients rather than just simple sugars.
Suggested foods include:
Milk
Cream soups
Milkshakes
Ice cream
Puddings
Custards
Farina
Pureed foods
Liquids supplements: Ensure®, Boost®, Carnation Instant Breakfast®, Enlive®.
Intact foods: Many people may be able to tolerate whole foods, such as:
Fruits (fresh or canned)
Applesauce
Apricots
Assorted fruit juices
Bananas
Cherries
Grapefruit sections
Fruit cocktail
Mandarin oranges
Mango
Melon
Nectarine
Peach, peeled
Pears, peeled
Plums
Pineapple
Strawberries
Tangerines
Vegetables (fresh or canned; some vegetables may be better tolerated if cooked)
Asparagus
Beets
Cabbage
Cauliflower
Celery
Chinese cabbage
Eggplant
Endive
Escarole
Green beans
Lettuce
Mushrooms
Onions
Peppers
Potatoes, white, peeled
Potatoes, sweet, peeled
Radish
Tomatoes
Sprouts
Squash
Protein
Chicken
Fish
Lean cuts of beef
Lean cuts of pork
Eggs
Egg substitutes
Dairy
Skim milk
Low-fat cheese
Pudding
Ice milk
Cottage cheese
Yogurt (no nuts, granola, seeds)
Starches
Pasta
White bread
Hard rolls
Muffins*
French bread
English muffins
Dry cereals**
Crackers (soda, graham)
Snack Foods
Graham crackers
Angel food cake
Vanilla wafers
Flavored gelatin
Fruit (listed above)
Low-fat pudding
Rice crispy bars
Dry cereal**
*avoid muffins containing bran, nuts and seeds
**2 grams of fiber or less per serving
Foods to avoid in your diet include:
High-fat meats
High-fat desserts
Nuts
Seeds
Whole grain breads
Whole grain cereals
Legumes (any beans, peas and lentils)
Fruits and vegetables associated with bezoar formation
Gastroparesis affects each person in a different way; therefore, foods that may work for one person may not work for another. Consult with your dietitian to find the foods that work best for you.
Teachback:
What is the most important thing you learned from this handout?
What changes will you make in your diet/lifestyle, based on what you learned today?
If you need more information please contact UW Health at one of the following locations:
UW Digestive Health Center
|
UW Health West Clinic
|
UW Health East Clinic
|
| UW Medical Foundation Nutrition 202 S Park St, Madison, WI 53705 appts: 608-287-2770 Appointments available at 12 locations uwhealth.org/nutrition |
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 05/09/2013
Copyright © 01/14/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#337
Print Health Fact For You