The treatment of people with gastroparesis generally relies on:
- dietary modifications
- medications that enhance gastric emptying, and
- medications that reduce nausea and vomiting.
Gastroparesis is characterized by symptoms and the confirmed delay of emptying of food from the stomach where no blockage is evident. In most individuals with gastroparesis, the cause of the disorder is not known. It also can occur as a result of several known conditions, especially in people with diabetes. It is more common in women and can have a major impact on quality of life.
Suggestions for modifications to diet in patients with gastroparesis are based largely on clinical experience. More scientific studies are needed to demonstrate what foods are better tolerated than others by patients with gastroparesis.
It is recommended that anyone with gastroparesis seek dietary counseling with a doctor and Registered Dietician to help individualize nutrition therapy and maximize nutritional benefits.
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Diet recommendations are likely to be of greatest benefit to those with mild to moderate disease. They are also tried in patients with more severe gastroparesis to complement other medical treatments.
Liquids
When basic dietary guidelines aren’t enough to control your gastroparesis, you may be advised to consume the bulk of your meals as semi-solids or liquids, such as puréed foods or soups. Stomach emptying of liquids is often normal in patients with gastroparesis. Calorie-containing drinks, such as Hawaiian Punch or Hi C, provide fluid and calories, hence are better than water alone.
Some options while on a liquid diet include:
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- Milk
- Instant breakfast
- Milkshakes
- Yogurt
- Puddings
- Custard
- Cereals (soft/easy to chew)
- Smoothies
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Supplements
To meet your nutritional needs, it may be necessary to supplement your diet with a commercially available liquid nutrient preparation that is low in fiber such as Ensure, Boost, or even baby foods.
Blenderized foods may also be used as a liquid nutrient source. Any food can be blenderized. Solid foods will need to be thinned with some type of liquid, such as broth, milk, juice, water. Remember to clean the blender well after each use.
Medications to avoid
There are quite a few medications that can delay stomach emptying. Tell your doctor about all the medications you are taking and ask if any could be slowing down your stomach emptying.
Here are some examples that can slow your stomach emptying:
- Aluminum-containing antacids (Amphojel)
- Narcotic pain medications (Percocet, Tylenol #3, Oxycontin, and others)
- Anticholinergic agents (Bentyl, Levsin, Elavil, and others)
- Bulk-forming agents (Metamucil, Perdiem, Fibercon, and others)
Diabetes
If your gastroparesis is due to diabetes, an important goal is to achieve or maintain good glucose control. This is achieved more easily by frequent monitoring of blood sugar levels and adjustment of insulin. Keeping your blood sugar under control may help stomach emptying. Let your doctor know if your blood sugar runs more than 200 on a regular basis.
Adapted from IFFGD Publication: Dietary and Nutritional Recommendations for Patients with Gastroparesis by Carol Rees Parrish, RD, MS, Nutrition Support Specialist, University of Virginia Health System, Charlottesville, VA; Edy Soffer, MD, Co-Director of the GI Motility Laboratory, Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, CA; and Henry Parkman, MD, Temple University School of Medicine, Philadelphia, PA.