Gastroparesis Diet Tips

Gastroparesis Diet Tips

 

Gastroparesis means “stomach (gastro) paralysis (paresis).” In gastroparesis, your stomach empties too slowly. Gastroparesis can have many causes, so symptoms range from mild (but annoying) to severe, and week-to-week or even day-to-day.

This handout is designed to give some suggestions for diet changes in the hope that symptoms will improve or even stop. Very few research studies have been done to guide us as to which foods are better tolerated by patients with gastroparesis. The suggestions are mostly based on experience and our understanding of how the stomach and different foods normally empty. Anyone with gastroparesis should see a doctor and a Registered Dietitian for advice on how to maximize their nutritional status.

 

The Basics

Volume

The larger the meal, the slower the stomach will empty. It is important to decrease the amount of food eaten at a meal, so you will have to eat more often. Smaller meals more often (6-8 or more if needed) may allow you to eat enough.

 

Liquids versus Solids

If decreasing the meal size and increasing the number of “meals” does not work, the next step is to switch to more liquid-type foods. Liquids empty the stomach more easily than solids do. Pureed foods may be better also.

 

Fiber

Fiber (found in many fruits, vegetables, and grains) may slow stomach emptying and fill the stomach up too fast. This won’t leave room for foods that may be easier tolerated. Cooked or pureed fruits and vegetables may digest faster (apple sauce, smoothies, etc). Soft, cooked vegetables may be better tolerated than raw vegetables.

 

You may also need to avoid over-the-counter fiber/bulking medicines like Metamucil® and others. Speak with your doctor before starting a fiber supplement.

 

Fat

Fat may slow stomach emptying in some patients, but many can easily consume fat in beverages. Our experience is that fat in liquid forms like whole milk, milkshakes, nutritional supplements, etc. is often well tolerated. Unless a fat-containing food or fluid clearly causes worse symptoms, fat should not be limited.

Medications

There are quite a few medications that can slow stomach emptying. Ask your doctor if any of the medicines you are on could be slowing down your stomach emptying.

 

Getting Started

  • Avoid large meals. Try 4-8 smaller meals and snacks.
  • You may need to avoid foods that are high in fat, such as fried or greasy foods. High fat drinks are usually ok – try them and see.
  • Chew foods well, especially meats. Meats may be easier to eat if ground or puréed.
  • Avoid high roughage foods because they may be harder for your stomach to empty. This includes skins, tough stalks, seeds, etc.
  • Avoid raw vegetables. Cook them until they are soft.
  • Stick to soft fruits such as bananas, canned pears, canned peaches, etc. You can also try cooked or pureed fruits such as smoothies and apple sauce.
  • Sit up while eating and stay upright for at least 1 hour after you finish. Try taking a nice walk after meals.
  • If you have diabetes, keep your blood sugar under control. Let your doctor know if your blood sugar runs >200 mg/dL on a regular basis.

 

Suggested Foods

 

Category

What to Eat

What to Avoid

Grains/Starches

  • White rice
  • White bread
  • White bread products (small bagels, English muffins, plain rolls, pita bread, flat bread)
  • Potato/sweet potato (no skins)
  • Tortillas / tortilla chips
  • Low-fiber cereal (rice/corn Chex, corn flakes, rice krispies, cheerios)
  • Cream of rice/wheat
  • Grits
  • White pasta
  • Egg noodles
  • Crackers/chips (oyster crackers, pretzels, saltines, baked potato chips)

 

 

  • Whole grain products
  • Products with nuts and seeds
  • Products with more than 2 g fiber per serving
  • Donuts, cakes, and muffins that are high in fat
  • Potato peels
  • Brown rice
  • Quinoa
  • Greasy potato chips (baked is okay)
  • Deep-fried French fries (baked is okay)

Proteins

  • Eggs (may only tolerate egg whites)
  • Tender chicken breast, no skin
  • White meat turkey, no skin
  • Fish
  • Seafood
  • Ground lean (95%) beef
  • Lean or shredded pork
  • Tofu
  • Smooth peanut or almond butter
  • Whey protein, pea protein, or rice protein powder
  • Almond flour

 

  • High-fat or fibrous meats (dark meat chicken/turkey, fatty cuts of beef)
  • Fried meat, poultry, or fish
  • Raw nuts
  • Beans
  • Lentils

Vegetables

 

  • Cooked vegetables (carrots, beets, spinach, green beans, squash)
  • Tomato sauce, tomato juice (unless this aggravates reflux)
  • Baby vegetable purees (jars or pouches)
  • Mashed/baked potatoes
  • Mushrooms
  • Raw vegetables
  • Lettuce
  • Corn
  • Brussels sprouts
  • Cabbage
  • Large amounts of broccoli and cauliflower
  • Celery

Fruits

 

  • Cooked fruits (baked apples, berries, or peaches)
  • Applesauce
  • Canned fruits
  • Bananas
  • Fruit juices
  • Melon
  • Smoothies
  • Skin on fruit (e.g. apple, pear)
  • Oranges (unless all white parts are removed)
  • Persimmons
  • Shredded coconut
  • Large portions of fruit

Dairy / Milk products

 

  • Milk (any type tolerated – e.g. skim, low-fat, whole, lactose-free)
  • Frozen yogurt
  • Greek yogurt
  • Kefir
  • Buttermilk
  • Plant-based milks (soy, pea, coconut)
  • Pudding
  • Custard
  • Cottage cheese
  • Large amounts of cheese

Soups

 

  • Broth, bouillon, strained creamed soups (with milk or water)
  • Bean soups
  • Stews with tough cuts of meat

Desserts/sweets

 

  • Angel food cake
  • Simple cookies: animal crackers, ginger snaps, graham crackers, vanilla wafers
  • Popsicles, sherbet, sorbet, frozen yogurt
  • Dark chocolate
  • White chocolate
  • Fried desserts
  • Full-fat ice cream
  • Cheesecake