A registered dietitian can be very helpful in providing
The purpose of the gastroparesis diet is to reduce
symptoms and maintain adequate nutrition and fluid intake. Step 1 is used when symptoms are more severe and
The two most common types of drugs prescribed to
you may advance to Steps 2 and 3 as symptoms improve.
treat gastroparesis are anti-emetics and prokinetics.
Step 1: Liquids
Anti-emetics – When nausea is a predominant symptom, an anti-nausea drug such as
Liquids usually leave the stomach quickly by gravity
prochlorperazine (Compazine) or ondansetron (Zofran)
alone. Gatorade, soft drinks and broths prevent
may be used to control nausea and vomiting.
dehydration and keep the body supplied with vital salts and minerals. Try to sip 1-2 ounces at a time with
Prokinetics – These types of drugs are used to
the goal of drinking at least 4 ounces an hour. You
may also try plain saltine crackers. Avoid all citrus and
• Metoclopramide (Reglan) – This prokinetic drug
increases the strength and frequency of the
Note: Step 1 is nutritionally inadequate and should
stomach muscle contractions and relaxes the valve
not be followed for more than three days without
that controls the release of food from your stomach
to your small intestine. Side effects are common and include drowsiness, depression and muscle spasms.
Step 2: Soups & Breads
• Domperidone – This drug is similar to
Try various soups with noodles, rice or crackers. This
metoclopramide, but without many of its side
step provides additional calories by adding small
effects. It is available in Canada and Europe; it is not
amounts of dietary fats. While fatty foods and oils can
delay stomach emptying, you may be able to tolerate
• Erythromycin – This drug is not a prokinetic; instead,
small amounts of fats such as peanut butter and
it’s a common antibiotic that produces short bursts
cheese (less than 40 grams each day). Food should be
of strong stomach contractions. However, most
divided into at least six small meals per day. Avoid milk-
people develop a tolerance to the drug fairly quickly
so it is usually used only intermittently or when
Step 3: Solid Foods
The goal of this step is to find a diet containing foods
that you enjoy and can maintain long-term without significant nausea and vomiting. Add starches such as
Gastroparesis is a common condition that may affect
noodles, pasta, rice and potatoes back into your diet.
anyone, but is most often seen as a complication
Chicken breast is usually well-tolerated. Fat is limited to
of insulin-dependent diabetes. Many cases have no
50 grams each day and raw, fibrous fruits and vegetables
identifiable cause. Gastroparesis causes bloating,
should also be restricted. Food should be divided into at
nausea, vomiting, a feeling of being full and contributes
least six small meals per day. Avoid red meat.
to poor blood sugar control. In severe cases, it can
A liquid multivitamin supplement is recommended in all
affect nutrition. Treatment is available, but as yet
there is no cure. Treatment consists of treating any underlying problem, diet and medications. By working with a physician, most patients are able to reach a satisfactory treatment program.
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, (pronounced gas-tro-par-EES-is), also
satiety), bloating, excessive belching and nausea. There
can be a vicious cycle. Gastroparesis doesn’t cause
called delayed gastric emptying, is a disorder in which
may be vomiting of undigested food (even several
diabetes, but inconsistent food absorption can play
the stomach takes too long to empty its contents. This
hours after eating), heartburn, pain in the upper
havoc with blood sugar levels, which makes diabetes
condition is very common and can be the cause of a
abdomen, lack of appetite, and weight loss due to poor
worse. In turn, poor control of blood sugar levels
number of abdominal complaints. It is usually not a
calorie intake and poor absorption of nutrients.
serious problem and there are effective treatments available.
Eating solid food, especially high-fiber foods such as raw fruits and vegetables, fatty foods, or drinks high in
What is the treatment?
How the stomach works.
fat or carbonation may add to these symptoms.
First, controlling diabetes or any other underlying condition that may be causing gastroparesis, such
Normally, muscles in the wall of the stomach work
How is gastroparesis diagnosed?
as an underactive thyroid, is the first step in treating
to grind the food into smaller pieces and then push
the condition. Beyond this, treatment usually involves
the churned and liquefied food into the duodenum,
Doctors use several tests to help diagnose
dietary changes and medications. In most cases,
the first part of the small intestine. However, in
gastroparesis. Some of these rule out conditions that
treatment does not “cure” gastroparesis – it helps you
gastroparesis, these stomach muscles work poorly
cause similar symptoms; others check for specific signs
manage the condition so you can be healthy and as
or not at all, preventing your stomach from emptying
properly. This can hold up digestion, cause increased
• Gastric Emptying Study - This study is usually
reflux, nausea and vomiting, and interfere with blood
considered to be the most accurate way to diagnose
gastroparesis. In this study, you eat a food item, most often egg salad, which contains a small
Changing how and what foods are eaten is helpful. The
What causes gastroparesis?
amount of “tracer”. After eating, you lie flat on a
most common recommended dietary changes include:
table while a scanner is placed over your stomach
The most common known cause of gastroparesis is
• Smaller, more frequent meals. Eat six small meals
to monitor the rate at which the food (tracer) leaves
diabetes. People with diabetes have high blood sugar,
per day, instead of three large meals.
which causes chemical changes in nerves and damages
• Avoid high-fiber foods. Foods high in fiber tend
the blood vessels that carry oxygen and nutrients to
• Upper GI Endoscopy (EGD) – Instead of helping
to stay in the stomach longer, so they should be
those nerves. Over time, these changes can damage
diagnose gastroparesis, this procedure is used to
restricted when symptoms are severe. Fibrous foods
the vagus nerve – the nerve that controls the muscles
rule out other conditions that can cause delayed
are also more likely to form bezoars than softer
gastric emptying. During the procedure, the doctor
foods. Foods most likely to cause bezoars include
passes a long, thin tube with a tiny camera through
In addition, there are a number of other causes for
dried figs, berries of all kinds, apples, coconut, corn,
your mouth and down your throat, or esophagus,
brussels sprouts, and potato and tomato peels.
into your stomach and the first part of your small
• Cut back on high-fat foods or added fats. Foods
intestine to check for any abnormalities.
high in fat naturally cause delay in emptying of the
• Certain medications, such as calcium blockers and
What are the complications?
• Nutritional supplements. Because gastroparesis
narcotics that weaken stomach contractions
• Weight loss and malnutrition - Problems can occur
interferes with digestion and absorption of
• Neurological conditions such as Parkinson’s disease,
when slow emptying of the stomach affects your
nutrients, people with gastroparesis may be
body’s ability to digest and absorb nutrients. Also,
deficient in important vitamins and minerals such
• Metabolic disorders such as adrenal or thyroid gland
if food stays in the stomach too long, it can cause
as vitamin B-12, iron and calcium. A liquid vitamin
bacterial overgrowth from the fermentation of the
and mineral supplement may help supply missing
food and disrupt the body’s normal balance of good
• Pureed and liquid foods. Most people with
In up to 40% of cases, people have what is called
• Bezoars - Undigested food in the stomach can
gastroparesis find that they do best with soups or
idiopathic gastroparesis, meaning the cause is not
harden into a bezoar (pronounced BEE-zawr), a solid
pureed foods. Liquid always leaves the stomach
known and cannot be found even after medical tests.
mass that’s similar to a hairball in a cat. Bezoars
faster than solid food so liquid-type foods such as
What are the symptoms?
may cause nausea and vomiting and may become
dangerous if they prevent food from passing into
• Avoid smoking, alcohol, coffee, spicy foods and
The most common symptoms of gastroparesis are a
mints. All of these things can irritate the lining of
feeling of fullness after only a few bites of food (early
• Blood sugar fluctuations – Diabetic gastroparesis
the stomach and create more acid reflux.
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