Purpose
Gastroparesis is the medical term for delayed stomach emptying. During the process of digestion, the stomach must contract to empty itself of food and liquid. Normally, it contracts about three times a minute. This empties the stomach within 90-120 minutes after eating. If contractions are sluggish or less frequent, stomach emptying is delayed. This results in bothersome and sometimes serious symptoms, as well as malnutrition, because food is not being digested properly.
Gastroparesis may be caused by various conditions such as diabetes mellitus, certain disorders of the nervous system, or certain drugs. Often however, no cause can be found although a viral infection is suspected in some. Usually, the physician prescribes medication to stimulate the stomach to contract. The purpose of the gastroparesis diet is to reduce symptoms and maintain adequate fluids and nutrition. There are three steps to the diet.
- STEP 1: DIET consists of liquids, which usually leave the stomach quickly by gravity alone. Liquids prevent dehydration and keep the body supplied with vital salts and minerals.
- STEP 2: DIET provides additional calories by adding a small amount of dietary fat — less than 40 gm each day. For patients with gastroparesis, fatty foods and oils should be restricted, because they delay stomach emptying. However, patients at the Step 2 level are usually able to tolerate this amount.
- STEP 3: DIET is designed for long-term maintenance. Fat is limited to 50 gm per day, and fibrous foods are restricted, because many plant fibers cannot be digested.
Nutrition Facts
The STEP 1 Gastroparesis Diet is inadequate in all nutrients except sodium and potassium. It should not be continued for more than three days without additional nutritional support. STEP 2 and STEP 3 Gastroparesis Diets may be inadequate in Vitamins A and C, and the mineral iron. A multivitamin supplement is usually prescribed.
Special Considerations
Diets must be tailored to the individual patient. This is because the degree of gastroparesis may range from severe and long-standing to mild and easily corrected. Patients may also have various medical conditions to be considered. For example, diabetes patients with gastroparesis are allowed sugar-containing liquids on the Step 1 diet, because that is their only source of carbohydrate. On the Step 2 and Step 3 diets, these patients should avoid concentrated sweets. These are noted with an asterisk (*) on the food lists.
On all of the diets, liquids and food should be eaten in small, frequent meals. This helps to maintain nutrition.
- Breakfast
- Gatorade 1/2 cup
- ginger ale 1/2 cup
- bouillon 3/4 cup
- saltine crackers 6
- Lunch
- Gatorade 1/2 cup
- Coke 1/2 cup
- bouillon 3/4 cup
- saltine crackers 6
- Dinner
- Gatorade 1/2 cup
- Sprite 1/2 cup
- bouillon 3/4 cup
- saltine crackers 6
This Sample Diet Provides the Following:
Calories 790 Fat 9 gm
Protein 11 gm Sodium 3531 mg
Carbohydrates 156 gm Potassium 244 mg
- Breakfast
- skim milk 1/2 cup
- poached egg 1
- white toast slice
- apple juice 1/2 cup
- Lunch
- mozzarella cheese 2 oz
- saltine crackers 6
- chicken noodle soup 3/4 cup
- Gatorade 1/2 cup
- Dinner
- peanut butter 1 Tbsp
- saltine crackers 6
- vanilla pudding 1/2 cup
- grape juice 1/2 cup
- Morning Snack
- ginger ale 1/2 cup
- canned pears 1/2 cup
- Afternoon Snack
- skim milk 1/2 cup
- cornflakes 1/2 cup
- sugar 2 tsp
- Evening Snack
- frozen yogurt 1/2 cup
- saltine crackers 6
This Sample Diet Provides the Following
Calories 1343 Fat 35 gm
Protein 52 gm Sodium 2639 mg
Carbohydrates 206 gm Potassium 1411 mg
- Breakfast
- skim milk 1/2 cup
- cream of wheat 1/2 cup
- sugar 2 tsp
- orange juice 1/2 cup
- white toast 1 slice
- margarine 1 tsp
- jelly 1 Tbsp
- Lunch
- tuna fish 2 oz
- low-fat mayonnaise 2 Tbsp
- white bread 2 slices
- canned peaches 1/2 cup
- Gatorade 1/2 cup
- Dinner
- baked chicken 2 oz
- white rice 1/2 cup
- cooked beets 1/2 cup
- dinner roll 1
- skim milk 1/2 cup
- margarine 2 tsp
- Morning Snack
- low-fat yogurt 1/2 cup
- Sprite 1/2 cup
- Afternoon Snack
- chocolate pudding 1/2 cup
- gingerale 1/2 cup
- Evening Snack
- ice milk 1/2 cup
- pretzels 2
This Sample Diet Provides the Following
Calories 1822 Fat 42 gm
Protein 75 gm Sodium 2234 mg
Carbohydrates 286 gm Potassium
Meal Patterns
With slow stomach emptying, the amount of food you eat during a meal can trigger gastroparesis symptoms if you are not careful. Eat a balanced diet, broken down into six small meals throughout the day. Sitting up at meals and walking between meals will also help with digestion and increase your appetite for the next meal. If weight loss or maintenance is a concern, be sure you are eating enough or consider adding additional small meals during the day.
Low-Fat Foods
The amount of fat in your meals can further delay stomach emptying. Low-fat meals are recommended for better tolerance. Meat is a good source of protein, but can be high in fat. Choose lean cuts and remove any visible fat during meal preparation. Poultry, lean ground beef, fish and eggs are good diet choices. Milk, yogurt and cheese are rich in protein, calcium and vitamin D, but can also be high in fat. Pick low-fat versions for easier digestion. Added butter, margarine, sour cream, oils and salad dressings can contribute a lot of fat to your diet. Use this group sparingly and instead flavor foods with natural herbs and seasonings.
Dietary Fiber
While fiber is important for bowel health, a high fiber diet may exacerbate gastroparesis symptoms. Low fiber foods are better tolerated. Stick with white bread, rice and pasta. Read cereal labels and choose low fiber versions. Fruits and vegetables can be included in your diet, but stick with low fiber choices such as applesauce, canned peaches, tangerines, skinned potatoes, zucchini, lettuce and celery. Once your gastroparesis symptoms improve, you may incorporate more fiber foods in your diet with caution. Start with very small amounts to determine if you are able to tolerate any of these foods.
Carbohydrates and Concentrated Sweets
Managing your blood sugar level and being aware of the carbohydrates in your diet is important if diabetes is the cause of your gastroparesis. Carbohydrate sources include breads and grains, fruit and fruit juices, dairy, vegetables, sweets and desserts and some beverages. Be consistent with the amount of carbohydrates you are eating and the timing of your meals. Reading labels is helpful to identify the serving size and carbohydrate amount in your foods. Avoid a lot of sweets and desserts with added sugar and fat like cake, cookies and brownies. Instead choose low-fat cake or pudding which can help control your intake of sugar and fat."
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