Gastroparesis is a condition in which the stomach empties slower than usual. In delayed stomach emptying, you may feel sick, have abdominal pain, vomit, and feel full even after taking a small amount of food.1 Slowing the digestive process makes it difficult to get enough essential nutrients like vitamins, minerals, and calories.
Gastroparesis can be caused by diabetes mellitus, surgery, certain medications, and brain disorders, including nerve damage.2 Diet management plays an important role in lessening the symptoms of gastroparesis. Gastroparesis diets are digested easily while providing all the important nutrients.
Where and how to start
A gastroparesis diet starts with liquids and gradually moves toward introducing solid foods back into the diet.3 There are three steps to managing a gastroparesis diet:
Step 1:
If you are experiencing severe gastroparesis, it is best to follow a liquid diet for a few days to allow time for healing without missing important nutrients. A liquid diet will prevent dehydration and provides all the essential minerals and salts your body needs.
Step 2:
After the liquid diet phase, slowly move towards a solid diet by introducing a variety of soft nutrient-dense foods. It is important to limit and manage fats (less than 40g/day) in a gastroparesis diet because fatty and oily foods increase the gastric emptying time, which may worsen the symptoms of gastroparesis.
Step 3:
This is a long-term whole foods diet plan consisting of no more than 50g of fats daily and restricted fiber intake. Fiber increases the amount of time food stays in the stomach, so fiber levels should be minimal.
General Guidelines
The following general guidelines should be adopted for the best chance of reducing the severity of symptoms from gastroparesis.4
- Drink an adequate amount of liquids to prevent dehydration.
- Eat small and frequent meals to reduce symptoms.
- Eat nutritious meals and avoid filling the stomach with snacks or empty calories. Start with solid foods in the morning and take liquids in the evening to avoid food sitting heavy in the stomach at night.
- Choose low-fat foods to ease symptoms. If you are experiencing unintentional weight loss, add fat in the form of beverages.
- Chew foods well. It is best to blend, cut, or mix meat, potatoes, vegetables, fruits, and other solid foods for better digestion.
- Don’t go to bed immediately after eating solid foods or snacks.
- Avoid sugar if you have diabetes.
- Quit drinking alcohol!
- Exercise regularly to increase digestion and enhance physiological metabolic processes.
| Step 3: Whole Diet Food Groups | ||
|---|---|---|
| Food Group | Recommend | Avoid |
| Milk & milk products | none | all |
| Vegetables | none | all |
| Fruits | none | all |
| Meat & meat substitutes | none | all |
| Bread & grains | plain saltine crackers | all others |
| Fats & oils | none | all |
| Beverages | Gatorade and soft drinks (sipped slowly throughout the day) | all others |
| Soups | Fat-free consommé and bouillon | all others |
| Sample Menu Step 1 | ||
|---|---|---|
| Breakfast | Lunch | Dinner |
|
|
|
| This sample diet provides the following: | |||
|---|---|---|---|
| Calories | 790 | Fat | 9 gm |
| Protein | 11 g | Sodium | 3,531 mg |
| Carbohydrates | 156 g | Potassium | 244 mg |
| Step 2: Introduce Solid Food Groups | ||
|---|---|---|
| Food Group | Recommend | Avoid |
| Milk & milk products | skim milk, products made with skim milk, low-fat yogurt, low-fat cheese | whole milk products, creams (sour cream, light or heavy cream, whipping cream), half & half |
| Soups | fat-free consommé & bouillon, soups made from skim milk, & fat-free broths containing pasta or noodles and allowed vegetables | soups made with cream, whole milk, or broths containing fat |
| Bread & grains | cream of wheat, pasta, white rice, egg noodles, low-fat crackers | oatmeal, whole grain rice, cereal, bread |
| Meat & meat substitutes | eggs, peanut butter (maximum 2 Tb/day) | beef, poultry, fish, pork, dried beans, peas, lentils |
| Vegetables | vegetable juice (tomato, V-8); soft-cooked vegetables without skins (acorn squash, beets, carrots, mushrooms, potatoes, spinach, summer squash, strained tomato sauce, yams) | all raw vegetables, cooked vegetables with skins, beans (green, wax, lima), broccoli, Brussels sprouts, cabbage, cauliflower, celery, corn, eggplant, onions, peas, peppers, pea pods, sauerkraut, turnips, water chestnuts, zucchini |
| Fruits | fruit juices (apple, grape, cranberry, pineapple, prune) canned fruits without skins (applesauce, peaches, pears) | citrus juices, all fresh and dried fruits, canned fruits with skins (apricots, cherries, blueberries, fruit cocktail, oranges, grapefruit, pineapple, plums, persimmons) |
| Fats & oils | any type of fat, but only in small amounts | none |
| Sweets & desserts* | hard candies, caramels, puddings & custards made from skim milk, frozen yogurt, fruit ice, gelatin, ice milk, jelly, honey, syrups | high-fat desserts (cakes, pies, cookies, pastries, ice cream), fruit preserves |
| Beverages | Gatorade, soft drinks (sipped slowly throughout the day) | all others, except allowed juices |
| Sample Menu Step 2 | ||
|---|---|---|
| Breakfast | Lunch | Dinner |
|
|
|
| Morning snack | Afternoon snack | Evening snack |
|
|
|
| This sample diet provides the following: | |||
|---|---|---|---|
| Calories | 1,343 | Fat | 35 gm |
| Protein | 52 g | Sodium | 2,639 mg |
| Carbohydrates | 206 gm | Potassium | 1,411 mg |
| Step 3: Whole Diet Food Groups | ||
|---|---|---|
| Food Group | Recommend | Avoid |
| Milk & milk products | skim milk, products made with skim milk, low-fat yogurt, low-fat cheese | whole milk products, creams (sour cream, light or heavy cream, whipping cream), half & half |
| Soups | fat-free consommé & bouillon, soups made from skim milk, & fat-free broths containing pasta or noodles and allowed vegetables | soups made with cream, whole milk, or broths containing fat |
| Fruits | fruit juices, canned fruits without skins (applesauce, peaches, pears) | all fresh & dried fruits, canned fruits with skins (apricots, cherries, plums, blueberries, fruit cocktail, oranges, grapefruit, pineapple, persimmons) |
| Meat & meat substitutes | eggs, peanut butter (2 Tb/day), poultry, fish, lean ground beef | whole-muscle meats (steaks, roasts, chops), dried beans, peas, lentils |
| Fats & oils | any type of fat, but only in small amounts | none |
| Bread & grains | cream of wheat, pasta, white rice, egg noodles, low-fat crackers | oatmeal, whole grain rice, cereal, bread |
| Vegetables | vegetable juices (tomato, V-8), soft-cooked vegetables without skins (acorn squash, beets, carrots, mushrooms, potatoes, spinach, summer squash, strained tomato sauce, yams) | all raw vegetables, cooked vegetables with skins: beans (green, wax, lima), broccoli, Brussels sprouts, cabbage, cauliflower, celery, corn, eggplant, onions, peas, peppers, pea pods, sauerkraut, turnips, water chestnuts, zucchini |
| Sweets & desserts* | hard candies, caramels, puddings & custards made from skim milk, frozen yogurt, fruit ice, gelatin, ice milk, jelly, honey, syrups | high-fat desserts (cakes, pies, cookies, pastries, ice cream), fruit preserves |
| Beverages | Gatorade, soft drinks (sipped slowly throughout the day), coffee, tea, and water* | all others, except allowed juices |
| *Note: Zero-calorie beverages should be limited if the patient cannot maintain adequate caloric intake. It is important to have enough calories. | ||
| Sample Menu Step 3 | ||
|---|---|---|
| Breakfast | Lunch | Dinner |
|
|
|
| Morning snack | Afternoon snack | Evening snack |
|
|
|
| This sample diet provides the following: | |||
|---|---|---|---|
| Calories | 1,822 | Fat | 42 gm |
| Protein | 75 gm | Sodium | 2,234 mg |
| Carbohydrates | 286 gm | Potassium | 2,467 mg |
Useful Recipes
Try the following recipes along with the sample menu items shown above.
Smoothies
In this recipe, mix all the ingredients until smooth.
- One ripe medium banana (or peaches)
- 1 cup fortified milk (or soymilk)
- 1 cup vanilla yogurt
- 1-2 Tb powdered sugar
- ½ cup ice cubes
Cut the fruits, combine all ingredients, blend until smooth, and add ice. Smoothies provide 500 calories and 22 g of protein.
Shakes
Lactose-free banana and strawberry shake
- One banana
- ½ cup soy/almond milk
- ½ cup liquid nutrition supplement
- ¼ cup pasteurized liquid egg substitute
- Two or more Tb strawberry syrup
This recipe provides 515 calories and 18 g of protein.
Similarly, try combining different ingredients to make a creamy peanut butter banana shake, a tropical smoothie, or any standard milkshake flavors.
Cauliflower Soup
- 4 cups cauliflower
- 3 cups chicken stock
- 1 Tb extra virgin olive oil
- Two garlic cloves, minced
- ½ cup parmesan cheese
Heat oil over medium heat and add garlic. Next, add chopped cauliflower and chicken stock and heat until the cauliflower softens. Using a blender, puree the cauliflower soup until smooth.
References
- Reddivari AKR, Mehta P. Gastroparesis. StatPearls. Published online December 31, 2021. Accessed May 24, 2022. https://www.ncbi.nlm.nih.gov/books/NBK551528/
- Camilleri M, Chedid V, Ford AC, et al. Gastroparesis. Nat Rev Dis Prim. 2018;4(1). doi:10.1038/S41572-018-0038-Z
- Camilleri M. Novel Diet, Drugs and Gastric Interventions for Gastroparesis. Clin Gastroenterol Hepatol. 2016;14(8):1072. doi:10.1016/J.CGH.2015.12.033
- Limketkai BN, LeBrett W, Lin L, Shah ND. Nutritional approaches for gastroparesis. lancet Gastroenterol Hepatol. 2020;5(11):1017-1026. doi:10.1016/S2468-1253(20)30078-9
