Gastroparesis Diet

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 1: Liquid Diet Food Groups
Food Group Recommend Avoid
Milk & milk products none all
Vegetables none all
Fruits none all
Bread & grains plain saltine crackers all others
Meat or meat substitutes none all
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
  • Gatorade 1/2 cup
  • ginger ale 1/2 cup
  • bouillon 3/4 cup
  • saltine crackers 6
  • Gatorade 1/2 cup
  • Coke 1/2 cup
  • bouillon 3/4 cup
  • saltine crackers 6
  • 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 g
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
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
Meat or meat substitutes eggs, peanut butter (maximum 2 Tb/day) beef, poultry, fish, pork, dried beans, peas, lentils
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
  • skim milk 1/2 cup
  • poached egg 1
  • white toast 1 slice
  • apple juice 1/2 cup
  • mozzarella cheese 2 oz
  • saltine crackers 6
  • chicken noodle soup 3/4 cup
  • Gatorade 1/2 cup
  • peanut butter 1 Tb
  • saltine crackers 6
  • vanilla pudding 1/2 cup
  • grape juice 1/2 cup
Morning snack Afternoon snack Evening snack
  • ginger ale 1/2 cup
  • canned pears 1/2 cup
  • skim milk 1/2 cup
  • cornflakes 1/2 cup
  • sugar 2 tsp
  • frozen yogurt 1/2 cup
  • saltine crackers 6
This sample diet provides the following:
Calories 1,343 Fat 35 gm
Protein 52 g Sodium 2,639 mg
Carbohydrates 206 g 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
  • skim milk 1/2 cup
  • cream of wheat 1/2 cup
  • sugar 2 tsp
  • orange juice 1/2 cup
  • white toast one slice
  • margarine 1 tsp
  • jelly 1 Tb
  • tuna fish 2 oz
  • low-fat mayonnaise 2 Tb
  • white bread two slices
  • canned peaches 1/2 cup
  • Gatorade 1/2 cup
  • 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 Afternoon snack Evening snack
  • baked chicken 2 oz
  • low-fat yogurt 1/2 cup
  • chocolate pudding 1/2 cup
  • ginger ale 1/2 cup
  • ice milk 1/2 cup
  • pretzels 2
This sample diet provides the following:
Calories 1,822 Fat 42 gm
Protein 75 g Sodium 2,234 mg
Carbohydrates 286 g Potassium 2,467 mg

References

  1. Reddivari AKR, Mehta P. Gastroparesis. StatPearls. Published online December 31, 2021. Accessed May 24, 2022. https://www.ncbi.nlm.nih.gov/books/NBK551528/
  2. Camilleri M, Chedid V, Ford AC, et al. Gastroparesis. Nat Rev Dis Prim. 2018;4(1). doi:10.1038/S41572-018-0038-Z
  3. 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
  4. 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

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