By: Angie Dye, MS, RDN, CSSD, LDN

August is National Gastroparesis Awareness Month. If you are good with Latin roots, you may realize that “gastro” refers to stomach and “paresis” refers to impaired movement, meaning that gastroparesis is a problem that affects the normal emptying of the stomach. This can lead to significant nutrition-related problems, as many people affected by gastroparesis suffer from early satiety (feeling very full after just a small amount of food), nausea, vomiting, and bloating.

While the incidence and prevalence of gastroparesis are not well-defined, the condition is estimated to affect up to 5 million individuals in the US (1).  When I first learned about gastroparesis many years ago in my dietetics training, it was mainly in the context of a complication from uncontrolled diabetes. Now 20 years later, most of the cases I see in my private practice are “idiopathic,” meaning the cause is unknown. Many patients with idiopathic gastroparesis develop symptoms following a virus or acute gastrointestinal illness.

While diagnosis of gastroparesis should always be performed by a physician, the dietitian plays an important role in helping patients manage symptoms with nutrition interventions.

Here are a few key concepts to nutrition interventions that assist with gastroparesis:

1. Choose small, frequent meals and snacks. With slow gastric emptying, small meals are much better tolerated than typical American larger meals. I typically encourage patients to try eating small amounts 5 or 6 times per day.
2. Keep fat and fiber content low. Both fat and fiber delay gastric emptying, so keeping these both low initially will allow the stomach to empty better. This may be the opposite of what patients consider “healthy,” as refined, white breads, cereals, and pastas that are low in fiber are the easiest to tolerate. Also things like fresh fruit and vegetables, which are normally considered healthful, can be very hard to tolerate. The goal would be resuming a higher fiber diet with more whole grains and fresh produce as symptoms improve, but in the short term the foods that are the healthiest for a person with slow gastric emptying may look different.
3. Liquids may be better tolerated than solids. Liquids tend to leave the stomach much more easily than solid food. I try to help my patients get the nutrients they need through smoothies, soups, juices and other liquid supplements, especially if their symptoms are severe.
4. Pay attention to hydration. Getting in adequate fluids, particularly in hot summer months, can be a challenge. I encourage fluids in between meals and create a plan to make sure fluid needs are met.
5. Avoid carbonation. Soda and other carbonated beverages aren’t so great for any of us, but those bubbles can add a lot of discomfort if stomach emptying is slow. Keep the liquids flat until symptoms improve.
6. Supplementation may be needed. If the diet is quite limited for a prolonged time, supplementation with vitamins, minerals or even an alternate feeding method such as a tube feeding may be required.
7. Know that it will get better. I have learned that everyone is different with how and when they improve symptomatically, but most patients do get some relief from these interventions and are able to resume more normalized eating in the future.

Angie Dye, MS, RDN, CSSD is a Private Practice Dietitian who specializes in Intuitive Eating, Sports Nutrition and Gastrointestinal Nutrition in Hershey, PA.  Follow her on Facebook,  Twitter @CarpeDiemRDN and Instagram @AngieDye3

Reference:

1. NIH, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Gastroparesis Clinical Research Consortium. https://repository.niddk.nih.gov/studies/gpcrc/ (Accessed January 16, 2018)