How Should I Eat With Gastroparesis?
I was recently diagnosed with gastroparesis, but I’m unclear about what I can and can’t eat. Do you have any meal-planning guidelines? Judy Ledford, Redlands, California
Meghann Moore, RD, CDE, MPH, responds:
Gastroparesis can make certain foods more difficult to digest, so it’s great you’re thinking in advance about meal planning.
What to Know
Gastroparesis is a complication of diabetes where the nerves and muscles that regulate stomach emptying do not work properly. This can lead to abdominal pain and discomfort with heartburn, fullness and bloating, nausea, and vomiting. Some people also experience constipation, diarrhea, or both. Gastroparesis may affect up to 50 percent of people with diabetes.
There is not a lot of research on nutrition and gastroparesis. Current recommendations are based on what we know about the disease and what patients tell us works for them. Meal-planning guidelines include eating foods that digest quickly: non–whole grain breads, cereals, and crackers; peeled soft fruits; well-cooked vegetables (not raw); lean proteins prepared with minimal fat; and juice and milk as tolerated.
Aim to eat six small, frequent meals and snacks during the day, with 15 to 45 grams of carbohydrate each. Liquid foods (beverages, shakes, soups) are more easily digested than solids, and low-fiber foods are best, as fiber can delay stomach emptying. Avoid high-fiber foods such as berries, brussels sprouts, whole grains, and legumes because of the risk for bezoar formation (an indigestible mass of food residue in the stomach).
A high-protein diet or neglecting to chew your food thoroughly can aggravate gastroparesis. Finally, be sure you are getting enough of the nutrients you need each day, especially magnesium, iron and ferritin, vitamin B12, and 25-hydroxy vitamin D; your doctor can monitor your lab values of these, and a dietitian can discuss foods that best meet your needs.
- Stick to small, frequent meals and snacks with foods that are low to moderate in fat and low in fiber.
- Eat slowly, take small bites of food, and chew your food well.
- Discuss with your doctor whether any medication changes are needed because of changes in when, what, and how often you eat.
- Do your best to keep your blood sugars in target range day to day, and avoid major glucose swings by keeping your carbohydrate intake moderate and spread evenly throughout the day.