Falling Back in Love With Food, One Small Portion at a Time – A Gastroparesis Journey

Hey everyone!

I hope you are all doing well and staying safe. This week’s post is going to focus on Gastroparesis and provide readers with tips and tricks to introducing foods back into their diets, keeping a food diary, and fun recipes to try!

Someone I love has recently crossed paths with a Gastroparesis diagnosis and I decided I wanted to learn more about it. After searching for more information, I decided it may be helpful to readers if I put my findings into one blog post. So here it goes!

So, first off – what is Gastroparesis?

Gastroparesis is when the emptying of the stomach is slowed or delayed without there being something physically blocking the pyloric sphincter. This causes those with the disease to experience symptoms such as:

Early satiety
Nausea
Vomiting
Constipation
Diarrhea
Abdominal pain
Weight loss
Poor appetite
Reflux ^1,2,5,6,7

Each individual is unique, and this disease affects everyone differently. Some people tolerate dairy, some people don’t. Some are able to still eat low-fiber, low-fat, and easy to digest solids. Others are able to tolerate pureed solids, while some can only tolerate a more liquid consistency diet.

This being said, your journey with Gastroparesis is completely your own! It is important to work with your Registered Dietitian to come up with a plan that works best for you and provides you with the proper nutrition that your body needs.

How is Gastroparesis diagnosed?

If you’re experiencing the symptoms listed above, your Doctor may decide to test you for Gastroparesis. So how is that done? There are quite a few different methods some of which include: endoscopy, blood tests, imaging, breath testing, and the most common: gastric emptying scintigraphy.⁶

Gastric emptying scintigraphy is a method in diagnosing Gastroparesis where the patient is given a small meal that contains a minimally radioactive substance (radioisotope). This substances allows a Radiologist to see (using imaging) the rate at which the meal empties out of the stomach. They rescan every hour to see the progress your stomach has made on digesting the meal. If after about 4 hours, there is 10% or more of the meal remaining in your stomach, this usually results in a Gastroparesis diagnosis.⁶

What are some of the causes of Gastroparesis?

Gastroparesis can result from gastric surgery, diabetes, nervous system diseases, hormonal response, idiopathic, neurological conditions, stress can be a caused by some medications.^5,6

Diabetic Gastroparesis

Gastroparesis is common in diabetics with uncontrolled blood sugars. Chronic hyperglycemia can result in nerve damage and issues with the autonomic nervous system, which causes slowed motility of the digestive system.^3,6,8,9

Complication of Gastroparesis – Bezoars

Some people may not realize there are serious complications that can arise if someone with gastroparesis does not properly manage their diet. One of these complications is bezoars or specifically, phytobezoars.

Phyto – what!?

Phytobezoars are masses of indigestible food fibers that form in the digestive tract. These masses can cause gastric bleeding, vomiting, loss of appetite, nausea, gangrene (which is death of tissue), ulcers, and obstructions.⁸ This is why it is extremely important to make dietary changes that will help you stay healthy and will hopefully keep your symptoms at bay.

So, now that we have touched upon what Gastroparesis is and the side effects it can bring with it, but what can we do to ease or alleviate some of these side-effects? One of the most important steps is a change in dietary habits.

Recommended foods:^4,7

Fruits

canned or fresh (if tolerated)

Fruit juices
Bananas
Grapefruit, sectioned
Mangos
Nectarines, sectioned
Applesauce
Pineapple
Pears, peeled
Cherries, peeled
Apricots, seedless
Melon, seedless
Peaches, peeled

Dairy

Fat-free or low-fat:

Milk
Yogurt
Cheese
Sour cream
Pudding
Cottage cheese

Grains

White bread
Seedless crackers
Grits
Pretzels
Pasta
Rice cakes
White rice

Vegetables

well-cooked; canned or fresh (if tolerated)

Vegetable juices
Carrots, peeled
Mushrooms
Spinach
Squash
Asparagus, tips only
Avocado, mashed
Cauliflower, well-cooked, mashed
Potatoes (white and sweet), peeled
Onions, finely chopped

Protein

Chicken, skinless
Fish
Eggs
Lean beef
Lean lamb
Tofu
Lean pork
Reduced-fat, creamy peanut butter
Pureed beans (if tolerated)
Pureed lentils, well-done (if tolerated)
Hummus (if tolerated)

Fats

Fat-free or low-fat dressing/mayonnaise/margarine
Butter or cooking oil, used in moderation (if tolerated)

Dessert

Fat-free or low-fat desserts (angel cake, FF/LF ice cream, FF/LF frozen yogurt, FF/LF Italian ice, gelatin, etc.)

Not recommended:^4,7

Fruits

Canned or fresh (if tolerated)

Raw fruit
Dried fruit
Fruit with skins on
Fruit with seeds
Rhubarb

Vegetables

Well-cooked; canned or fresh (if tolerated)

Raw vegetables
Cooked vegetables with skins on
Asparagus stalks
Water chestnuts
Turnips
Cabbage

Protein

Bacon
Bologna
Organ meats
Regular-fat peanut butter or chunky
Tough meats: steaks, chops, roasts
Dried beans
Sausage
Salami
Hot Dogs
Duck
Fish in oil

Fat

Regular mayonnaise
Lard
Shortening

Grains

Whole grains
Donuts
Oatmeal
Gnocchi
Pizza crust (thick)
Bran
Cereals
Bagels
Dumplings
Fettuccini
Crackers with seeds

Dairy

Full fat products: cheese, yogurt, pudding, cream cheese, sour cream, etc.
Heavy whipping cream
2% milk
Whole milk

Desserts

Cakes
Pies
Full-fat ice cream/frozen yogurt
Cookies
Pastries

Helpful meal time tips

Avoiding high-fat and high-fiber foods is recommended when following a Gastroparesis diet. Highly fibrous and high-fat foods are digested more slowly, worsening your symptoms. By avoiding these kinds of foods, this could help with symptom management.^3,4,6,7

If you are currently tolerating liquids only, it is extremely important to be sure you are getting the appropriate nutrients through your liquid diet. Work with a Registered Dietitian to formulate a plan that works for you and your tolerance. Some of the best ways are to use nutrient rich smoothies and protein shakes.

Soup is a great option as well!

Trying to consume smaller portions, more frequently is recommended for most people with gastroparesis. When you are consuming larger portions, it takes longer for the stomach to digest. This, in combination with delayed emptying, can cause a flare up of uncomfortable symptoms.⁶

Be sure to chew your foods very well. If your foods are not being chewed very well, this makes more work for your stomach. Well masticated foods will help take any extra stress off your stomach during the digestion process.^4,6

It is also recommended that you remain standing for about an hour after eating and to make sure you do not eat while laying down. This can help encourage the stomach to digest what you’ve consumed and improve symptoms. Even better, going for a walk after eating can encourage digestion.^4,6

Nutritional Supplements

If you have trouble getting enough calories, protein, and nutrients from foods alone, speak with your Dietitian and see if starting on a nutritional supplement may be a good decision for you. There are different protein shakes and supplements with additional calories that can aid your food intake to get you where you need to be.

Advanced cases of Gastroparesis-

Sometimes with more severe cases of Gastroparesis, some individuals require a feeding tube. This can be a jejunostomy tube which is a feeding tube that goes into your jejunum, bypassing both the stomach and the duodenum. This is a very commonly used feeding method for advanced cases of gastroparesis where the stomach and duodenum are no longer functioning adequately enough to keep you nourished. Parenteral nutrition is also an option, but is only used in severe cases when the digestive system is no longer a functional option. This bypasses the digestive system completely and delivers nutrients intravenously. There are many complications that can arise from this method and should only be used if the digestive track is no longer an appropriate option.⁶

Whoa – where do I start?

So, now you have an idea of what is recommended and not-recommended, but where do you start? This can feel like a huge hurdle, but no need to fear, it doesn’t have to be! So, next choose a starting point. If there are a few recommended foods you know you tolerate with little or no complications, start there. Then, after a few days, add in one new food item at a time. This will most certainly help you identify if one food causes you more discomfort than another. It is extremely important that you establish a starting point though. If you don’t, you will not be able to identify which foods are causing you problems and which are not.*

Be sure that with each new food, you are keeping track of it in your food diary. Also, keep track of when you ate it and be sure to write down how you felt afterwards and if you experienced any symptoms write down what they were! This will also help you identify how certain foods make you feel so you can plan meals accordingly. *Disclaimer: be sure to work with a registered dietitian while checking your tolerance of certain foods. Going through your food diary together can be very beneficial!

Going forward –

How do we take this information and turn it into real meals that you will enjoy? Loving food again can be quite the challenge, especially when for so long it has caused you trouble and pain. I want you to know your relationship with food can get better. It’ll take time to learn your body and what works best for you but once you do, doors will open for new food possibilities. Now, it is very easy to look at your new dietary restrictions and see the negative. That is ok. Allow yourself time to be upset about how things have drastically changed. But, don’t stay in that sadness too long. There are so many ways to add pizzazz to your foods while still following a modified diet. There are many different flavor combinations, molds, and methods. If you ever get stuck and need some new ideas – definitely utilize Google, or one of my favorites: Pinterest. These resources can give you plenty of new ideas to try. You can also look into different cook books and what those in the support groups might recommend. Be sure to look for credible information and if you have any questions or concerns about information you found definitely consult with your Registered Dietitian or Doctor.

Recipes to try:

Helpful links and resources

Here are some helpful links that can direct you to further information should you seek more or even to a support group here in the New England area. If you are a reader from outside of the New England area simply searching for “Gastroparesis support groups near me” can help you locate local resources. Another helpful resource I found was Facebook! There are so many different groups on Facebook where people post about their own experiences. I definitely recommended checking out the link to the Facebook page below! Good luck on your journey everyone! I wish nothing but health and wellness!

Support groups and additional resources:

https://www.facebook.com/gastroparesissupport/

https://curegp.org/resources/

Find a doctor in the Southern NH, Massachusetts area:

https://www.snhhealth.org/find-a-doctor/jassir-witta

https://integratedgic.com/