Sponsored by G-PACT

Crystal SaltrelliCertified Health Counselor

Crystal@LivingWithGastroparesis.com

Angie MoedingRegistered Dietitian

MoedingA@G-PACT.org

I’ve recently been diagnosed with gastroparesis and I’m not sure what to eat or how to eat. Can you give me some guidelines?

Submitted by: Christine

Small, Frequent MealsLow-FatLow-Fiber

Are the dietary suggestions different if you have idiopathic versus diabetic gastroparesis?

Submitted by: Amy

• No studies have been conducted regarding the optimal diet for managing gastroparesis

• Recommendations are based on what is likely to be helpful for most patients

• Specific dietary tolerances vary• Symptoms and reactions to certain foods may

change from day-to-day• Over-restricting your diet can unnecessarily limit

proper nutrition

• Helps to reduce fullness and stomach distention• Largest determinant of gastric emptying time is volume• A large meal empties more slowly than a small meal…BUT…• A certain amount of food is required to trigger the empting

response• A general recommendation is 1 to 1 ½ cups of food per meal• The optimal amount of time between meals is different for each

person – usually somewhere between 2 and 4 hours• Can alternate solid and liquid/semi-liquid meals or start the day

with solids and progress to liquids towards the evening• Experiment to find the pattern that works best for you

• Dietary fat delays gastric emptying. Most patients benefit from following a low-fat (not no-fat!) diet.

• A typical recommendation is no more than 40 grams/day.

• Any type of fat (butter, oils, etc.) can be considered GP-friendly in small amounts.

• If symptoms progress as the day goes on, foods/meals containing fat may be better tolerated earlier in the day.

• Some patients can tolerate fat in the liquid form (i.e. full-fat dairy, coconut milk, milk shakes or ice cream).

What if certain foods are higher in fat but they don’t seem to cause any symptoms? Is it safe to eat them?

Submitted by: John

Fiber also delays gastric emptying. GP patients should reduce the amount of fiber in their diet in accordance with their symptoms.A typical recommendation is 10-15 grams per dayCertain fiber-containing foods, such as vegetables, fruits, legumes, etc., may be well-tolerated when cooked and/or pureed. All food should be chewed very well to aid in digestion. Foods that cannot be easily chewed, such as broccoli, corn, popcorn, nuts, and seeds, may need to be avoided.

Is it possible to safely consume enough fiber for good health and regular bowel movements on a gastroparesis diet? Are some kinds of fiber better for GP patients than others?

Submitted by: Barbara & Others

What are bezoars and how worried do I need to be about getting one?

Submitted by: Emma

Are “stringy” foods or things with larges particles, such as cooked yams/squash, applesauce, dried spices, nuts, and bananas likely to cause bezoars?

Submitted by: Heather

It is possible for food that is poorly digested to collect in the stomach and form a mass called a bezoar. It’s important to note that bezoars are rare, occurring in only about 20% of gastroparesis patients .Specific foods associated with bezoar formation include: apples, berries, broccoli, Brussels sprouts, coconuts, corn, green beans, figs, oranges, persimmons, potato peels, and sauerkraut. Fiber supplements such as Metamucil, Peridem, Benefiber, Fibercon and Citrucel should also be avoided if bezoar formation is a concern.

My doctor told me to eat white bread, white rice, and canned fruits and vegetables. How can this be healthy? It goes against everything I’ve heard about good nutrition.

Submitted by: Donna

Meat/Poultry• Lean ground beef• Ground turkey• Turkey breast• Chicken breast• Poultry Sausage

FishEggs/Egg WhitesNut Butters• Creamy/Smooth

Vegetables• Well Cooked• Pureed, if necessary• Ex: carrots, spinach, potatoes,

yams/sweet potatoes, beetsFruits• Ripe, cooked, stewed, juiced,

blended or pureed• Ex: applesauce, bananas, soft

melons, mangos, papaya, peaches, pears

Grains• Rice• Pasta• Bread/rolls/pitas• Crackers• Hot cereals

Cream of Wheat; Cream of Rice; Cream of Buckwheat; Oatmeal, if tolerated

• Cold cerealsCheck fiber content; avoid dried fruits, nuts or seeds

Dairy (or dairy alternative)• Cheese• Yogurt/Kefir• Milk• Puddings

Treats (in moderation)• Rice Krispie Treats• Low-fat baked goods• Caramels, marshmallows,

hard candies

Can you provide some tips for Type 1 Diabetics on a liquid/soft food diet?

Submitted by: Jodi

Liquids and pureed foods usually empty more quickly and easily than solid foods. A full-liquid diet may be helpful in managing severe DTP symptoms.Note: Nutrient-dense or acidic liquids empty more slowly than other liquids. Diluting them with up to equal parts water will speed emptying.A full liquid diet includes: shakes & smoothies, blended soups, pureed fruits and veggies, puddings, jello, hot cereals, milk, juice, etc.

How do we ensure proper nutrition during the times when we can’t eat solid food?

Submitted by: Michelle

Nutritional Supplement Drinks• Boost/Ensure/Enlive

• Orgain (organic; half the sugar)

Smoothies• Use any fruit that is well-tolerated

• Blend with regular yogurt, Greek yogurt, dairy or non-dairy milk, supplement drink or fruit juice

• Optional: peanut/almond butter

• Optional: protein powder (experiment to determine which type works best for you – rice, whey, egg white, soy, etc.)

Fresh Juice • Contains enzymes, vitamins and

minerals

• Juicing removes most of the fiber

• Strain to remove remaining pulp

• Diluting fresh juice with water may make it easier to digest

• Most fruits/veggies can be juiced

Baby Food Fruits & Veggies• Already pureed and strained

• Wide variety of options

• Try mixing baby veggies in with mashed potatoes to improve taste

Refrigerated, flash-pasteurized fruit/veggie juices

• Bolthouse Farms/Naked/Odwalla• Can strain before drinking if there

are seeds or excess pulp• Choose juices with the highest

vitamin/mineral content (found on nutrition facts panel)

• Avoid juices with added sugar• Start with ~4 ounces diluted with

up to an equal amount of water

Soups• Puree prepared or homemade

varieties containing cooked veggies, lean meats/poultry and/or pasta, rice or other tolerated grains

Hot Cereals• Cream of wheat, rice, brown rice,

and buckwheat are all low fiber options

• Can add pureed fruits, maple syrup, nut butters, etc.

Cooked, pureed fruits and veggies

My son is 5 years old. Do you have any kid-friendly, GP-friendly diet suggestions?

Submitted by: Chrissy

Keep a food journal to help determine which foods cause or exacerbate symptoms and which do not.Focus on maximizing the nutrition in each bite or sip you take. Minimize junk food and empty calories.Keep a variety of easy, GP-friendly options on hand to minimize both stress and boredom.Consider both the nutrition facts and ingredient labels when deciding if a product is “GP-friendly.” (ex: a product that contains “whole grains” but has only 1 gram of fiber, would be acceptable.)

Is it possible to maintain a normal lifestyle – for example go out to dinner or travel with family and friends?

Submitted by: Alison & Others

The Gastroparesis GourmetA GP-Friendly Cookbook$15; available via G-PACT’s website

www.G-PACT.org

www.LivingWithGastroparesis.com