Overview
Dietary management of gastroparesis
Important
This information is produced for adults under the care of Guy’s and St Thomas’ hospitals. We usually give you the information after an assessment or appointment. Your dietitian or other health professional may give you different guidance, depending on your specific medical needs.
It is important to check with a health professional before making any changes to your diet. Please contact your dietitian if you have any questions or concerns.
If you are not a patient at Guy’s and St Thomas’ hospitals, please contact a GP or specialist health professional.
This information gives advice about your diet to help you manage your symptoms if you have been diagnosed with gastroparesis.
Gastroparesis describes the symptoms of delayed stomach emptying. The cause is often not known but people with type 1 diabetes are more commonly affected.
Food usually moves at a steady rate from the stomach into the bowel. Delayed stomach emptying means that the food you eat moves at a slower rate from the stomach into the bowel.
This information covers:
- the symptoms of gastroparesis
- the treatments for gastroparesis
- changes to your diet
- suggestions for meals and snacks
- diet advice for severe symptoms
If you have any questions or concerns, please speak to your dietitian.
Symptoms of gastroparesis
The symptoms of gastroparesis are:
- discomfort or pain in the tummy (abdomen)
- bloating
- feeling very full after eating small amounts of food, or being unable to finish meals
- feeling sick (nausea) and sometimes being sick (vomiting)
If people have severe symptoms, they may lose weight because they cannot eat and drink enough. Your dietitian can guide you depending on your individual needs.
Treatments for gastroparesis
The treatments for gastroparesis include lifestyle changes, medicines and changes to your diet.
Lifestyle changes
Here are some lifestyle changes that can help you to manage gastroparesis:
- Eat slowly and chew food well: If you chew each mouthful and break down food as much as possible before it reaches the stomach, this can improve your symptoms. Try to take 15 to 30 minutes to finish main meals. Make sure that you sit upright to eat and do not hunch over your food.
- Regular meals: Aim to eat small meals regularly. Instead of typically having 3 meals a day, you could have 3 small meals and 2 to 3 snacks. This makes it more likely that you can tolerate your food. Try to spread these meals and snacks evenly throughout the day. Avoid only eating 1 meal a day. If you have type 1 diabetes and need help with your mealtime insulin, please speak to your diabetes dietitian.
- Avoid eating late at night: Aim to have your main meal earlier in the evening. If you are mobile (active) and upright for 1 to 2 hours after meals, this will help with food digestion and stomach emptying.
Medicines
Medicines for gastroparesis can include the following:
- Prokinetics: Examples of these medicines are metoclopramide and domperidone. They help to speed up stomach emptying and reduce bloating and fullness after meals. It is best to take the medicines just before you eat your main meals.
- Anti-sickness medicines: An example is prochlorperazine. These medicines help to prevent you from feeling sick (nausea) or being sick (vomiting). It is best to take the medicines just before meals if you feel sick.
Your medical team may need to review and change your other medicines. This is to make sure that they do not contribute to slowing down your stomach emptying.
If lifestyle changes and medicines do not help or your symptoms continue, your doctor may prescribe other treatments.
Changes to your diet
This section gives guidance on how changes to your diet can help to manage gastroparesis symptoms.
Texture
It is usually easier for your body to cope with soft foods that can be mashed and liquid foods, such as smooth soups and smoothies.
Reduced fibre
Here are some tips for reducing the fibre in your diet to help manage your symptoms:
Do
- avoid foods high in fibre, which have more than 6g of fibre in each 100g and can slow down stomach emptying
- swap wholemeal, wholegrain or brown bread, pasta, rice and breakfast cereals for white bread, pasta, rice, crackers and low-fibre breakfast cereals, such as rice pops and cornflakes
- peel potatoes, fruits and vegetables where possible and cook vegetables until soft
- reduce the raw fruits, raw vegetables and salads that you eat
- limit pulses, beans or peas and lentils, dried fruit, nuts, seeds and brassica vegetables, such as cauliflower, broccoli and Brussels sprouts
- try to reduce the fibre in your diet to help control your current symptoms, even if you have diabetes and were advised to eat high-fibre or low glycaemic index foods
Reduced fat
Here are some tips for reducing the fat in your diet to help manage your symptoms:
Do
- avoid foods high in fat, which have more than 17.5g of fat in each 100g and reduce the speed that food empties from the stomach
- limit high-fat foods, such as biscuits, cakes, pastries, chips or fries, nuts and seeds
- avoid high-fat meats, such as pork belly, salami, chicken wings or fried chicken, sausages, burgers, goat, mutton, oxtail and cow, chicken or pig feet
- choose plain fish fillets, chicken thighs or breast, turkey, low-fat mince and lean pork or beef steak
- cut any fat that you can see off meat and avoid fish or chicken skin
- grill, bake, boil, casserole and steam foods with small amounts of oil, rather than frying or roasting them
Fluids with food
Here are some tips for managing the fluids that you drink:
Do
- stay hydrated by sipping fluid throughout the day
Don't
- do not drink large amounts of fluids (more than 100ml) at the same time as you eat because it is likely to make you feel fuller
- do not have fizzy (carbonated) drinks if they make you feel bloated and uncomfortable
Other tips
Here are some other tips with your diet to help manage gastroparesis symptoms:
Do
- use a spray oil when cooking to reduce the fat content, or a maximum of 1 teaspoon oil
- use garlic, black pepper, tomato purée or dried herbs to flavour food instead of adding onions
- use small amounts of extra light spread on bread or toast
Suggestions for meals and snacks
This section gives examples of meals and snacks that may help with symptoms of gastroparesis.
Breakfast
Suitable options for breakfast include:
- Cornflakes or Rice Krispies® with skimmed or semi-skimmed milk
- low-fat yoghurt with peeled soft fruit or a banana
- scrambled, boiled or poached egg with white toast (using a small amount of low-fat spread)
Lunch
Suitable options for lunch include:
- a white bread sandwich or wrap with chicken, ham or tuna, low-fat mayonnaise and peeled cucumber
- soup (smooth consistency) with a white bread roll
Dinner
Suitable options for dinner include:
- chicken breast (skin removed) with white pasta and smooth tomato sauce
- tofu with white rice or noodles and peeled, well-cooked vegetables
- baked white fish with mashed potato and peeled, well-cooked vegetables
Pudding
Suitable options for pudding include:
- tinned peaches
- sorbet
- an iced lolly or ice cream with low or reduced fat
- low-fat custard
Snacks
Suitable options for snacks include:
- plain rice cakes with low-fat cream cheese
- baked crisps or low-fat crisps
- fruit, such as melon, berries or peeled soft fruit
- peeled cucumber sticks with a low-fat salsa or dip
Diet advice for severe symptoms
If you get severe gastroparesis symptoms, you may be advised to follow a liquid or purée diet temporarily. This can help you to meet your nutritional needs.
Your dietitian will give you more detailed advice and prescribe supplementary drinks, if needed.