What is gastroparesis?

• Gastroparesis is a motility disorder of the stomach, where there is a delay in the stomach’s ability to empty into the small intestine. It is often a chronic disorder. Sometimes it is a brief issue for a child, after an infection.
• Symptoms vary from person to person and can change over time.
• Gastroparesis is suspected based on symptoms. It is confirmed by a gastric emptying scintigraphy scan. This study measures the rate of gastric emptying over 2 to 4 hours after your child is given a test meal.
• Gastroparesis is managed in several ways:
  • Finding the cause for gastroparesis.
  • Symptom relief using diet and medicines.
  • Improving nutrition intake.
  • Preventing or correcting any fluid and electrolytes imbalances.

What are the symptoms of gastroparesis?

• Decreased appetite, nausea, vomiting, reflux, abdominal pain, bloating, fullness, early satiety (feeling full quickly), bad breath, weight loss and progressive decrease in appetite as the day goes on (oral intake is best for breakfast and the smallest for dinner).

Foods that can trigger gastroparesis:

• Large, high-fat, high-protein, and high-fiber meals.

Other factors that contribute to gastroparesis:

• Small intestinal bacterial overgrowth, constipation, use of high-fat overnight feeds, muscle or nerve abnormalities of the GI tract, prior GI surgery, medicines, and recent viral illness.

Healthy eating when gastroparesis is a concern

• The goal is to eat small frequent meals while limiting high-fiber and high-fat foods.
• Since liquids move more easily through the stomach, they may be better tolerated than solids.
• For weight gain we may recommend high-calorie liquids including oral supplements in between meals.

Foods that should be limited include:

• Whole corn, popcorn, whole grains, bran cereal, coconut, nuts/seeds, celery (raw), green beans, whole legumes, and greasy/fried foods.  
  
  Note: High-fiber foods such as beans, nuts and fruit/vegetables are often better tolerated cooked and in puree form such as smoothies, applesauce, nut butters, hummus, vegetable juice and blended soups.

Foods that should be considered:

• Dairy: cottage cheese, kefir, pudding, ricotta cheese, yogurt, milk (low-fat or nondairy milk substitute).
• Fruit: applesauce, banana, canned peaches/pears, melon, mango, nectarines, papaya (remove skin from fresh fruit).
• Vegetables: butternut squash, mashed and peeled white/sweet potato, chopped cooked spinach or greens, boiled carrots/zucchini, tomato sauce.
• Grains: bread (white), cereal (low fiber), crackers (plain), couscous, grits, noodles, pasta, polenta, rice (white), rice cakes, tortillas.
• Protein: chicken, eggs, fish, hummus (2 tablespoons), meatballs or meat loaf made with lean meat, nut butter (1 tablespoon), refried beans (fat free), tofu, cooked beans, or lentils in soups.
• Fat: vegetable/nut/olive/avocado oil or butter (1 to 2 teaspoon serving size) OR 1/8 avocado.
• Herbs: Adding herbs may be beneficial. Some of the following may be added to food or may be available as a supplement. Consider the following after discussion with your health care provider. You can make an appointment with a registered dietitian who can help you with adding these herbs to your diet.
  • Peppermint and caraway oil may reduce spasms in the GI tract, helping with pain and distention.
  • Fennel may relax intestinal muscles and reduces gas.
  • Ginger may relieve nausea.
  • Kiwi contains a compound called actinidin. This may improve gastric emptying, GI motility, constipation, and enhance digestion of protein.
  • Amla fruit may help promote gastric emptying, strengthen lower esophageal sphincter, and relieve constipation.
  • Artichoke leaf extract may help promote gastric emptying.

Recipe suggestions

Soup ideas (thicken, blend and season as desired):

Tip: Use white potato, cornstarch, or a small amount of white beans to thicken a cream soup, in place of heavy cream.

• Butternut squash
• Carrot ginger
• Chicken rice
• Cream of cauliflower
• Cream of mushroom
• Cream of tomato and/or roasted red pepper
• Egg drop
• Miso with tofu
• Potato leek
• Split pea, bean, or lentil
• Turkey Noodle

Smoothie ideas:

• Frozen berries blended with low-fat vanilla yogurt (strain seeds).
• Banana, 1 tablespoon peanut butter and low-fat chocolate milk.
• Avocado (1/8), banana, cocoa powder, soy milk and vanilla extract.
• Pumpkin puree, oat milk, maple syrup and cinnamon.
• Frozen OJ blended with vanilla frozen yogurt.

Basic meal plan (example):

• Breakfast: 1 small white bagel, 2 tablespoons lite cream cheese or mashed avocado, ½ cup OJ
• Snack: 6 ounces low-fat yogurt, ½ cup canned peaches
• Lunch: 2 ounces turkey, 1 ounce cheese slice on 2 slices white bread with mustard, 1 cup sherbet
• Snack: ½ cup pretzels, 2 tablespoons hummus
• Dinner: 3 ounces baked fish/chicken, 1/2 cup white rice OR noodles, ½ cup cooked carrots/zucchini, 2 teaspoons butter or oil
• Snack: ¾ cup corn flakes, ½ banana, 1 cup low-fat milk OR 1 tablespoon peanut butter with 10 plain crackers

Puree/liquid meal plan (example):

• Breakfast: ½ cup cream of rice cereal with 1 teaspoon butter, 1 cup smoothie or liquid nutrition supplement
• Snack: 3/4 cup low-fat cottage cheese and ½ cup grape juice OR ½ cup part-skim ricotta cheese blended with ½ cup canned apricots
• Lunch: 2 scrambled eggs, ½ cup grits topped with 1 tablespoon parmesan cheese, ½ cup vegetable juice, ½ cup low-fat pudding
• Snack: 1 cup cream soup, ½ cup applesauce
• Dinner: 2 to 3 ounces meatloaf, ½ cup mashed potato, ½ cup mashed squash
• Snack: 1 cup smoothie or liquid nutrition supplement

Additional resources

• Food as Medicine podcast
• Integrative Medicine - Primary Care Perspectives Podcast