Elisa Ross, RDN, LD, is a registered dietitian nutritionist in midcoast Maine. She helps clients improve their health and well-being through the use of whole foods and lifestyle changes. She welcomes requests for future article topics as well as general comments and questions. Visit her website at www.elisarossnutrition.com, send an email to elisarossnutrition@gmail.com or call 338-1655.
If you answer yes to many of the following questions, you may have gastroparesis: Do you get full early in a meal? Does food often seem to just sit there, almost like a brick in your stomach? Is your belly often visibly distended? Do you feel better in the morning, but then have a belly that continues to bulge throughout the day? Does your appetite wane as the day goes on? If you think this may describe you, there is still good news — a lot can be done with diet and lifestyle to manage symptoms.

Gastroparesis is a motility disorder of the stomach, literally translating to “gastric paralysis.” It affects two to four percent of the population and is more common in women. A healthy stomach is a key player in the body’s ability to turn food into nutrients that fuel our bodies. A normal stomach grinds food into smaller particles (similar to a blender), combines it with acid and digestive juices, and propels the liquefied food into the small intestine, where further digestion and nutrient absorption take place. The stomach should empty at least ninety percent of a meal’s volume after four hours. In gastroparesis, this process is impaired to various degrees. Food stays in the stomach much longer than normal, leading to the uncomfortable symptoms below.

Symptoms

Gastroparesis is characterized by early satiety or a sensation of fullness early in a meal, decreased appetite, nausea, vomiting, bloating or distention, heartburn, regurgitation, and abdominal pain all can occur as meal contents stay in the stomach for longer than they should. Complications from gastroparesis can be serious, and sometimes even life threatening: it can lead to electrolyte imbalances and dehydration from the inability to keep food or fluids down. Early satiety and nausea can also lead to unintentional weight loss and/or malnutrition as you reduce the amounts of calories and nutrients you are able to eat in a day. Paradoxically, some actually gain weight as they turn to more refined carbohydrates such as pasta and refined flour breads in an effort to alleviate their symptoms. Gastoparesis can also predispose one to SIBO, Small Intestinal Bacterial Overgrowth, as food sits in the stomach longer and lingers in the intestines. Poor blood sugar control in those with diabetes can also occur. Symptoms range in severity and can significantly affect quality of life, including one’s physical, emotional, and mental health.

Causes

The cause of gastroparesis is not always known and subsequently labeled idiopathic. Other causes include uncontrolled diabetes (Type 1 and Type 2); certain surgeries if the vagus nerve – a major digestive system nerve — was injured; neuromuscular diseases; autoimmune conditions; endocrine disorders like hypothyroidism; viral infections; psychological conditions; certain cancer treatments; and eating disorders, among others. Certain medications can also slow gastric emptying, including narcotics, diabetes medications, and tricyclic antidepressants.

Diagnosis

There are many ways to diagnose gastroparesis. There are also medications that can help, though these are often not used as first line therapy. These topics are beyond the scope of this article. If you suspect you have gastroparesis, make sure you see a doctor to get an accurate diagnosis and recommendations on appropriate course of action.

Nutrition

Diet can be very helpful in managing gastroparesis symptoms. Texture, fiber content, and fat content can all affect the rate of stomach emptying. Texture is an important concept to be aware of. If you think of your stomach as a blender, would it have an easier time blending a raw kale salad or steamed carrots? Generally, softer, wetter, and well-cooked vegetables will be better tolerated. Smoothies, soups, and stews can come in very handy. A blender can be very useful for this. Along the same lines, avoiding very rough forms of fiber such as large seeds (pomegranate), fruit peels, and brans can be helpful. It goes without saying that chewing well and for a long time is key. Fat will delay stomach emptying, but it is also essential for health. Don’t overdo fat, but make sure you get enough. Fat in liquids will be easier to tolerate than fats in solid form.

Meal volume and timing are also important. The smaller the meal, the less time the stomach takes to empty. Smaller meals allow more room in the stomach for “blenderizing” to occur, improving digestion and emptying. But, the smaller the meal, the more meals one needs to have to get all nutrients in. Allowing four hours in between meals is ideal, though not always feasible. Weight status is an important consideration here.

Last, being sedentary is best avoided. Light physical activity after meals can help speed up gastric emptying. Going for a short walk after a meal or even walking around the house is a pleasant way to get in this activity, and has other benefits as well.

These are just some examples of how symptoms can be managed with diet and lifestyle. As you can see, there is much that can be done, and that is in your control. If you are struggling with gastroparesis, know that there is more help available. Speak with a knowledgeable health care practitioner who can give you more targeted direction based on your particular needs and preferences.

If you would like your nutrition questions answered, send them to the email below.

The information provided in this article is intended for general use only and is not to be used in place of medical advice from a licensed health professional.