210.634.2200

Gastroparesis, nicknamed “stomach paralysis,” is defined by having delayed stomach emptying or having an extended time of emptying stomach contents into the intestines. This condition commonly results in symptoms such as:

  • early satiety
  • poor appetite
  • abdominal discomfort
  • bloating
  • nausea
  • vomiting
  • acid reflux

This condition can also result in malnutrition and unexpected weight loss due to inadequate food intake, bacterial overgrowth, and in more extreme cases can lead to stomach or small intestinal obstructions called bezoars. While one in four adults in the United States have similar symptoms, only about one in 2,000 adults are diagnosed.

What can cause gastroparesis?

Common etiologies of gastroparesis tend to focus around conditions that affect the neurological system, conditions that affect:

  • blood sugar control
  • systemic disorders
  • radiation and other cancer treatments
  • some eating disorders
  • some medications such as narcotics, calcium channel blockers
  • some nerve signal blockers (anticholinergics), and tricyclic antidepressants

Conditions or surgeries that mess with the vagus nerve, the longest nerve in the body that reaches behind the stomach, are among the most common causes. Diabetic conditions are also often linked due to neuropathy causing nerve damage and hyperglycemia which is known to slow gastric emptying. While these are the most common, around 1/3 of cases have an unknown cause.

How do I know if I have gastroparesis?

Most physicians will request an endoscopy, but the gold standard for diagnosing gastroparesis involves a scintigraphy. During this procedure, the patient consumes food or drink with radioactive material that helps the examiners measure the rate of gastric emptying 1-4 hours following consumption. If 10% of the contents remain in the stomach after four hours, then this often confirms the diagnosis. Other tests include gastric emptying breath tests, and some may use motility capsules to also measure emptying.

Which foods and beverages can affect gastroparesis?

Foods that take more energy and that are harder to breakdown can slow digestion even further, leading to an exaggeration of symptoms. Examples of these include foods heavy in protein, fiber, and fat. In addition, those who suffer from gastroparesis usually have higher markers of inflammation in their body and may have certain food triggers that may also amplify symptoms. Beverages that increase acid production are also common triggers. Examples of items based on this description includes:

  • Large portions of meat
  • Keto products with large amounts of fiber to lower net carbs
  • Fried foods
  • Raw fruits and vegetables
  • Legumes
  • Alcohol
  • Carbonated beverages

What other behaviors aggravate symptoms of gastroparesis?

Eating practices that create more work for the stomach and the rest of the digestive system will also stress this condition. Examples include eating quickly, large bite sizes, poorly chewing food, eating large portions, binge eating, and overeating. Habits such as smoking have also been linked with slowing gastric emptying.

What can I do to help treat gastroparesis?

Treatment often depends on severity and frequency of symptoms. Nutrition is often a great start to controlling gastroparesis. First recommendations often include consuming smaller and more frequent meals to avoid overeating, eating 4-6 times per day. Second, it is recommended to minimize consumption of triggering foods and drinks. Aim to eat:

  • lower residue/fiber foods
  • moderate amounts of lean protein (2-3oz per meal)
  • cooked vegetables and fruits
  • foods low in fat (though if needing the calories liquids with higher fat tend to be tolerated easier)
  • In extreme cases, more pureed or liquids

It is important to note that while some food triggers are common, each individual will have varying food/beverage triggers and their treatment should be personalized based on their individual reactions. Practicing intuitive or mindful eating is also a great way to slow down and chew food thoroughly, assisting the digestive system. It can also assist you in identifying dietary and other triggers for exacerbation of gastroparesis symptoms. It is also recommended to do some light activity such as walking following meals and to avoid lying down to help increase the rate of stomach emptying.

If these methods do not work, medications and prokinetic agents can also be prescribed by your doctor to help. Antiemetic agents can also help reduce nausea and vomiting to help promote meal consistency and increased food intake. Using these medications in tandem with the other methods mentioned above helps best when working with more stubborn cases. If your case is more extreme and these methods don’t work, your provider may consider enteral nutrition.

How can the Bariatric Counseling Center help me with gastroparesis?

While some recommendations seem simple on paper, changing eating methods and habits and discovering your triggers can be overwhelming. At BCC, our dietitians and other health professionals will work with you and your medical providers in order to find a routine and plan that suits your needs best. In our program, you will eat a variety of meals with our team three times a week, so we can help you adjust your eating habits through observation. We can provide feedback to you on your bite size, eating speed, and other habits. Our culinary staff can typically accommodate modifying recipes to avoid trigger foods and we will help you to avoid your dietary triggers while dining with us.

Our meals take place mid-program, so we will have 90 minutes together after program to help you observe your responses to various foods and eating behaviors. Our team can also help you track your symptoms, help you develop a meal plan, and help you develop a movement plan to reduce your triggers, symptoms and discomfort and improve your health. We will work closely with you to help you better discover your hunger and fullness cues and to make sense of symptoms like bloating that may represent hunger, fullness, irritation, or something else entirely.

For further help with practicing and setting up better habits for you, call the Bariatric Counseling Center at 210-634-2200 for more information about how our IOP can help you today!

References

Jones J. Gastroparesis. Today’s Dietitian Website. https://www.todaysdietitian.com/newarchives/070114p16.shtml. July 2014. Accessed January 30, 2024.

Gastroparesis. National Institute of Diabetes and Digestive and Kidney Diseases NIH website. https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis. Updated January 2018. Accessed February 1, 2024.