Page 1 of 6 Clinical Nutrition Services Diet Tips for Gastroparesis Outpatient nutrition visit What is gastroparesis? Gastroparesis means your stomach empties more slowly than normal. It can cause nausea, vomiting, heartburn, bloating, belching, feeling full quickly, smaller appetite, weight loss or feeling tired. Your symptoms may vary from day to day. Diet basics Large meals, solid foods and foods high in fiber or fat stay in the stomach even longer in people with gastroparesis. Changing your diet will help you feel better. Meal size How to stay healthy Abdominal pain, nausea and dehydration are the top reasons patients with gastroparesis come to the hospital. Our goal is to help you avoid this. Eat 5 to 8 small meals per day. Make sure to get enough fluid, even when your symptoms are bad. Eat less fat (less than 50 grams/day) Eat less fiber (less than 15 grams/day) Walk or stretch for 10 minutes after eating. Try relaxation techniques or exercise to decrease stress. Smaller meals empty from the stomach faster, so they cause fewer symptoms. If you make your meals smaller, you should eat more often to get enough nutrients. We suggest 5 to 8 small meals per day. Liquid, pureed or solid foods Liquids and purees (the next step up), empty from the stomach more quickly than solid foods. You can try these if your symptoms are bad, or if you find it is not helping to eat small, frequent meals. You can put most foods in a blender. Strained baby foods are an option when you don t want to use a blender. You can make solids, purees and baby foods thinner by adding broth, milk, water, or juice. If most of your diet is liquid, have some drinks that are rich in nutrients, like nutrition supplements (Boost, Ensure, Carnation Instant Breakfast), kefir, milk or unsweetened fruit or vegetable juice. If you are deaf or hard of hearing, please let us know. We provide many free services including sign language interpreters, oral interpreters, TTYs, telephone amplifiers, note takers and written materials.
Page 2 of 6 Fiber Try eating fewer of the foods that are high in fiber, such as raw fruits or vegetables (especially those with seeds and skins) and whole grains. Replace those foods with fruit and vegetable juices and purees to make sure you get enough nutrients. You can also try peeled fruits and well-cooked vegetables, if they do not cause problems for you. Fat Cut back on high fat foods, such as certain meats, fried foods, desserts and bakery items. Higher fat beverages, like whole milk and nutritional supplements, often do not cause problems. If you are eating less fat and have trouble getting enough calories, try having higher fat beverages. Physical activity Walk for at least 10 minutes after eating or do some light stretching. This can help your stomach empty. Regular physical activity can help reduce stress. This will make your gastroparesis and your overall health better. Try to get at least 30 minutes of physical activity, 5 days per week. FODMAPs If you are still not feeling well after trying the diet and exercise changes above, ask your dietitian or doctor about a low FODMAP diet. FODMAPs are a type of carbohydrate found in some foods. They are not easily digested or absorbed. They can cause many of the same symptoms as gastroparesis. Checklist for symptom improvement Discuss your diagnosis of gastroparesis with your care team Eat small meals many times a day Chew foods well Remain sitting up for at least 1 hour after eating Ask your doctor or pharmacist about all the medicines you are taking (prescription and over-the-counter). Some can slow digestion. Drink enough fluids Start a multivitamin Eat less fat (less than 50 grams/day) Eat less fiber (less than 15 grams/day) Have fewer of the foods that are hard to digest (may be different for each person) Have liquids that are rich in nutrients (Boost, Ensure, Carnation Instant Breakfast) Keep a food and symptom journal Walk 20 to 30 minutes each day Reduce and manage stress Try relaxation exercises, biofeedback, guided imagery and mindfulness Use heat for pain Quit smoking Focus on nutrient rich foods Reduce FODMAPS Ask your doctor about medical treatment options
Page 3 of 6 Diet suggestions Food group Try Avoid Grains White bread, rolls, biscuits, bagels and English muffins Low fat crackers without seeds Refined cereals (puffed rice, corn flakes, Chex) Cream of wheat, cream of rice Pancakes or waffles made from white flour White rice or white pasta Rice cakes Fruits Canned or cooked fruits (no pineapple) Pureed fruits (apple sauce, fruit pouch) Peeled fruits (apple, pear, peach, mango, or plum) Strained baby fruit Banana (ripe) or melon Fruit juice (no pulp) Vegetables Canned or well cooked without skins or seeds (carrots, beets, peeled sweet potatoes or squash) Mashed potatoes or baked French fries (no skin) Vegetable juice (no pulp), tomato sauce or paste Strained baby vegetables Proteins Poultry without skin (chicken, turkey, duck) Fish or shellfish Lean ground beef, pork chop or pork loin Well-cooked tender beef Low fat lunch meats Eggs (limit yolks) Tofu Smooth nut butters Strained baby food meats Breads and cereals made with whole wheat or whole grain or containing nuts, seeds, or dried fruit Graham crackers Oatmeal, granola, banana bread, muffins Brown rice, wild rice, barley, whole wheat pasta Popcorn Whole apple, pear, peach, mango, or plum with skin Berries, cherries, coconut, dried fruit, figs, grapefruit, grapes, kiwi, orange, pineapple Fruit juice with pulp Raw or fried vegetables Bell peppers, cabbage, corn, broccoli, Brussels sprouts, cauliflower, celery, mushrooms, onion, lettuce, pea pods, potatoes (whole with skin) spinach, whole tomatoes, zucchini Poultry with skin (chicken, turkey, duck) Tough meats with gristle High fat meat (corned beef, bacon, prime rib) or lunch meat (bologna, salami) Fried meats (chicken strips) Hot dogs, bratwurst, sausage Dried beans, peas, lentils Whole nuts Chunky nut butters
Page 4 of 6 Food group Try Avoid Milk products Desserts, Sweets, and Snacks Low fat milk, yogurt or cottage cheese (skim or 1%) Soy, almond, or rice milk Kefir, low fat ice cream or frozen yogurt Cream-soup (made with skim or 1% milk) Broth-based soups Low-fat ice cream or frozen yogurt Sherbet or fruit ice Jello Marshmallows Hard candy Pudding (made from skim-milk) Angel food cake Low fat cookies (vanilla wafers or ginger snaps) Whole fat milk, yogurt or cottage cheese Yogurt with fruit or granola High fat cheese Cream, cream-based soups or Half and Half Sour cream Regular ice cream Sweets made with whole wheat flour or bran or those containing seeds, nuts, dried fruit or coconut Cakes Pies Cookies Regular ice cream Popcorn, nuts, seeds Chocolate Olives Potato chips Fats and oils Butter Oil Margarine Mayonnaise Salad dressing None Limit total intake to 2 teaspoons a day.
Page 5 of 6 Sample 1500 calorie menu for gastroparesis Breakfast (300 calories) Choose one food from each group. Group A 1 cup Cream of Wheat or Cream of Rice 1 cup dry cereal (puffed rice, Cheerios, Rice Chex) 1 slice white toast 1 white English Muffin 1 small pancake, waffle or tortilla (6 inches) Group B 1 egg or 3 egg whites (boiled, scrambled, poached) 1 Tablespoon peanut butter 1 cup low fat milk ¾ cup low fat yogurt or cottage cheese Group C 1 small banana 1 cup applesauce, canned pears or peaches 1 pouch of pureed fruit 1 medium apple or peach (without skin) Snack (200 calories) Choose one: 1 cup low fat Greek yogurt with 2 teaspoons honey ¾ cup cottage cheese with ½ cup canned peaches or pears 1 string cheese with 40 Goldfish Crackers 2 rice cakes with 1.5 Tablespoons peanut butter 1 hardboiled egg with 8 soda crackers 2 wedges Laughing Cow cheese and 8 water crackers 40 small pretzel sticks with 1 peeled apple or pear 1 tortilla (6 inches) with 1 ounce low fat cheese and 2 Tablespoons salsa 1/3 cup canned tuna (packed in water) with 1 Tablespoons light mayo and 8 soda crackers Lunch (400 calories) Choose one food from each group. Group A 2 slices white bread 3/4 cups white pasta or white rice 1 pita 2 tortillas (6 inches) 3/4 cup mashed potatoes Group B 2 eggs (boiled, scrambled, poached) 2 Tablespoons peanut butter 3 ounces lean chicken, tuna, pork or lunch meat 3 ounces low fat cheese
Page 6 of 6 Group C 1 small banana 1 pouch of pureed fruit 1 medium apple or peach (without skin) ¾ cup well-cooked vegetables (without skin) ¾ cup low fat yogurt or cottage cheese 1 cup broth-based soup Snack (200 calories) Choose one: 1 cup low fat Greek yogurt with 2 teaspoons honey ¾ cup cottage cheese with ½ cup canned peaches or pears 1 string cheese with 40 Goldfish Crackers 2 rice cakes with 1.5 Tablespoons peanut butter 1 hardboiled egg with 8 soda crackers 2 wedges Laughing Cow cheese and 8 water crackers 40 small pretzel sticks with 1 peeled apple or pear 1 tortilla (6 inches) with 1 ounce low fat cheese and 2 Tablespoons salsa 1/3 cup canned tuna (packed in water) with 1 Tablespoons light mayo and 8 soda crackers Dinner (400 calories) Choose one food from each group. Group A 3/4 cups white pasta, white rice, cooked quinoa or mashed potatoes 2 slices sourdough bread 2 tortillas (6 inches each) Group B 3 ounces chicken (without skin) 3 ounces turkey (without skin or ground) 3 ounces pork loin or pork chop 3 ounces lean beef (ground or tender) 3 ounces fish (baked or broiled) 3 ounces tofu (not fried) 3 ounces cheese Group C ¾ cup well-cooked vegetables (without skin) 1 cup broth-based soup 3/4 cup butternut squash, tomato, or carrot soup 1 cup low fat milk 6 ounces of 100% fruit or vegetable juice For more information on diet, visit: www.gicare.com/diets/gastroparesis-diet www.digestivedistress.com/what-to-eat-diabeticsidiopathics For informational purposes only. Not to replace the advice of your health care provider. Copyright 2007 Fairview Health Services. All rights reserved. SMARTworks 522875 Rev 01/16.