The Gastroparesis Diet & Recipe Help/Ideas
The following is a published paper by Dr. Jackson explaining the Gastroparesis diet. I know this is a *massive* change to make, especially since we could eat almost anything before gastroparesis. However, following this diet will help avoid those severe spasms and pain if you can stick to the diet.
I apologise to this who are unable to eat or drink like me. I only put it up so it can help those who are able to tolerate some foods. I hope this helps.
Gastroparesis Diet for Delayed Stomach Emptying
Purpose
Gastroparesis is the medical term for delayed stomach emptying. During the process of digestion, the stomach must contract to empty itself of food and liquid. Normally, it contracts about three times a minute. This empties the stomach within 90-120 minutes after eating. If contractions are sluggish or less frequent, stomach emptying is delayed. This results in bothersome and sometimes serious symptoms, as well as malnutrition, because food is not being digested properly.
Gastroparesis may be caused by various conditions such as diabetes mellitus, certain disorders of the nervous system, or certain drugs. Often however, no cause can be found although a viral infection is suspected in some. Usually, the physician prescribes medication to stimulate the stomach to contract. The purpose of the gastroparesis diet is to reduce symptoms and maintain adequate fluids and nutrition. There are three steps to the diet.
STEP 1 DIET consists of liquids, which usually leave the stomach quickly by gravity alone. Liquids prevent dehydration and keep the body supplied with vital salts and minerals.STEP 2 DIET provides additional calories by adding a small amount of dietary fat — less than 40 gm each day. For patients with gastroparesis, fatty foods and oils should be restricted, because they delay stomach emptying. However, patients at the Step 2 level are usually able to tolerate this amount.STEP 3 DIET is designed for long-term maintenance. Fat is limited to 50 gm per day, and fibrous foods are restricted, because many plant fibers cannot be digested.
Nutrition Facts
The STEP 1 Gastroparesis Diet is inadequate in all nutrients except sodium and potassium. It should not be continued for more than three days without additional nutritional support. STEP 2 and STEP 3 Gastroparesis Diets may be inadequate in Vitamins A and C, and the mineral iron. A multi-vitamin supplement is usually prescribed.
| Special Considerations |
|---|
|
| Step 1 Food Groups | ||
|---|---|---|
| Group | Recommend | Avoid |
| Milk & milk products | none | all |
| Vegetables | none | all |
| Fruits | none | all |
| Breads & grains | plain saltine crackers | all others |
| Meat or meat substitutes | none | all |
| Fats & oils | none | all |
| Beverages | Gatorade and soft drinks (sipped slowly throughout the day) | all others |
| Soups | fat-free consommé and bouillon | all others |
| Sample Menu Step 1 | ||
|---|---|---|
| Breakfast | Lunch | Dinner |
|
|
|
| This Sample Diet Provides the Following | |||
|---|---|---|---|
| Calories | 790 | Fat | 9 gm |
| Protein | 11 gm | Sodium | 3531 mg |
| Carbohydrates | 156 gm | Potassium | 244 mg |
| Step 2 Food Groups | ||
|---|---|---|
| Group | Recommend | Avoid |
| Milk & milk products | skim milk, products made with skim milk, low-fat yogurt, low-fat cheeses | whole milk products, creams (sour, light, heavy, whipping), half & half |
| Soups | fat-free consommé & bouillon, soups made from skim milk, & fat-free broths containing pasta or noodles and allowed vegetables | soups made with cream, whole milk, or broths containing fat |
| Bread & grains | breads & cereals, cream of wheat, pasta, white rice, egg noodles, low-fat crackers | oatmeal; whole grain rice, cereal, bread |
| Meat & meat substitutes | eggs, peanut butter (maximum 2 Tbsp/day) | beef; poultry; fish; pork products; dried beans, pea, & lentils |
| Vegetables | vegetable juice (tomato, V-8); well-cooked vegetables without skins (acorn squash, beets, carrots, mushrooms, potatoes, spinach, summer squash, strained tomato sauce, yams) | all raw vegetables; cooked vegetables with skins; beans (green, wax, lima), broccoli, Brussels sprouts, cabbage, cauliflower, celery, corn, eggplant, onions, peas, peppers, pea pods, sauerkraut, turnips, water chestnuts, zucchini |
| Fruits | apple juice, cranberry juice, grape juice, pineapple, prune juice, canned fruits without skins (applesauce, peaches, pears) | citrus juices, all fresh and dried fruits, canned fruits with skins (apricots, cherries, blueberries, fruit cocktail, oranges, grapefruit, pineapple, plums, persimmons) |
| Fats & oils | any type of fat, but only in small amounts | none |
| Sweets & desserts* | hard candies, caramels, puddings & custards made from skim milk, frozen yogurt, fruit ice, gelatin, ice milk, jelly, honey, syrups | high-fat desserts (cakes, pies, cookies, pastries, ice cream), fruit preserves |
| Beverages | Gatorade*, soft drinks* (sipped slowly throughout the day) | all others, except allowed juices |
| *Concentrated sweets | ||
| Sample Menu Step 2 | ||
|---|---|---|
| Breakfast | Lunch | Dinner |
|
|
|
| Morning Snack | Afternoon Snack | Evening Snack |
|
|
|
| This Sample Diet Provides the Following | |||
|---|---|---|---|
| Calories | 1343 | Fat | 35 gm |
| Protein | 52 gm | Sodium | 2639 mg |
| Carbohydrates | 206 gm | Potassium | 1411 mg |
| Step 3 Food Groups | ||
|---|---|---|
| Group | Recommend | Avoid |
| Milk & milk products | skim milk, products made with skim milk, low-fat yogurt, low-fat cheeses | whole milk products, creams (sour, light, heavy, whipping), half & half |
| Soups | fat-free consommé & bouillon, soups made from skim milk, & fat-free broths containing pasta or noodles and allowed vegetables | soups made with cream, whole milk, or broths containing fat |
| Fruits | fruit juices, canned fruits without skins (applesauce, peaches, pears) | all fresh & dried fruits, canned fruits with skins (apricots, cherries, plums, blueberries, fruit cocktail, oranges, grapefruit, pineapple, persimmons) |
| Meat & meat substitutes | eggs, peanut butter (2 Tbsp/day), poultry, fish, lean ground beef | fibrous meats (steaks, roasts, chops), dried beans, peas, lentils |
| Fats & oils | any type of fat, but only in small amounts | none |
| Breads & grains | breads & cereals, cream of wheat, pasta, white rice, egg noodles, low-fat crackers | oatmeal; whole grain rice, cereal, bread |
| Vegetables | vegetable juices (tomato V-8), well-cooked vegetables without skins (acorn squash, beets, carrots, mushrooms, potatoes, spinach, summers quash, strained tomato sauce, yams) | all raw vegetables; cooked vegetables with skins: beans (green, wax, lima), broccoli, Brussels sprouts, cabbage, cauliflower, celery, corn, eggplant, onions, peas, peppers, pea pods, sauerkraut, turnips, water chestnuts, zucchini |
| Sweets & desserts* | hard candies, caramels, puddings & custards made from skim milk, frozen yogurt, fruit ice, gelatin, ice milk, jelly, honey, syrups | high-fat desserts (cakes, pies, cookies, pastries, ice cream), fruit preserves |
| Beverages | Gatorade*, soft drinks* (sipped slowly throughout the day), coffee, tea, water (note: non-caloric beverages should be limited if patient cannot maintain adequate caloric intake) | all others, except allowed juices |
| *Concentrated sweets | ||
| Sample Menu Step 3 | ||
|---|---|---|
| Breakfast | Lunch | Dinner |
|
|
|
| Morning Snack | Afternoon Snack | Evening Snack |
|
|
|
| This Sample Diet Provides the Following | |||
|---|---|---|---|
| Calories | 1822 | Fat | 42 gm |
| Protein | 75 gm | Sodium | 2234 mg |
| Carbohydrates | 286 gm | Potassium | 2467 mg |
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Sample Diet for Gastroparesis
Gastroparesis causes chronic delaying of stomach emptying. It can occur in conjunction with several diseases including diabetes. If you have gastroparesis, you may experience nausea, bloating, heartburn and weight loss, as noted by the International Foundation for Functional Gastrointestinal Disorders. This condition affects the amounts of food you can eat and how well your system can digest them. To obtain the needed nutrition from your diet, you will have to make adjustments to accommodate the changes in your stomach.
General Diet Considerations
When you first develop gastroparesis, keep certain considerations in mind when planning your diet. Eating smaller, more frequent meals can allow you to avoid stomach distention; smaller meals may leave the stomach faster than large meals, according to the American Motility Society. To maintain adequate nutrition, you may need to eat four to six times each day. You should also avoid foods that are high in fiber and high in fat because both of these substances can slow down gastric emptying. In some patients, the slow emptying can lead to a blockage in the stomach called a bezoar. Foods that are not easily chewed like popcorn, nuts, and seeds may not leave the stomach properly and can lead to discomfort.
Your doctor and dietitian may start you on a diet of liquids and advance your diet gradually as tolerated while remembering these basic considerations, as noted by Pennsylvania-based Jackson Siegelbaum Gastroenterology.
Stage One Gastroparesis Diet
In the first stage of the gastroparesis diet, your doctor will place you on a liquid diet. Liquids tend to leave the stomach normally no matter what; your dietitian can make sure that you get enough vitamins and minerals during this stage, according to Jackson Siegelbaum Gastroenterology. During this stage, you will need to avoid all fiber foods like fruits and vegetables; dairy products should also be avoided because of the amount of fat. Saltine crackers, sports and soft drinks, and bouillon are all safe to eat during stage one. Your dietitian will carefully monitor what you eat to keep you hydrated and healthy.
Stage Two Gastroparesis Diet
In the second stage of the diet, your dietitian will add less than 40 g of fats to your diet each day; this adds calories while still limiting the amount of fat that you intake, as noted by Jackson Siegelbaum Gastroenterology. You can begin to include some low-fat dairy products like cheese or milk and bread, pasta and cereals made from white flour. Some well-cooked vegetables are acceptable during this stage as well like beets, carrots, yams and potatoes -- all without skins. Fruit juices and canned fruits without skins can be eaten as well. Fruits like apples, berries and figs and vegetables like green beans, beans and Brussels sprouts have all been associated with bezoar formation, as noted by the UVA Digestive Health Center. Sweets like frozen yogurt, fruit ices and gelatins are acceptable as well. Your portion sizes will be smaller than before but you can still get plenty of nutrition.
Stage Three Gastroparesis Diet
For the third part or long-term maintenance of your diet, the amount of fat is increased to 50 g each day, which many people with gastroparesis can tolerate, as noted by Jackson Siegelbaum Gastroenterology. Foods with fiber remain limited; you can continue to eat well-cooked vegetables without skins and canned fruits without skins. Vegetable juices and fruit juices are all acceptable as tolerated. Long term, you can eat meats like lean ground beef, poultry, and fish; however, fibrous steaks may cause problems. If you puree or grind most meats, you should be able to tolerate small portions of many different types of meats, as noted by the UVA Digestive Health Center.
Dietary Supplementation
Even with assistance from your dietitian, you may still have difficulties obtaining all of the nutrients and calories that you require each day. Instead of drinking water, you may want to drink a higher calories fruit juice. Adding powdered milk to dishes or beverages can also add extra calories without adding extra volume to your meal. Instant breakfast or protein powder can also add needed calories, according to the UVA Digestive Health Center. Liquid nutrient beverages can also help your get additional calories and nutrients without adding fiber, as noted by the American Motility Society. Adding ice cream or sherbet to the nutrient beverage can also boost their caloric and nutrient values.
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Fruits With Gastroparesis
Gastroparesis is a difficult medical condition because it interferes with proper nutrition and the symptoms are unpredictable. Sometimes, you may be able to eat small meals, but other times you may not even be able to drink fluids. Gastroparesis is often managed with a strict diet plan, and fruits have a critical, yet surprising, role in dietary intervention.
Overview
Muscles in the stomach contract to push food into the small intestine. When the nerves that controls the stomach muscles do not work properly, food moves too slowly or even stops moving and stays in the stomach. This is called delayed gastric emptying, or gastroparesis. If you have gastroparesis, you may go through periods when you can only consume liquids and you may have times when you can't tolerate putting anything in your stomach. Dietary interventions are part of the treatment, and fruit is an important consideration.
Complications
Bacterial overgrowth can occur when food stays in the stomach too long. A second serious complication is that food can harden into a solid mass when it sits in the stomach. This mass, called a bezoar, causes nausea and vomiting. Bezoars are dangerous if they block the opening into the small intestine.
Fruit has a critical role in the management of gastroparesis because it is high in fiber. Normally, you need to consume enough dietary fiber because it reduces cholesterol, keeps blood glucose balanced, encourages the growth of healthy bacteria and prevents constipation. However, indigestible fiber stays in the stomach too long and may slow down the passage of food through the stomach, further aggravating the complications that already exist. If you have gastroparesis, you must restrict fiber, being especially careful about the amount of fruit you eat and the form it takes. Some fruits are known to contribute to bezoar formation and need to be avoided.
Fruit in the Diet
As a general rule of thumb, you should avoid all raw fruit and canned fruits with skins due to their fiber content. Some specific fruits that contribute to bezoars include blackberries, blueberries, raspberries, strawberries, apples, oranges, kiwi and dried fruits such as apricots, dates, figs, prunes and raisins. Fruit juices are often better tolerated, but you should not drink citrus juices. If your symptoms are not active and your doctor or dietitian approves, you can try to blend raw fruits into liquid smoothies or even consider strained baby food fruits.
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Foods You Can Eat When You Have Gastroparesis
"Gastroparesis is a condition in which food is delayed in emptying from your stomach into your small intestine. According to a 2008 article in "The Medscape Journal of Medicine," 4 percent of the United States population experiences symptoms of gastroparesis, which include nausea, vomiting, abdominal pain and bloating, weight loss, acid reflux and early satiety. Uncontrolled blood sugar with diabetes is often the cause of gastroparesis but intestinal surgery, Parkinson's disease, multiple sclerosis and other unknown causes contribute to the development of this condition. Treatment involves medication to stimulate stomach emptying and a diet that helps manage gastroparesis symptoms.
Meal Patterns
With slow stomach emptying, the amount of food you eat during a meal can trigger gastroparesis symptoms if you are not careful. Eat a balanced diet, broken down into six small meals throughout the day. Sitting up at meals and walking between meals will also help with digestion and increase your appetite for the next meal. If weight loss or maintenance is a concern, be sure you are eating enough or consider adding additional small meals during the day.
Low-Fat Foods
The amount of fat in your meals can further delay stomach emptying. Low-fat meals are recommended for better tolerance. Meat is a good source of protein, but can be high in fat. Choose lean cuts and remove any visible fat during meal preparation. Poultry, lean ground beef, fish and eggs are good diet choices. Milk, yogurt and cheese are rich in protein, calcium and vitamin D, but can also be high in fat. Pick low-fat versions for easier digestion. Added butter, margarine, sour cream, oils and salad dressings can contribute a lot of fat to your diet. Use this group sparingly and instead flavor foods with natural herbs and seasonings.
Dietary Fiber
Carbohydrates and Concentrated Sweets
Managing your blood sugar level and being aware of the carbohydrates in your diet is important if diabetes is the cause of your gastroparesis. Carbohydrate sources include breads and grains, fruit and fruit juices, dairy, vegetables, sweets and desserts and some beverages. Be consistent with the amount of carbohydrates you are eating and the timing of your meals. Reading labels is helpful to identify the serving size and carbohydrate amount in your foods. Avoid a lot of sweets and desserts with added sugar and fat like cake, cookies and brownies. Instead choose low-fat cake or pudding which can help control your intake of sugar and fat."
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http://www.livestrong.com/article/434917-sample-diet-for-gastroparesis/ (By Dominique Brooks)
http://www.livestrong.com/article/408015-foods-you-can-eat-when-you-have-gastroparesis/#ixzz2PjiAmh3D
http://www.livestrong.com/article/518486-fruits-with-gastroparesis/ (By Sandi Busch)
© Frank W. Jackson, M.D.
Link found: http://gicare.com/diets/gastroparesis-diet/
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