Diet & gastroparesis

The goal: eating enough, with the best possible tolerance

In gastroparesis, the stomach empties more slowly without any mechanical blockage. This can cause, among other things, early fullness, a lasting feeling of fullness, nausea or vomiting.

Adapting your diet helps some people manage their symptoms better, but you still need to meet your nutritional needs. A very restrictive diet can lead to inadequate intake.

This means finding a balance between tolerance, hydration and sufficient nutritional intake.

Splitting food intake into smaller meals

Guidelines often suggest five or six small nutritious meals rather than two or three larger ones. The aim is to spread intake throughout the day.

LARGE MEALS

1

One big intake

A large volume can be harder to tolerate for some people.

OR

SMALLER, MORE FREQUENT MEALS

1 2 3 4 5 6

Intake spread out

Try several small servings if larger meals make your symptoms worse.

Smaller meals do not mean eating less. When eating is already difficult, the aim is still to cover energy, protein, nutrient and fluid needs as far as possible.

Texture can change tolerance

Soft, well-cooked foods are often suggested. When solid foods become difficult, more processed textures can sometimes be better tolerated.

Solid Usual texture

→

Tender Well cooked, easy to chew

→

Minced Small pieces

→

Blended Purée or smooth texture

→

Liquid Depending on needs and tolerance

The small-particle diet

The American College of Gastroenterology guidelines suggest a diet of foods broken down into small particles to improve food tolerance and some symptoms.

In practice, this can mean careful chewing, sufficient cooking, or blended or chopped food.

This recommendation remains conditional, however: the available data do not show that a single dietary approach suits everyone.

Fibre and fat

General guidelines for gastroparesis often suggest a diet lower in fibre and fat. This does not necessarily mean cutting them out completely.

Fibre

Some very high-fibre foods can be hard to tolerate. The quantity, cooking and texture can be adapted according to symptoms and the advice of the care team.

Fat

Very fatty foods may also be less well tolerated by some people. Energy needs must nevertheless be taken into account before any major restriction.

Avoid cutting out more and more foods

Cutting out many foods one after another can make your diet insufficient. If you have significant difficulties, specialist dietary support can be particularly helpful.

On the plate

Commonly mentioned examples, to try according to your own tolerance: these are neither compulsory lists nor bans.

Often better tolerated

Blended soups, purées, mashed vegetables
Fruit compotes, peeled cooked fruit, very ripe banana
Well-cooked pasta, rice and semolina, soft white bread
Eggs, fish, ham, minced or blended meat
Smooth dairy (yoghurt, soft cheese, custard desserts)
Milky drinks, seedless smoothies

Often harder to tolerate

Raw vegetables, salads, stringy vegetables
Skins, seeds, dried fruit and whole nuts
Pulses (lentils, chickpeas, dried beans)
Tough or fibrous meat, fried food, very fatty dishes
Wholemeal bread and bran-rich cereals
Fizzy drinks

Meal ideas: blended vegetable soup with ham, mashed potato with flaked fish, soft omelette, semolina pudding, fruit compote.

Hydration is part of nutritional care

Nausea and vomiting can make it hard to stay hydrated. Yet sufficient fluid intake is important, in particular to prevent dehydration.

When drinking becomes difficult, how to spread drinks out can be discussed with the medical or dietetic team.

Noting what you tolerate and what you don’t

Noting down a few details can help you spot trends without scrutinising every meal.

1 Try

A quantity, a texture or a way of preparing food.

2 Observe

How well is the meal tolerated?

3 Write down

Only the information that is really useful.

4 Adjust

Size, texture or make-up if needed.

Start again at the next meal

Food / meal ……………………

Quantity ……………………

Texture ……………………

Symptoms ……………………

Overall tolerance ☆ ☆ ☆ ☆ ☆

Printable symptom sheet (PDF, in French) ↗ Tracking your symptoms

Eating well with FODMAPs

FODMAPs are sugars that some people’s gut digests poorly. These guidelines help you find your way, with the support of a doctor or a dietitian.

Careful if you have gastroparesis: FODMAPs concern sugars poorly digested by the gut, not stomach emptying. A low-FODMAP food may be poorly tolerated with gastroparesis.

The 6 FODMAP families

Each family has its own colour. People are rarely sensitive to all of them.

Fructans

Chains of fructose, found in cereals and some vegetables.

E.g.: wheat, garlic, onion, leek

GOS

Sugars in pulses (galacto-oligosaccharides).

E.g.: lentils, chickpeas, beans

Lactose

The sugar in milk.

E.g.: milk, yoghurts, cream, fromage blanc

Fructose

Fructose in excess of glucose.

E.g.: honey, apple, pear, mango

Sorbitol

A polyol, natural or added.

E.g.: avocado, plum, sugar-free chewing gum

Mannitol

Another polyol.

E.g.: mushrooms, celery, cauliflower

The 3 phases, simply

Important: do not start on your own, especially if you are losing weight or your intake is already low. Ask a dietitian for advice.

1

Giving the gut a rest

2 to 6 weeks

You mainly eat low-FODMAP foods and cut down on the ones to limit. The aim: to see if symptoms improve.

2

Testing family by family

About 6 to 8 weeks

You reintroduce one family at a time, gently, and note how you feel. The aim: to find out what causes problems.

3

Eating to measure

Long term

You go back to eating everything that agrees with you and only limit what bothers you. Phase 1 is not meant to last.

Table 1 · Low-FODMAP foods

Low in FODMAPs, in normal portions

Vegetables

Carrot, cucumber, chicory, spinach, all salad leaves, chard, kale, parsnip, potato, pumpkin, radish, olives, bamboo shoots, ginger, gherkins, canned button mushrooms, green part of leeks and spring onions

Fruit (one at a time)

Orange, clementine, mandarin, kiwi, pineapple, strawberries, blueberries, papaya, passion fruit, not-too-ripe banana (FODMAP guide)

Starchy foods

Rice, quinoa, millet, buckwheat, polenta, tapioca, starches, gluten-free pasta and bread (without added inulin)

Protein

Plain meat, fish, seafood and eggs (no garlic or onion marinade), firm tofu

Dairy

Lactose-free milk and yoghurts, comté, emmental, gruyère, parmesan, cheddar, brie, camembert, feta, butter

Fats

All oils. Tip: garlic-infused oil gives the flavour without the FODMAPs

Seasonings

Fresh herbs, spices (except garlic and onion powder), salt, pepper, mustard, soy sauce, cider, wine and rice vinegars, mayonnaise, tomato paste

Sweet things

White or brown sugar, maple syrup, classic strawberry jam

Drinks

Water, weak tea, peppermint tea, almond drink, carrot or tomato juice (one glass per meal)

Snacks

Peanuts, macadamia nuts, plain crisps, popcorn, puffed rice cakes

Remember to check the labels on ready meals: garlic and onion often hide in them.

Table 2 · Foods to limit

Sorted by family: spot the ones that cause you problems

Fructans
Garlic, onion, shallot, white part of leek, artichoke, Brussels sprouts, beetroot, wheat, rye and barley (regular bread, pasta and biscuits), cashew nuts, pistachios
GOS
Lentils, chickpeas, dried beans, peas, whole soybean milk. Tip: canned and well rinsed, they are easier to digest
Lactose
Cow’s, goat’s or sheep’s milk, regular yoghurts, cream, fromage blanc, petits-suisses, ricotta, ice cream
Fructose
Honey, agave syrup, apple, pear, mango, watermelon, fruit juice, asparagus
Sorbitol
Avocado, sweetcorn, plum, cherry, apricot, blackberries, sugar-free sweets and chewing gum
Mannitol
Fresh mushrooms, celery, cauliflower, sweet potato, watermelon
Avoid
In phase 1, garlic and onion (fresh, powdered or hidden in ready meals): they are among the hardest to digest.

Table 3 · Amounts per food

The maximum amount per serving for 159 foods, with their families. Members only.

See the table (members)

Important: these guidelines do not replace the advice of a doctor or a dietitian.

Some signs should prompt you to ask for help

Gastroparesis can lead to malnutrition, dehydration and unintentional weight loss.

Unintentional weight loss

Weight loss you did not seek should be reported to the medical team.

Very low intake

When eating enough becomes impossible over time, a nutritional assessment is important.

Severe vomiting

Repeated vomiting can compromise nutritional intake and hydration.

Difficulty staying hydrated

If you can no longer keep up sufficient fluid intake, seek medical advice quickly.

An increasingly restricted diet is not a lasting solution. If you can no longer meet your needs despite these adjustments, talk to your gastroenterologist, doctor or dietitian. Other forms of nutritional support can be considered when they are needed.

In an emergency (France): call 15 or 112. Our “I’m going to A&E” sheet (PDF, in French) ↗

Artificial nutrition

In some situations, enteral or, more rarely, parenteral nutrition may be needed to maintain sufficient intake. These solutions do not mean the illness is automatically progressing: whether they are needed depends on each person’s situation.

Artificial nutrition See our page on artificial nutrition →

Sources

SED Gastroparésie N’Cie Understanding gastroparesis → NIDDK — National Institutes of Health Treatment of gastroparesis and dietary changes → American College of Gastroenterology Clinical guidelines on gastroparesis →

Important information

This page provides general information and does not replace medical advice or personalised dietary support. Nutritional needs and tolerance can vary greatly from one person to another.

The food & hydration sheet

A printable sheet to note what you eat and drink, and gradually find out what suits you best.

Download the sheet (PDF, in French) ↗ All our practical guides