Adult Gastroenterology Associates
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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. 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 Diets must be tailored to the individual patient. This is because the degree of gastroparesis may range from severe and long-standing to mild and easily corrected. Patients may also have various medical conditions to be considered. For example, diabetes patients with gastroparesis are allowed sugar-containing liquids on the Step 1 diet, because that is their only source of carbohydrate. On the Step 2 and Step 3 diets, these patients should avoid concentrated sweets. These are noted with an asterisk (*) on the food lists. On all of the diets, liquids and food should be eaten in small, frequent meals. This helps to maintain nutrition. 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 Meats & 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 Gatorade 1/2 cup ginger ale 1/2 cup bouillon 3/4 cup saltine crackers 6 Gatorade 1/2 cup Coke 1/2 cup bouillon 3/4 cup saltine crackers 6 Gatorade 1/2 cup Sprite 1/2 cup bouillon 3/4 cup saltine crackers 6 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 skim milk 1/2 cup poached egg 1 white toast slice apple juice 1/2 cup mozzarella cheese 2 oz saltine crackers 6 chicken noodle soup 3/4 cup Gatorade 1/2 cup peanut butter 1 Tbsp saltine crackers 6 vanilla pudding 1/2 cup grape juice 1/2 cup Morning Snack Afternoon Snack Evening Snack ginger ale 1/2 cup canned pears 1/2 cup skim milk 1/2 cup cornflakes 1/2 cup sugar 2 tsp frozen yogurt 1/2 cup saltine crackers 6 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 skim milk 1/2 cup cream of wheat 1/2 cup sugar 2 tsp orange juice 1/2 cup white toast 1 slice margarine 1 tsp jelly 1 Tbsp tuna fish 2 oz low-fat mayonnaise 2 Tbsp white bread 2 slices canned peaches 1/2 cup Gatorade 1.2 cup baked chicken 2 oz white rice 1/2 cup cooked beets 1/2 cup dinner roll 1 skim milk 1/2 cup margarine 2 tsp Morning Snack Afternoon Snack Evening Snack low-fat yogurt 1/2 cup Sprite 1/2 cup chocolate pudding 1/2 cup gingerale 1/2 cup ice milk 1/2 cup pretzels 2 This Sample Diet Provides the Following Calories 1822 Fat 42 gm Protein 75 gm Sodium 2234 mg Carbohydrates 286 gm Potassium 2467 mg