In this blog post about Gastroparesis, we aim to spread awareness of this under-recognised medical condition by delving into what Gastroparesis is, how it affects those diagnosed, and treatment options available, including dietary management.
What is Gastroparesis?
Gastroparesis (or Delayed Gastric Emptying) is a long-term health condition in which the functioning of the stomach is decreased, meaning that the stomach empties too slowly (1). This is thought to be because the nerves and muscles that control how the stomach empties do not function effectively, allowing food to stay in the stomach for longer than average. Because food passes through the stomach slower than usual, a wide variety of symptoms can occur (2).
Causes Many cases of Gastroparesis are ‘idopathic,’ meaning there is no known cause (3). Idiopathic gastroparesis accounts for around 39% of all cases in the UK, and most cases in the USA (3, 4).
Known causes of gastroparesis include; diabetes (type 1 and 2) and complications of some types of abdominal surgery (1,2).
Possible risk factors for Gastroparesis include Parkinson’s disease, scleroderma & opioid painkillers and scleroderma (1,3). Gastroparesis is also seen in patients with connective tissue disorders, such as Ehlers-Danlos Syndrome, but further research is required to understand the possible link (5, 6).
Prevalence
Although much of the research on Gastroparesis originates from the USA, one UK study estimated that the prevalence of diagnosed gastroparesis is roughly 14 per 100,000 people (4). Data also shows that gastroparesis is more common in women than men (4).
Symptoms
Symptoms and their severity varies from person to person and can be chronic or acute, often appearing during or after a meal (7). Although symptoms are not always visible to others, the condition can significantly impact one’s life (8).
Symptoms of gastroparesis can include:
Nausea
Feeling full very quickly
Vomiting
Loss of appetite
Bloating
Abdominal pain
Weight loss*
Due to these symptoms, serious complications such as dehydration and malnutrition can arise (1).
*It is important to note that weight loss is not a prerequisite for diagnosing Gastroparesis. Although weight loss can occur, it’s estimated that around 60% of UK patients with gastroparesis are overweight or obese (4). The presence of overweight or obesity shouldn’t mean a diagnosis cannot be pursued.
Diagnosis During the diagnostic process, your doctor will examine and ask about your symptoms and medical history. Various tests, such as scans, blood tests and endoscopies, may then be carried out to rule out other conditions (1, 9).
After this, should your doctor still suspect Gastroparesis, a Gastric Emptying Test will be required to confirm the diagnosis. These tests measure how quickly the stomach empties (9).
Treatment
Gastroparesis is a long-term condition. Treatment options focus on symptom management and, where necessary, medical intervention to ensure the patient meets their nutritional requirements.
Treatment options depend on symptoms and their severity but include (1,10):
Dietary changes
Medications
Surgery
Feeding tubes
Parenteral Nutrition
Dietary Management
Upon diagnosis, referral to a dietitian is highly beneficial to ensure that appropriate dietary management can be implemented. This involves ensuring that an individual’s nutritional requirements are met to prevent or treat malnutrition and dehydration whilst also managing symptoms (10). Gastroparesis affects people differently, meaning that dietary management will also be different for each patient. This is why it’s important to see a dietitian so that dietary advice can be tailored specifically to each patient, their symptoms and individual nutritional requirements.
As more research is needed on nutrition for Gastroparesis, current dietary recommendations are based on which foods increase or decrease rates of gastric emptying, and how difficult they are for the body to digest (10). General dietary recommendations include (1, 10):
Eating smaller, more frequent meals
Eating foods that are lower in fibre and fat, as they will be easier to digest
Trying soft and liquids foods, which are easier to digest
Eating slowly and chewing food well, whilst in an upright position
Avoiding alcohol and tobacco, as they can slow gastric emptying
Foods that are usually well tolerated:
Low-fat dairy products (e.g. low-fat cheese) & eggs
White cereals (e.g. white bread, rice, pasta, rice krispies)
Lower fibre, well-cooked vegetables with no skin, seeds or stalks (e.g. potato, swede)
Lean meat & poultry (e.g. chicken), fish (avoiding the skin as it’s harder to digest)
Soft foods (e.g. mashed potato, well-cooked vegetables)
Liquid foods (e.g. soups, protein shakes, smoothies)
Foods that may not be tolerated / may exacerbate symptoms:
Fruits & Vegetables that are high in fibre and/or have a skin on (e.g. oranges, broccoli, corn, potato skins)
Raw vegetables
Nuts and seeds, wholegrain cereals
High-fat foods (e.g. full-fat dairy, deep-fried foods)
Fatty cuts of meat
Beans & pulses
Fizzy drinks
Accessing Dietetic Support If you would like further help and advice in the management of Gastroparesis, we can help! At CityDietitians, we have dietitians with experience in helping patients manage Gastroparesis. To ensure you book with the right dietitian for you, please email us at enquiry@citydietitians.co.uk.
Resources
Video of a specialist gastroenterologist talking about gastroparesis
Gastroparesis support Facebook support group
References