Gastroparesis: What You Need to Know
Gastroparesis is a condition in which the stomach is slow to empty, preventing digestion from occurring normally. This happens due to a motility issue in which the stomach does not contract, caused by damage to the vagus nerve.
Gastroparesis can cause the food to remain in the stomach too long and ferment, resulting in bacterial infections. It can also cause the food to harden and form solid masses, called bezoars, in the stomach; these can block and further delay digestion. With slow digestion, there can also be a struggle with blood sugar levels, particularly for those who are already diabetic or hypoglycemic. I personally suffered from major issues with blood sugar control and weight loss– by the time I was admitted to the hospital when I got my diagnosis, my blood sugar was so low I was at risk for becoming comatose.
Though for many patients there is a cause for gastroparesis, such as diabetes or surgery, in a lot of cases there is no known or traceable cause. This is called idiopathic gastroparesis, which is what I was diagnosed with.
Symptoms of gastroparesis can be exhausting, painful, and frustrating. The symptoms of gastroparesis include:
- Vomiting (including the vomiting of undigested food hours or even days later)
- Lack of appetite
- Feeling full after eating very little
- Abdominal pain
- Unintentional weight loss
- Poor blood sugar control (particularly dangerous for diabetics)
- Heartburn or GERD
Treatments for Gastroparesis
After testing has happened and a diagnosis of gastroparesis is made, it’s time to start figuring out a plan for treatment.
One of the challenges everyone with gastroparesis struggles with is finding what works for them personally. Though there are a lot of commonalities in everyone with GP about things we shouldn’t eat (high fiber, broccoli, big hunks of steak), each person with gastroparesis has their own triggers and their own unique list of foods that they can eat. Example: I personally can mostly stomach dairy, while I know a lot of people with gastroparesis cannot. It takes a lot of time, patience, and sometimes setbacks to figure out what we can and cannot eat.
That being said, there are a lot of options for treatment, depending on the severity of your symptoms and their impact on your body. These treatments vary from changes in eating habit to changes in diet to medical interventions.
The following treatments are all commonly used to treat gastroparesis and its symptoms (though you should consult with your doctor before trying any of them):
Depending on the severity of your symptoms and your personal tolerances for different foods, your doctor may recommend different dietary alterations. During a set back and flare up of symptoms, for example, a lot of people with gastroparesis will stick to an entirely liquid diet. While I was recovering from my hospitalization, I stuck to mostly liquid foods with some semi-soft foods mixed in (i.e., yogurt and mashed potatoes).
One of the most difficult parts of finding what diet works for you is that it’s different for each individual case of gastroparesis. I may be able to eat something that the person next to me with gastroparesis cannot, and vice versa. There’s a certain amount of trial and error to figure out what diet and foods will work best for you.
No matter what, there are some foods that almost all patients with gastroparesis should avoid. These include:
- High fiber food (a lot of times this includes raw fruits and vegetables)
- Anything fried. Don’t do it. Just don’t.
- Foods high in fat (for some, this means sticking to low- fat dairy, though others are able to tolerate it)
- Foods known to be difficult to digest (I miss my steaks!)
Foods people with gastroparesis are commonly able to eat:
- Clear broths
- Soups, smoothies, and pureed foods
- Cottage Cheese
- White starches (pastas, potatoes, and rice)
- Lean poultry like baked chicken breast
For specifics, there’s a great list of foods you can eat and foods you should eat or avoid here, and I highly recommend taking a look at it and talking about it with your dietician or doctor. It gives you specific fruits, vegetables, and other foods that you could try or should avoid. It’s made my life a lot easier.
Dietary restrictions and tolerances vary from person to person with gastroparesis, so not all of the recipes on this site will work for everyone. In addition to that, this site has recipes for everyone in all stages of gastroparesis, including those in Stage 1 on a liquid diet, and going all the way to those in long term maintenance mode. I encourage everyone to use only the recipes they know or believe they would be able to tolerate, and to make adjustments to the recipes if necessary to not cause set-backs in your health. You can read about this in my legal disclaimer.
Changes in Eating Habits
Not only do many gastroparesis patients benefit from alterations in diet, they also benefit in changes in their overall eating habits. There are several eating habits that benefit and speed up digestion, including the following tips commonly recommended for those diagnosed with gastroparesis:
- Eating smaller but more frequent meals (think 4-6 meals a day instead of 3).
- Drink sips of water between bites of food.
- Walk around or sit up after eating to aid digestion.
- Chew food thoroughly. Totally pulverize it to make digestion easier.
While there is no cure for gastroparesis, there are a lot of really good medical interventions that, for many, offer relief from symptoms and can help manage the condition. These treatments include:
There are several medications that are useful for managing gastroparesis and its symptoms. Examples include:
- Reglan: This medication will cause the stomach to contract, and is taken before eating. Because of this, it helps to decrease vomiting and nausea. This medication is best used for short term purposes, as long term it can have neurological side effects.
- Erythromycin: One antibiotic that also triggers stomach contractions, like Reglan, but without the neurological side effects. Typical risks of antibiotics are included for this medication.
- Domperidone: A medication you can get with a prescription from Canada, it’s like Reglan without the side effects. I love this stuff– it’s what I’m on, and with my dietary adjustments (and other treatment plans), it’s worked for me.
- Zofran and other nausea medications: These medications help control nausea, which is a symptom a lot of gastroparesis patients struggle with.
The gastric pacemaker is a relatively new breakthrough, but it’s a massive one and has seen a lot of success in cases where medication just isn’t cutting it. Formally called Gastric Electrical Stimulation, the device is surgically implanted in the abdominal wall. Gentle electrical impulses from the device stimulate the stomach to cause contractions needed for digestion. You can see an article about gastric pacemakers here.
When medications and the gastric pacemaker don’t work in severe cases of gastroparesis, a feeding tube can be used to provide the patient with necessary nutrients. Feeding tubes are placed surgically into the small intestine, allowing nutrients to bypass the stomach entirely.
Can you die from Gastroparesis?
This is a question I’ve seen asked a lot, and it’s one I asked my own doctor. When people get diagnosed with anything, they sometimes use the “can you die from it” question to gauge the seriousness of their ailment.
The answer to this question is kind of no but also yes, in my opinion.
Will you gastroparesis kill you in the same way that a heart attack or an aneurism will– suddenly and directly? No, not really. Can complications and the effects of gastroparesis cause death? Yes.
I can attest to this first hand, as I was a very high risk for being a gastroparesis casualty before I was even diagnosed. In my case, I had lost so much weight so quickly and had been malnourished for so long that I was at risk for (and starting to see effects of) multi system organ failure and heart complications. Think the effects anorexia has on the body– in my case, it wasn’t entirely different, just faster and more sudden.
Other complications can include bacterial infections in the blood, coming from ports or PICC lines. Effects from malnourishment or weight loss can cause other health issues.
Fortunately, with good treatments in place, deaths due to gastroparesis are not as common as getting the diagnosis is. It’s something a lot of patients die with eventually, not necessarily die from. In most cases, feeding tubes when necessary are able to provide nutrients that are needed.
Gastroparesis is scary, whether your life is in immediate jeopardy or not. But always remember that a positive attitude can make a huge difference– I was cracking jokes with the nurses while I was filling out the will the hospital provided, and I honestly believe that made a difference in my ability to recover.
Gastroparesis will affect your life, but it doesn’t have to define it.
Dealing with gastroparesis on a daily basis can be frustrating, scary, and exhausting. Though this site focuses almost entirely on recipes (and recipe ideas) for people with gastroparesis, there are some other great sites that cover everything from lifestyle changes, potential medical treatments, and support for those in the gastroparesis community. There is fortunately not a shortage of good information about gastroparesis for those who are looking.
I personally have used each of these resources below and recommend them. Please note that none of these sites, including this one, are a substitute for medical advice and attention, nor should they be used as such. They are just great resources that offer information, support, and encouragement for living with and managing gastroparesis.
Here are some of my favorite gastroparesis resources:
Living with Gastroparesis: I think this is one of the best (if not THE best) resources for those diagnosed with gastroparesis (or their family members). It’s run by a certified health counselor who was diagnosed with gastroparesis herself. She’s got a free ebook with some recommended recipes and a fantastic guide about what gastroparesis is, how to live with it, and really great details about what to and not to eat.
Emily’s Stomach: Another site run by someone living with gastroparesis, Emily’s stomach provides a great community and some miscellaneous resources for patients with gastroparesis. This blog focuses a lot on life with gastroparesis.
As I discover more resources, I’ll share them here. If you have any that have helped you, please let me know so I can add them to the list!