Five Tips for Managing Gastroparesis

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Last night I counted out six okra pods on my plate along with white rice, peeled apple slices and grilled chicken. According to the nutritionist I consulted when I was diagnosed with gastroparesis, the okra should be a no-no because it’s high fiber. But our garden is overflowing with okra, and I love itGastroparesis causes the stomach to empty too slowly. It may be caused by diabetes or other diseases, or as a side effect from radiation, surgery or certain medications. In the majority of cases, however, there is no known cause. That’s idiopathic gastroparesis.

My gastroparesis began after I finished cancer treatment and it got worse over time. Did the radiation, aimed at my sternum right above the vagus nerve that controls the stomach, cause my gastroparesis? Maybe. Am I one of majority with idiopathic gastroparesis? Could be. No one really knows.

I didn’t know I had this condition. I just knew that sometimes I had nausea and vomiting for no apparent reason. These episodes often happened after I ate out, and I learned to associate the rich foods on restaurant menus with getting sick. Avoiding fried foods helped, but didn’t solve the problem.

A series of tests ruled out some possible causes, such as a digestive tract cancer or celiac disease. Finally there was one test left to try--the gastric emptying study.

When I arrived at the nuclear medicine section of my hospital, I was given an egg sandwich laced with a radioactive tracer substance on white bread toast to eat--pretty tasty except for the thought of swallowing radioactive eggs! They took a scan of my digestive system. An hour later another scan, and an hour later, another. This test told my doctors that my egg sandwich was staying in my stomach far too long. I have slow stomach emptying gastroparesis.

After seeing the results of the test, the gastroenterologist was amazed that I wasn’t vomiting all the time. He suggested some medications to try, offered some lifestyle tips, and sent me to a nutritionist to find a diet that worked for me.

When I talked to the nutritionist, I realized why I was getting sick after eating out: the salad! I had cut back on fatty foods at restaurants, but I was chowing down on high fiber, raw vegetable salads. I learned that lettuce is not my friend. According to the diet expert, it’s important to avoid any high fiber vegetable or fruit.

But we have a garden. In the summer, at least half my plate was piled high with veggies and berries. So over the years I’ve learned some tips that keep me nausea-free most of the time.

1. Know when to stop.

I’ve learned to pay attention when I start feeling full. I stop eating even if there is still food on the plate. Part of my problem in restaurants or at dinner parties was that I didn’t want to hurt anyone’s feelings by not eating what I was served. Now I put the fork down even when the food is delicious.

2. Eat small meals throughout the day.

If I stop as soon as I start to feel full, I am hungry in an hour or two. Sometimes I finish my supper later, but I also try to snack throughout the day. I have a sweet tooth, so I’m tempted to choose sweets, but I try to include protein in my snacks, such as nuts or cheese.

3. Chew food thoroughly.

I’ve learned to eat slowly and chew food well so that it is easier to digest. Saliva has substances that begin the digestion process, so now I even chew soft foods, including oatmeal. It is especially important to thoroughly chew hard foods such as nuts and broccoli.

4. Learn your trigger foods.

According to most gastroparesis diets, all fatty and high fiber foods are problematic. Gastroparesis diets look really boring: cream of wheat for breakfast, applesauce and low-fat yogurt for lunch, turkey with mashed potatoes and boiled carrots for supper with smoothies or nutrition drinks for snacks. I needed to find a more interesting, tasty diet.

I’ve learned that I can enjoy salads and vegetables in small amounts, usually a half-cup serving. That’s why I counted out the six okra and had white rice and peeled apples with it. In another meal I might have a higher fiber starch if my green veggie is lower in fiber.

I have found that I have to be particularly careful with lettuce. It tastes good and seems harmless, but many of my nausea bouts were preceded by a green salad, so I eat just a little. Because each person is different, it will take some experimenting to learn what you can tolerate.

Soups and smoothies offer people with gastroparesis good nutrition that is easily digested. If you love the flavor of blueberries, but can’t eat them because of the skins, you can still get the taste of blueberries in a smoothie.

5. Stay upright after meals.

I used to go to bed and read or watch television not long after supper. After being on my feet all day teaching, I longed to be horizontal. But I needed gravity to help that food move on down. Now I stay upright for at least an hour after eating and usually two or three.

Lifestyle changes may not be enough to manage severe gastroparesis. A gastroenterologist can help you make decisions about medications. In extreme cases, surgical procedures may be used. But modifying what and how you eat can make a significant improvement for most people with gastroparesis.

See More Helpful Articles:

Gastroparesis; What You Need to Know

Sources:

Dietary and Lifestyle Measures. About Gastroparesis. International Foundation for Functional Gastrointestinal Disorders. February 19, 2016. Accessed from http://www.aboutgastroparesis.org/dietary-lifestyle-measures/basic-dietary-guidelines.html August 29, 2016.

Gastroparesis. National Institute of Diabetes and Digestive and Kidney Diseases. Accessed from https://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/gastroparesis/Pages/facts.aspx August 29, 2016.

Gastroparesis. Patient Education and Resource Center. American College of Gastroenterology. Accessed from http://patients.gi.org/topics/gastroparesis/ August 29, 2016.


Phyllis Johnson is an inflammatory breast cancer survivor who serves on the Board of Directors for the Inflammatory Breast Cancer Research Foundation, the oldest 501(3)(c) organization focused on research for IBC. She is a list monitor for an online support group at www.ibcsupport.org. She stays current on cancer information through attendance at conferences such as the National Breast Cancer Coalition’s Project LEAD® Institute. A retired teacher, she has been writing about cancer issues at HealthCentral since 2007.

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