Gastroparesis Diet Myths & Misconceptions

Posted in: Diet ♦ Tuesday, March 8th, 2011, 9:40 am ♦ 16 Comments

As both an experienced GPer and a Certified Health Counselor, I know that dietary modifications are vital to a good gastroparesis management plan. But I also know that there are many misconceptions when it comes to the “rules” of eating for GP.

For example, here’s an anonymous message that I received yesterday:

Butternut squash, parsnips and turnup [sic] are all hard to digest and should not be eaten. One ounce of meat is all you can eat in a meal, sweets of all kinds are not allowed as well as candy.

Though no other information was provided, I imagine the comments are in reference to my Winter Vegetable Soup recipe, the ginger treats I recently told you about, and possibly my Eating for Gastroparesis eBook, which features recipes like Butternut Squash Risotto and Oven Fried Chicken.

Here’s the thing:  these aren’t unusual statements, but they’re not universal truths either.  Certainly they may be true for the person who wrote this message, but not for all GPers.  That’s because gastroparesis isn’t one condition with one presentation. While the diagnosis is the same, gastric emptying times can range from nearly normal to extremely delayed.  Likewise, the type and severity of symptoms, as well as the underlying cause, varies drastically from person to person.  While I’m all for general guidelines like the ones I describe in the eBook, to me it just doesn’t make sense to tout such specific rules for such an individualized condition.

In addition, arbitrarily limiting or eliminating foods that don’t provoke symptoms can lead to an overly restrictive diet, which isn’t good for your body or mind.  In my health counseling programs, I’ve encountered many GPers who strictly follow all of the “rules” they’ve heard (mostly from well-meaning but unqualified sources), leaving them with only a handful of foods to choose from.  Not surprisingly, they’re usually malnourished — regardless of weight – which only enhances their physical and mental struggles.

When I ask them why they chose to remove a particular food, the answer is more often because they thought they should than because it exacerbated symptoms.  In fact, the participants in my programs almost always reintroduce a number of foods that they’d previously eliminated…and feel no worse because of it.  (They also typically discover some foods or eating patterns that they thought were “safe” but were actually provoking symptoms.)

The bottom line is this:  if butternut squash, parsnips, turnips or any other food exacerbates your symptoms, don’t eat it. If you find that you feel better when you eliminate sugar,* then by all means avoid it. If you feel fine after eating one ounce of meat, but sick after eating two ounces…you guessed it, only eat one ounce.  Otherwise, continue to enjoy GP-friendly versions of these foods in the amount and combination that minimizes your symptoms while maximizing your nutrition and enjoyment.

Here are a few other things to keep in mind as you build your optimal GP-friendly diet:

  • Following a low-fat, low-fiber diet is a way to manage and alleviate the symptoms of gastroparesis; it’s not a treatment for the condition itself.
  • Unlike gluten in cases of Celiac disease, fat and fiber do not damage the GI tract of people with gastroparesis. They simply increase gastric emptying time of a particular food or meal.
  • Eating a food or a meal that is not “gastroparesis-friendly” may exacerbate symptoms in the short term because the food will digest more slowly, but it will not make the condition worse overall.**
  • For most people, there is a point at which further restricting your diet will not further alleviate your symptoms.
  • Adhering to a GP-friendly diet will not cure gastroparesis. Your stomach may certainly begin to function properly again over time, but probably not because you removed fat and/or fiber from your diet.

All of that said, with proper attention to personal tolerances and careful consideration of overall nutrition, dietary modifications can be a very effective tool for managing symptoms while still living well with gastroparesis.

*If you notice a vast difference in bloating and bowel habits after eliminating sugar, consider an evaluation for small bowel bacterial overgrowth.

**The exception being in cases of bezoar formation. A bezoar is a hardened mass of undigested food that can block the outlet of the stomach causing a severe flare up in nausea and vomiting. It’s estimated that only about 20% of GPers get bezoars, though once you have had one you are at greater risk of having another. To be on the safe side, people with gastroparesis should avoid the foods most associated with bezoar formation, including apple peels, berries, broccoli, Brussels sprouts, coconuts, corn, green beans, figs,oranges, persimmons, potato peels, sauerkraut, and tomato skins. Also use caution with nuts, seeds and beans/legumes. Fiber supplements such as Metamucil, Peridem, Benefiber,Fibercon and Citrucel should also be avoided.

UPDATE!  An FAQ Friday video about the Purpose and Limitations of  a GP-friendly has been posted on my YouTube channel.

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16 Responses to “Gastroparesis Diet Myths & Misconceptions”

  1. Posted by: Mollee
    March 8th, 2011 at 3:10 pm

    Thanks for the shout-out, Crystal! When I first read your e-book, I was very comforted by the fact that I wouldn’t make my condition worse if I experimented with different foods and accidentally ate one that disagreed with me.

    One thing I recently added to my diet that isn’t necessarily recommended for individuals with gastroparesis is cooked, puréed cauliflower. I also eat fresh avocado in small amounts sometimes.

    The word “sometimes” is key because I’ve learned that my tolerance level varies from day to day, so I’m more cautious on days when I wake up feeling especially nauseated. Eating for GP is like a life-long science experiment — there are so many variables!

  2. Posted by: Anita
    March 9th, 2011 at 3:39 am

    What a great blog post Crystal! It serves as a gentle reminder that we are all still individual in our tolerances even if our diagnosis is similiar.

  3. Posted by: Kim
    March 9th, 2011 at 3:51 pm

    So true, every day is an experiment. Some days I find I
    have no tolerance for certain foods, and other days, I could almost
    eat anything. Definitely finding that different foods work better
    than others and maybe eat more of them than previously, but I feel
    better. Drinking plenty of water, juicing vegetables, and eating
    what feels right seems to be the best way to manage for me. The
    Ebook has been a great reference and helpful reminder. We all have
    GP but it certainly is as individual as the person.

  4. Posted by: Sue
    March 10th, 2011 at 5:06 am

    Any and all positive info on how to deal with GP is greatly
    appreciated. Having just been recently diagnosis with GP has been a
    major stumbling block in my life, so blogs like this and ‘Broken
    Stomach” are heaven sent…it is amazing the lack of
    info/knowledge/awareness of GP…what is being done to promote
    education…reading these entries gives me a bit of hope in my
    upcoming food adventures…

  5. Posted by: Jo
    March 10th, 2011 at 6:22 am

    Very true Crystal. I hated the idea of being bound to “The
    Diet” and have other the years experimented with what I can and
    cannot eat (which can change per day or week too, depending on how
    I’ve been feeling or what’s going on in my life) and have expanded
    my diet. I still experiment to this day. I’ve found over time that
    I can handle higher fat things than the GP diet recommends so
    cupcakes & some pastries are okay for my digestive system
    & my soul, if not my weight. Also, I can eat butternut
    squash, parsnips and (sometimes) turnips, if they are well-cooked
    or pureed. I cannot eat beef at all, good days or bad days. I’ve
    found, for me, that it works best if I try new things several days
    apart because I have a very delayed reaction since my stomach
    emptying time has largely settled on about 6.5 hours. I usually
    won’t know for sure until a day or two later if something won’t
    work and will lead to days or weeks of pain. But that won’t stop me
    from trying new stuff, or new combinations of stuff. I know by now
    that eventually the pain will go away (it will be touchy for awhile
    but I’m careful directly after a flare for awhile), and the
    pleasure of expanding my eating options is worth it for
    me.

  6. Posted by: Linda
    March 13th, 2011 at 11:49 pm

    I just found your website and find it very interesting
    about the fiber and avoiding it. I have been drinking metamucil for
    over 20 years and have not been told to stop. Never have had an
    issue with it, but have to be careful that I haven’t eaten much
    when I drink it, but continue to drink it everyday. My doctor put
    me on it when I had my second flare-u[ (of course no one knew what
    it was at the time!) but have only been recently diagnosed with GP
    about 1 2/ years ago. Thanks for the tips! They have all been very
    helpful to me as my doctors have not been very good on advise other
    than “low fat”.

  7. Posted by: Linda K
    March 27th, 2011 at 12:49 am

    59 female newly diagnosis GPer also – November I put myself on just liquids due to being so nauseated and not knowing why. It took many tests to finally diagnosis me with PG two weeks ago. Your site has been so helpful and encouraging with so many suggestions. What I found most helpful was statements about finding what works for me – kind of what I was doing on my own. If I ate something over the last months and I was sick the next day – then I would go back to Gatorade and crackers for a day or two until I was no longer nauseated. So it was great to see your step 1Diet to know I was treating myself by what my body was telling me without even knowing it. After my emptying test (85% still in my stomach after 2 hours) the doctor called to put me on Domperidone which I have been on now for a week. Not sure if it is helping or if my own diet experimenting is working. I won’t actually see the doctor until the middle of next month. In the mean time your site looks like it will be the most helpful as I don’t know what else the doctor would be able to do for me expect maybe aim me towards a nutritionist. Thanks again – I will be doing a lot of reading.

  8. [...] the eBook and here on the blog, I’ve told you that eating non GP-friendly foods will not make your gastroparesis more [...]

  9. [...] If you’re afraid of varying your diet because you might get sick, commit to trying one new GP-friendly food this week. If you’re afraid to exericse because you might feel worse, take a walk around [...]

  10. Posted by: Shelby Berry
    August 9th, 2011 at 12:33 am

    You know, it seems to me that this isn’t only true with Gastroparesis but other diseases/illnesses also. I think that it is easier for medical professionals to streamline a problem rather than fully understanding a patient and their illness. And out of paranoia I sort of wonder if main streaming is partially for legal reasons. I think that you are truly stepping outside of the box Crystal and that is part of what makes you so amazing!

    I’m not sure where this saying originates from, I heard it on Scrubs, but I’ve been using it a lot…”Treat the patient, not the disease.”

  11. Posted by: Christina Lyons
    November 2nd, 2011 at 8:35 am

    I’ve been recently diagnosed with GP and am still learning about it. Thank you for creating this website, very informative. It has been really frustrating, I have been so sick for months before finally being dianosed with GP. My Gastro Emptying Study showed that it takes 485 minutes to empty half of its contents. My Gastro Specialist simply told me the results of the test and that I have Gastropareses, prescribes Reglan and tells me he’s referring me to the Gastroparesis Clinic at Allegheny General in Pittsburgh. No diet recommendations or guidelines other than avoid foods that cause heartburn & reflux; smaller meals, avoid fatty foods, caffeine, alcohol, spicy foods and chocolate. That was almost a month ago and I still have not heard from the Gastroparesis Clinic in Pittsburgh. I called two weeks ago and was told, so sorry your records that were faxed over didn’t go through and they didn’t realize it. So in the mean time, I am trying to learn as much about this as I can. I mostly maintain with supplement drinks, I can only eat very little, one snack a day. As far as the Reglan goes, I will not take it. The risk for tardive dyskenisia is more than I’m willing to chance. I will be checking out your eBook.

  12. Posted by: Kitty
    February 11th, 2012 at 9:04 am

    The video said they are supposed to give you a GP friendly meal to do the emptying scan….Why do often times give you oatmeal, then? Does that mean your results could be inacurate since to my knowledge we are supposed to avoid oatmeal?

  13. Posted by: Steve
    April 23rd, 2012 at 12:50 am

    My wife was recently diagnosed with GP. While it’s some relief to know the medical profession has a grouping for the symptoms, it’s very frustrating that so little research seems directed to understanding its causes, and potential treatments.

    My question: Do you have any information whether taking a stool softener pill might aid the GP symptoms of bloating, stomach-area pain, and constipation? I realize no one talks of constipation, but in my wife’s case there seems to be that additional symptom.

    Thanks!

  14. Posted by: Crystal
    April 23rd, 2012 at 12:54 am

    Hi, Steve. Welcome to the site. Actually, I do talk about constipation! It can certainly be related to GP in terms of symptom management. Check out this video: http://www.youtube.com/watch?v=c322eoNk8G4

    Best wishes to your wife!

  15. Posted by: Brian
    September 28th, 2012 at 8:53 pm

    I’m an Er Trauma NS, and I see patients all the time with abdominal issues. Over the last year I have felt this upper epigastric pain/bloat/pressure come and go every once in a while and never thought much of it. Never any heartburn, no diarrhea, sometimes associated with constipation, then later diarrhea.

    Last night I came home from a very busy Er shift, with no lunch break, and had to inhale my food in about 3 minutes while at work. Felt full and a bloat but did contribute that to a little constipation (btw I’m 43, workout all the time, in great shape and stick with a very healthy diet). By 10pm (home and after work) I had extreme epigastric pain….brought me to my knees, and all I could think of was “crap, I’ve got an intestinal blockage.” By 2am I was in such pain I almost woke my son to take me to the ER; but being a Ns I really did not want the experience. I walked and walked downstairs….tried throwing up…..and what little that came out did relieve some pain (So now I’m thinking…great if I do go to the Er they will put in an NG tube….screw that). After vomiting the pain eased, but then came back….felt like a gas bubble from hell that just would not release.

    By 4am, I vomited a little again, had major diarrhea…..and all that was left in the way of pain was a dull ache this morning. (btw during this time I never had any flu-like symptoms).

    So all day today been drinking just water….feeling better, but got hungry….ate 5 strawberries and 1/2 cup blueberries and pain is back…..(not as severe…but back).

    So started researching and looks like GP may be what I’m dealing with. I know a Dr will have to rule out and test…..but what are your thoughts? Btw before extreme abdominal pain last night I had a crappy snack of cheese and crackers…..

    So looks like liquid diet for a bit. Can I do things like Odwalla or Naked green machine juice? What do you recommend?

    Thank you,
    Brian

  16. Posted by: ethel
    September 14th, 2013 at 9:17 pm

    thanks Crystal, I’ve been reading your latest book and it has given me some good ideas regarding food.

    thanks

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