Thursday, April 21, 2011

Gastroparesis - one more possibility for that nausea

Gastroparesis Diet for Delayed Stomach Emptying

Author:  Frank W. Jackson, M.D.

Prebiotics in your diet or in a supplement naturally restore digestive balance and healthLearn more . . .  

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 although a viral infection is suspected in some. 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
  1. 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.
  2. 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
Meat or 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

Prebiotics in your diet or in a supplement naturally restore digestive balance and health.  Learn more . . .  


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1 comment:

  1. I HAVE BEEN DIAGNOSIS WITH GASTROPARESIS, AND I AM ON THE DIET BUT HOW LONG DO I STAY ON STEP 1 AND THEN STEP 2? MY DR. NEVER SAID ANYTHING ABOUT THE TIME PERIODS?

    ReplyDelete