MEDICAL MANAGEMENT
Gastroparesis is a condition where the stomach takes too long to empty food into the small intestine, even though there is no physical blockage. This can cause nausea, vomiting, feeling full quickly, bloating, and belly pain. Along with dietary changes (eating smaller, more frequent, low-fat, low-fiber meals with soft or well-chewed foods), your doctor may prescribe medications from one or more of the following groups: prokinetics, antiemetics, and/or antacids.
Important First Steps
Before starting any medication, your healthcare team will likely recommend:
Eating small, frequent meals (4–6 per day instead of 3 large ones)
Choosing soft, well-cooked, low-fat, low-fiber foods
Chewing food thoroughly into small pieces
Adding soups and liquid-based meals to your diet
Avoiding fatty, spicy, acidic, and high-fiber foods
If you have diabetes, working to keep your blood sugar well controlled
Reviewing your current medications — some drugs (such as opioid pain medications and certain diabetes/weight-loss medications like GLP-1 receptor agonists) can slow stomach emptying and may need to be adjusted
Why Nutrition Matters in Gastroparesis
Gastroparesis slows the movement of food from your stomach into your intestines. This can cause nausea, vomiting, feeling full quickly, and belly pain — all of which can make it hard to eat enough. Over time, this may lead to weight loss, dehydration, and shortages of important vitamins and minerals.
Research shows that nearly two-thirds of gastroparesis patients eat less than 60% of the calories they need each day. That is why regular nutritional check-ups are an important part of managing this condition.
What Should Be Assessed?
Your healthcare team should evaluate the following areas on a regular basis:
Calorie and protein intake. Are you eating enough each day to maintain your weight and energy? Many patients with gastroparesis eat far fewer calories than they need without realizing it.
Body weight and weight trends. Tracking your weight over time helps your care team spot unintentional weight loss early.
Hydration status. Nausea and vomiting can lead to dehydration. Signs include dark urine, dizziness, dry mouth, and fatigue.
Vitamin and mineral levels. Gastroparesis puts you at higher risk for deficiencies in:
- Vitamin D — important for bone health
- Vitamin B12 — important for nerves and blood cells
- Iron — important for preventing anemia
- Calcium — important for bones and muscles
- Potassium and magnesium — important for heart and muscle function
- Folate, Vitamin E, and Vitamin K — important for blood health and overall function
Your doctor may order blood tests to check these levels, especially if you have been eating poorly for a long time.
Bone health. Because vitamin D and calcium deficiency are common, your doctor may recommend a bone density scan (DEXA scan) to check for thinning bones (osteopenia or osteoporosis).
Eating patterns and food avoidance. Your care team should ask about which foods you are avoiding and why. Some patients develop a pattern of extreme food avoidance that can worsen malnutrition. A dietitian can help you find foods that are easier to tolerate while still meeting your nutritional needs.
Blood sugar control. If you have diabetes, gastroparesis can make blood sugar levels harder to manage. Regular monitoring of blood sugar and hemoglobin A1c is important.
Dietary Tips to Help You Get Better Nutrition
Eat small, frequent meals — aim for 4 to 6 smaller meals instead of 3 large ones.
Choose soft, small-particle foods — foods that are easy to chew into tiny pieces or are already smooth (like soups, smoothies, and well-cooked vegetables) leave the stomach more easily.
Limit fat in solid foods — fatty solid foods slow stomach emptying. However, high-fat liquids (like nutrition shakes) are often better tolerated.
Reduce high-fiber foods — raw vegetables, skins, seeds, and tough fibers can be hard to digest. Cooking and peeling fruits and vegetables can help.
Stay hydrated — sip fluids throughout the day, especially if you are vomiting.
Consider a daily multivitamin — only about one-third of gastroparesis patients take a multivitamin, but it can help fill nutritional gaps. Talk to your doctor or dietitian about what is right for you.
A REGISTERED DIETICIAN with experience in gastroparesis can be an invaluable part of your care team. Studies show that patients who receive nutritional counseling are more likely to meet their daily calorie needs. We refer all our patients to Nourish Nutritional Counseling.
When to Seek Additional Help
Talk to your healthcare team if you:
Are losing weight without trying
Cannot keep food or liquids down for more than a day
Feel dizzy, weak, or extremely fatigued
Notice signs of dehydration