Dietary modification for gastroparesis

Initial management of gastroparesis is dietary modificationStrijbos, 2019. Advise patients to:

• eat small, frequent meals of soft or easily macerated foods
• chew their food well
• avoid high-fat and high-fibre foodsLimketkai, 2020.

Gastric emptying of liquids is generally less affected by gastroparesis than emptying of solids; occasionally a pureed or liquid diet (using oral nutritional supplements) is required to maintain caloric intake. Refer patients to an accredited practising dietitian if intake is deteriorating or nutritional status has been compromised. If nutrition cannot be maintained by oral intake, overnight gastric or jejunal feeding via an endoscopically or surgically placed feeding tube may be necessary (see Enteral nutrition support in adults)Limketkai, 2020.

In patients with gastroparesis and diabetes, variable gastric emptying can cause postprandial hypoglycaemia and a deterioration in the glycaemic profile. Optimising the glycaemic profile is important because hyperglycaemia delays gastric emptyingLimketkai, 2020.