From the Guidelines
For a 15-year-old girl with gastroparesis not responding to treatment, adopting a low-fiber, low-fat diet with small, frequent meals is crucial to manage symptoms. This approach is supported by the most recent evidence from the 2024 study published in Diabetes Care 1, which suggests that a low-fiber, low-fat eating plan provided in small frequent meals with a greater proportion of liquid calories may be useful in managing gastroparesis.
Key Lifestyle Modifications
- Eat smaller, more frequent meals (5-6 per day) to reduce stomach distension
- Focus on low-fat, low-fiber foods that are easier to digest, such as well-cooked vegetables, lean proteins, and refined grains
- Avoid high-fat foods, carbonated beverages, alcohol, and smoking which can worsen symptoms
- Stay well-hydrated with water throughout the day
- Consider a liquid or pureed diet during flare-ups
Supplements and Additional Interventions
- Nutritional supplements like Ensure or Boost may help maintain nutrition when eating is difficult
- Ginger supplements (250-500mg capsules) may improve gastric emptying, as suggested by the 2022 study published in Clinical Gastroenterology and Hepatology 1
- For severe cases, a multivitamin and possibly vitamin D supplementation might be necessary if malnutrition is a concern
- Stress management techniques such as meditation or yoga could help, as stress can worsen gastroparesis symptoms It's essential to work with a gastroenterologist and dietitian to develop a personalized plan, as these suggestions should complement, not replace, medical treatment. The 2022 study 1 provides a comprehensive overview of treatment options for refractory gastroparesis, including medications and other interventions, which can be considered in conjunction with lifestyle modifications.
From the Research
Lifestyle Changes
- For a 15-year-old girl with gastroparesis, lifestyle changes may include eating smaller, more frequent meals to reduce symptoms of nausea and vomiting 2, 3
- Avoiding fatty or high-fiber foods that can slow down gastric emptying 2, 3
- Staying hydrated by drinking plenty of water 2, 3
Diet
- A gastroparesis-friendly diet may include low-fat, low-fiber foods such as bananas, rice, applesauce, and toast 2, 3
- Avoiding carbonated drinks and caffeine that can exacerbate symptoms 2, 3
- Considering a liquid or pureed diet if symptoms are severe 4, 5
Supplements
- There is limited evidence on the use of supplements in gastroparesis management, but some studies suggest that prokinetic agents such as metoclopramide and erythromycin may be effective in reprogramming gastric motility 6
- Vitamin and mineral supplements may be necessary if the patient is experiencing malabsorption due to gastroparesis 2, 3
Treatment Options
- If treatment is not working, alternative options may include gastric electrical stimulation, intrapyloric botulinum toxin, or surgical interventions such as gastric pacemaker implantation 3, 4, 5
- "Pulse Therapy" using metoclopramide and erythromycin may be considered to reprogram gastric motility and delay or avoid the need for gastric electrical stimulants 6