Nutrition Tips in Gastroparesis

For many patients living with HSD/EDS, functional disorders of the gastrointestinal tract can be very hard to manage.  Here we would like to provide some insight on nutrition strategies that can help ameliorate the symptoms associated with gastroparesis.  Using the 2016 National Inpatient Sample of the Healthcare Cost and Utilization Project, a case control study was completed in the journal of Rheumatology reviewing the prevalence of gastrointestinal conditions in hospitalized EDS patients.  2,007 patients were identified with EDS and of those, GI conditions occurred in 44% of the patients with 180 or 9% of patients presenting with Gastroparesis.  Gastroparesis is identified as impaired stomach emptying.  Symptoms associated with the condition can include nausea, vomiting, abdominal bloating, pain, fullness, indigestion, lack of appetite and weight loss. The mechanism of cause for gastroparesis is not fully known but may involve the extracellular matrix.  Extensive distension within the gut wall may interfere with gut-mechano-receptors affecting motility.

The nutritional management of Gastroparesis can involve:

Alterations to Diet:

• Small frequent meals consumed every 3 hours
• Foods that are low in fat and fiber
• Alternating textures of foods. For example, smooth soups and smoothies for one meal followed by a regular textured meal.
• Incorporating well cooked vegetables over raw foods.

Exercise:

• Post-meal walk

Mind-Body Practices:

• Vagus Nerve Stimulation:
  • Diaphragmatic Breathing
  • Meditation
  • Cold Showers
  • Gargling, singing, humming

Supplementation:

• Digestive bitters may help to simulate gastric juices such as hydrochloric acid, digestive enzymes and bile to help stimulate digestion and motility. Bitters can include artichoke, dandelion, chamomile, ginger, anise, and coffee. Some of these can be used as a tea or taken in supplement form. Some supplements to consider:
  • Pure Encapsulations 1000 mg Ginger Extract at bedtime (help with the migrating motor complex that occurs during fasting)
  • Ginger Tea: fresh ginger cut to the size of your 5th digit and steeped into 150 ml of boiling water for 5-10 minutes and strained. Consume prior to meals
  • Pure Encapsulations Motilpro
  • Integrative Therapeutics Motility Activator
  • Rejuvica Health Digestapro
• As with any supplement, you may want to discuss with your doctor or registered dietitian prior to use to ensure there are no contraindications with medications or other medical conditions.

Medications:

• There are medications your physician can prescribe to help with gastric motility. These include Reglan, erythromycin and domperidone.  You may want to discuss with your physician to determine if these are appropriate options for you.

There are many resources on nutrition and EDS/HSD gut health.  If you would like to learn more, take a look at the Mayo Clinic’s resource for more information on symptoms, causes, and complications of gastroparesis:  Gastroparesis - Symptoms and causes

If you feel you need more assistance with managing your symptoms with diet, you can always ask your physician for a referral to see a registered dietitian.

Author: Lisa Mejia, RDN, LD/N