Normal digestion typically takes 36 hours from ingestion to excretion. Within the first six to eight hours, food goes from the stomach to the small intestine (Mahan, & Raymond, 2017). However, that is not always the case, as sometimes there is a delay in gastric emptying (emptying of the contents in the stomach to the small intestine). Gastroparesis, which means paralysis of the stomach, is a condition characterized by damaged nerves and muscles not functioning properly or adequately (Mahan, & Raymond, 2017; Kumar, Chapman, Javed, Alam, Malik, & Azmi, 2018). The stomach attempts to pass food to the small intestine, the next stage of digestion, but either cannot or does so very slowly. These complications can occur as a result of an obstruction within the stomach and/or intestines, diabetes, post-surgery, idiopathic (no known cause), or some neurological disorders (Camilleri, 2016; Haans, & Masclee, 2007; Homko, Duffy, Friedenberg, Boden, & Parkman, 2015; Kumar, Chapman, Javed, Alam, Malik, & Azmi, 2018).
Symptoms typically include bloating, decreased appetite, nausea, vomiting, early satiety, feeling full almost immediately after eating, and pain within the abdomen (Haans, & Masclee, 2007; Mahan, & Raymond, 2017). Violent or persistent vomiting for several hours after eating is highly indicative of gastroparesis (Haans, & Masclee, 2007). Due to the varying causes of gastroparesis, certain symptoms are more prevalent in different causes. For example, nausea, vomiting, bloating, and early satiety are typically apparent and present in idiopathic gastroparesis (Haans, & Masclee, 2007). On the other hand, vomiting as opposed to nausea, was more prevalent and severe in gastroparesis caused by diabetes than of those afflicted by an idiopathic cause (Kumar, Chapman, Javed, Alam, Malik, & Azmi, 2018).
Typical treatments include modifications to dietary habits, intake, the assistance of drugs to promote movement within the stomach, drugs to alleviate symptoms of nausea and vomiting, and mechanical assistance (gastric pacemaker to stimulate movement of the stomach; Camilleri, 2016; Haans, & Masclee, 2007; Homko, Duffy, Friedenberg, Boden, & Parkman, 2015; Kumar, Chapman, Javed, Alam, Malik, & Azmi, 2018). For the purposes of this article, we will focus on the treatment that involves changes to dietary habits and intake. It is recommended to adjust and incorporate dietary habits that can affect the stomach’s ability to move the food contents. However, advice should be tailored to fit an individual’s intolerance with specific foods. General guidelines include limiting high fat foods, as traditionally high fat in a diet slows the process of gastric emptying (Haans, & Masclee, 2007; Homko, Duffy, Friedenberg, Boden, & Parkman, 2015). Although consumption of smaller, more frequent meals has been recommended as treatment for decades; the practice was recommended without evidence of application. Although more recently, studies have been conducted to prove the efficacy of smaller meals (Camilleri, 2016). Finding reductions in symptoms such as nausea, vomiting, bloating, fullness, and heartburn (Camilleri, 2016). Avoidance of Acidic or spicy foods because they can exacerbate symptoms and further the complications of gastric emptying. Limit the consumption of non-digestible fiber since fiber slows the process as well (Haans, & Masclee, 2007; Mahan, & Raymond, 2017). Also, fiber can increase the risk of forming a bezoar (build-up of undigested foods).
Reverences
Camilleri, M. (2016). Novel Diet, Drugs, and Gastric Interventions for Gastroparesis. Clinical Gastroenterology and Hepatology, 14(8), 1072-1080. doi:10.1016/j.cgh.2015.12.033
Haans, J. J., & Masclee, A. A. (2007). Review article: The diagnosis and management of gastroparesis. Alimentary Pharmacology & Therapeutics, 26, 37-46. doi:10.1111/j.1365-2036.2007.03534.x
Homko, C. J., Duffy, F., Friedenberg, F. K., Boden, G., & Parkman, H. P. (2015). Effect of dietary fat and food consistency on gastroparesis symptoms in patients with gastroparesis. Neurogastroenterology & Motility, 27(4), 501-508. doi:10.1111/nmo.12519
Kumar, M., Chapman, A., Javed, S., Alam, U., Malik, R. A., & Azmi, S. (2018). The Investigation and Treatment of Diabetic Gastroparesis. Clinical Therapeutics, 40(6), 850-861. doi:10.1016/j.clinthera.2018.04.012
Mahan, L. K., & Raymond, J. L. (2017). Krauses food & the nutrition care process. St. Louis, MO: Elsevier
