The human stomch carefully regulates the outflow of food that it partially digests. This food is pushed out into the small intestine for digestion to be completed. However, food and fluids do not just flow through the stomach. It is slowly released anywhere between 45 minutes to 3 hours and sometimes even longer after eating a meal.
The quantity and type of meal are some of the main factors in determining how fast the stomach contents empty out. Liquid meals naturally empty out of the stomach faster than solid meals. The outflow is controlled by the muscles of the stomach which squeezes out the partially digested food into the small intestine.
This is regulated by the pyloric sphincter – the muscular end portion of the stomach. This sphincter widens and narrows to allow stomach contents to pass out. The muscles in the stomach wall further push out the contents. However, when problems rise with these muscles or the nerves that control these muscles then the emptying of the stomach may be slower than normal.
This is known as gastroparesis. It can lead to various complications if not treated and managed properly. Severe dehydration, malnutrition, hard masses in the gut (bezoars) and extreme fluctuations of blood glucose levels are some of the complications that may arise. It can be dangerous and even life threatening at times.
Read more on gastroparesis.
How To Spot Gastroparesis
Gastroparesis may often be missed in the early stages due to the vague symptms like fullness after eating just a few bites or a small meal. Even when later symptoms develop, it may be misdiagnosed for a host of other gastrointestinal conditions due to the non-specific symptoms. Diagnostic investigations are usually necessary to confirm a diagnosis of gastroparesis.
Feeling Full Too Soon
One of the first signs of gastroparesis is the uncharacteristic sensation of fullness after even small meals. As the condition progresses, a person with gastroparesis will find that they are satisfied after just a few bites of food. Overall there is an associated loss of appetite. No other symptoms may be present in early gastroparesis and these symptoms are often ignored.
Nausea and Vomiting
This is a common symptom of many stomach conditions. Nausea is the feeling of wanting to vomit and vomiting may or may not occur. It is usually a result of irritation of the stomach and neighboring parts of the digestive tract.
The nausea worsens after meals. Similarly vomiting after meals (usually after a few hours) becomes a common symptom in due course. Most of the time it is after eating larger meals and the vomitus contained undigested food.
Since the food in the stomach canot be properly digested and emptied out into the small intestine, it may flow backward up into the esophagus (food pipe). Along with the food, stomach acid and digestive enzymes also flow upward into the esophagus. This acid reflux causes a burning sensation in the chest (heartburn) and further contributes to symptoms like nausea and bloating.
Abdominal pain also occurs in gastroparesis. It may not always be present and only occur after eating certain meals. The pain may be felt in the region of the stomach (left upper quadrant of the abdomen) and is often felt under the left rib cage where the stomach is located. However, it may also be diffuse abdominal pain that is not isolated to one specific region of the abdomen.
Abdominal bloating is another common symptom of gastroparesis. It is a sensation of fullness or tightness in the abdomen. There may be accompanying swelling (distension) of the abdomen. The bloating may vary significantly. At times the bloating may be significant with abdominal distension and eases a few hours later. It is usually related to eating and with the consumpion of certain foods.
Diet for Gastroparesis
The treatment of gastroparesis requires diagnosing the underlying cause and treating it accordingly. This may require medication and surgery. However, dietary modification is an important part of managing gastroparesis, irrespective of the cause. It is always advisable to consult with a dietitian for guidance on a suitable eating plan.
Foods to Eat and Avoid
The key factor in dietary management of gastropresis is to eat smaller meals more frequently rather than opting for a few large meals in a day.
- Fruits and vegetables that are not too fibrous are recommended but should be well cooked rather than eaten raw.
- Low-fat foods should be consumed rather than fatty foods. However, liquid fats like those in milk are usually better tolerated but not be every person.
- Lean meats, chicken without skin, certain shellfish and canned fish like tuna (not in oil) are some of the animal protein that can be consumed. It should not be fried.
- Eggs and tofu can also be consumed but should be prepared in a way that does not require oil. Frying should be avoided.
- Bread, bread rolls, bagels, muffins, tortillas, french fries, potatoes, rice and pasta are acceptable starches.
Eating Plan and Lifestyle Habits
It is advisable to get professional advice about a suitable eating plan for gastroparesis. However, the following tips along with the foods to eat and avoid can help to formulate an eating plan.
- Eat 6 to 8 meals daily instead of 3 large meals that is the norm for most people. These frequent meals should be small.
- Alcohol intake must be limited or avoided altogether. Carbonated drinks such as sodas should also be avoided.
- Ensure sufficient water intake of at least 50 ounces (approximately 1.5 liters) daily. Sufficiet water must be consumed during and after meals.
- Liquid or semi-solid meals are usually preferable. Soups and pureed foods are ideal semi-solid food options but should not contain large amounts of fat.
- Avoid the intake of high fiber foods or fiber supplements.
- Mild exercise after meals is also advisable. It assists with digestion. Avoid lying flat or sleeping for at least 2 hours after meals.
While dietary changes and lifestyle modification are important factors in managing gastroparesis, it should not replace medical and surgical treatment. It is important to discuss treatment options with a medical professional and understand the benefits of different treatments.