No fiber. No fat. My diet is pretty much the antithesis of commonly practiced healthy guidelines. Gastroparesis is an up and down condition. It flares and wanes depending on many things, some of which you have no control over. Pain, nausea, and vomiting are often relentless.
Since gastroparesis is basically a paralyzed stomach, learning major trigger foods and the finding the right diet for your body is incredibly important. It takes a long time to figure out your “safe” foods as well as developing an understanding that this condition doesn’t get better. It may stay the same, you might find treatments that work, but your digestive system never goes back to perfect.
I, like many gastroparesis patients, am rarely hungry. The signals that the stomach sends to the brain are partially dependent on movement. When your stomach and parts of the intestines don’t move, those signals are rare. Think of the movement like squeezing a small tomato. Depending on the voracity and pace of the squeeze, the fruit is squished, mashed, and then moved around until most of it is out of the fist. If you can’t squeeze the tomato, it just sits there. Start adding other food in that fist, and boom, your fist is full until you manually empty it or the food rots away.
Thankfully, our stomachs are full of digestive enzymes and acids that assist in this breakdown process. What those juices can’t do is easily breakdown fats and fiber. This is part of the reason many people choose a high fat high fiber diet, because you stay fuller longer. When I eat high fiber foods such as oats, beans, or broccoli (all of which I sadly love) they slowly breakdown in my gut and move through the rest of my digestive tract. But, some of those fibers can get left behind in the stomach. When too many of those pieces accumulate, they form types of balls known as bezoars. A gastroenterologist then has to use a device to go down into your stomach and remove that indigestible mess. Thankfully, I’ve only had to have that removal once. It’s not fun and bezoars are not commonly looked for when you first present with gastroparesis symptoms.
While the stomach acids are flowing and the food is attempting to move through the uncooperative sphincter into the intestines, nausea and sometimes pain is present. This is often occurring both quickly and hours after eating. Vomiting can easily happen when your body gets mad enough. Though, I usually feel that constant nausea is worse than actually expelling the contents of my stomach. Again, knowing your safe and easily digested foods makes a huge difference to how you feel post-meal. When this disease gets to the point where the stomach is completely non-functioning, most patients are moved to a liquid only diet and eventually a feeding tube is put in. While this is not an ideal situation (infections, appearance, lifestyle adjustments, and missing eating are all common issues) most of us would choose it over the agony of constant nausea, vomiting, and pain. It becomes the only way to keep weight on and to make sure the person is getting all the nutrients that they need.
If you are in the pre-feeding tube stage, like myself, there are some tips and tricks for handling the stress of daily eating. Tip #1: Do not eat at least four hours before bed. Yes, there are exceptions when an occasion dictates, but you want your food to be processing out of your stomach before lying down. Tip #2: Utilize well-known home remedies for nausea (i.e. ginger, mint, warm liquids, laying on your left side, and walking after a meal). Tip #3: Find anti-nausea medications that work for you. There can be difficult side effects for some of these meds, but I have found that a few of them are worth those new symptoms. Tip #4: Laxatives aren’t anything shameful. Most of us have constipation as a component of our condition. After all, when foods aren’t moving through your system, the waste isn’t either. Tip #5: Be forthcoming with your doctor and get a gastroenterologist who has familiarity with this condition. You need to be heard and understood. Don’t be afraid to be graphic about your daily struggles and make sure they test you thoroughly to properly diagnose your gastroparesis. This is especially important for women and people of color. Tip #6: Be experimental. I underwent a treatment where they put Botox in the sphincter of my stomach to keep it open longer. I take a medication that isn’t legal in my country. I have used alternative substances that encourage the appetite. Do whatever you can to make your life more comfortable. Tip #7: Don’t let your stomach dictate your social life. I have zero shame or discomfort sitting with people who are eating while I just sip on a water. I’ll often order an appetizer that I can pick at while others order main dishes. At homes, where custom dictates that I eat, I’ve mastered the peck and move food around the plate method. People will usually be thrilled if you say that you just aren’t very hungry, but that you, “want a plate to take home because it is so good!”
Learning your safe foods is a process of trial and error. You should also play around with how they are prepared to find what works best. Here are some of my top picks and safe meals: white rice, potatoes, chicken, fish, mushrooms, tofu, onion, noodles, non-dairy soups, turkey, most spices, vinegar, applesauce, pickles, olive oil, sesame oil, Greek or Icelandic style yogurts, peas, and most items made with rice flour. Sugar is easily digestible, but my gut doesn’t like artificial sweeteners. Corn is a no-go, but items made with cornmeal are fine.
There are ways, albeit odd ones, of enjoying foods that can hurt me. For example, I eat oranges by sucking out the juices and discarding the flesh. I eat small amounts of fibrous vegetables and fruits in their pureed, juiced, or soups form. Heavier meats or fried versions of my safe meats, I will only have a bite or two at the most. Popcorn turns into a whole ordeal as I remove the kernels from each popped piece. Being a creative eater makes the complications a lot more bearable.
I listen to my body. If it is going through a bad stretch of nausea and vomiting, I eat purely for sustenance. Sometimes that means loosing a lot of weight, but I know that I will regain it when the flare eases. Stress is a major aggravator. Sometimes, it is difficult to recognize that trigger. We all have stressful lives. By incorporating light exercise, spending time in nature, meditation, and enjoying hobbies into my daily routine, I help cut down on mounting pressures.
Anyone with gastroparesis… please know that you aren’t alone. Yes, it’s a rare condition. Those of us who continue to handle the daily frustrations of a broken stomach understand you. We know what it’s like to be misdiagnosed and not believed. We are fellow fighters in the battle for nutrition and maintain the hope of an effective treatment.