How To Follow a Gastroparesis Diet: What To Eat and What To Avoid

When you’re living with gastroparesis, it can be tough to get the nutrition you need. Because your stomach doesn’t move food through your system as well as it should, you can be at risk for weight loss and nutritional deficiencies. But it can be hard to convince yourself to eat when you’re feeling nauseated, bloated and full after just a few bites.

We talked with registered dietitian Amanda Igel, RD, LD, about following a gastroparesis diet, or eating plan, so you can take the best care of yourself — on both good and bad days.

Diet modifications for gastroparesis

Chances are that your gastroparesis symptoms ebb and flow, with some days being better than others. Even some times of day being better than others. That’s normal.

Igel recommends listening to your body’s cues to guide your diet day to day. “On the worst days, you may only be able to tolerate a liquid diet. But as your symptoms improve, you can slowly start incorporating more foods,” she says.

Let’s take a look at Igel’s recommendations of what to eat (and to avoid) based on how you’re feeling.

Stage 1 gastroparesis diet: Severe symptoms

If you can’t tolerate food but can keep down liquids, stick to beverages that can help you keep hydrated and maintain your electrolytes, like:

• Sports drinks and rehydration solutions (like Gatorade®, PowerAde® and Pedialyte®).
• Boullion.
• Caffeine-free clear liquids.
• Broth.

If you can tolerate some saltine crackers, that can help keep your energy up some, too.

“If you find that you need to rely on a stage 1 diet often or if you can’t tolerate foods for more than three days at a time, check in with a healthcare provider,” Igel recommends. “You might benefit from some additional nutritional support.”

Stage 2 gastroparesis diet: Moderate symptoms

When you’re feeling like you can tolerate a liquid diet and a little more, you can start adding some additional foods.

“When tolerating clear liquids well, you can start adding some additional soft and easy to digest foods,” Igel says. “These foods are generally low in fat, moist and can dissolve easily in your mouth without any effortful chewing.”

Continue with stage 1 foods, and try adding some foods, like:

• Skim-milk products, like yogurt, cheese, pudding and custard.
• Fat-free broth with noodles.
• Cream of Wheat®.
• Vegetable juice.
• Fruit juice.
• Skin-free canned fruits.
• Creamy peanut butter.
• Poultry, like ground turkey and chicken.

Stage 3 gastroparesis diet: Mild and minimal symptoms

Even on your better days, it’s still important to keep up a healthy gastroparesis diet.

“When you’re living with gastroparesis, limiting your intake of fat and plant fibers is important,” Igel shares. “Fat and fiber are tough for your stomach to digest, and result in slower emptying from your stomach to your small intestine.”

Fat naturally slows stomach emptying. So, choosing foods labeled “low fat,” “nonfat” or “fat-free” may help with symptoms. People with gastroparesis should avoid high-fat, fried or greasy foods.

But note that liquid fat in beverages might help if you’re experiencing unintentional weight loss.

Fiber also slows stomach emptying, Igel adds. Avoid high-fiber foods because they may remain in your stomach or may cause bezoar formation (a blockage in your stomach).

Which foods to eat and avoid with gastroparesis

Here’s what to try and what to avoid on a healthy gastroparesis diet.

Grains and breads

People with gastroparesis should be wary of whole grains because of their high fiber content. When choosing breads, pastas and other grain products, your better choices are foods with less fiber.

Good choices for people with gastroparesis include:

• White bread.
• Low-fiber cereal (look for 2 grams of fiber or less per serving).
• Cream of Wheat®.
• Cream of Rice®
• Grits.
• White rice.
• Low-fat, low-fiber crackers.
• Seedless breads, rolls and crackers.
• Pretzels.
• Rice cakes.

Grains with high fiber content (greater than 2 grams per serving) should be limited. That includes products like:

• Dense and compact starches, like bagels, gnocchi, tortellini, dumplings and thick pizza crust.
• Whole-grain foods (including breads, pastas, crackers and more).
• Steel-cut or rolled oats (instant oatmeal is typically OK).
• Chinese noodles.
• Bran cereals.
• Shredded wheat.
• Granola.

Fruit

Fruit is packed with vitamins and minerals that your body needs. But fruits that are high in fiber can be tough to digest when you’re living with gastroparesis.

Some of the best choices for fruit in a gastroparesis-friendly diet include fruits that are peeled and cooked. That’s because cooking can help to break down fiber so your body can process it more easily.

Raw and dried fruits should be avoided. Fruit skins also tend to have higher levels of fiber. Skins should be limited if not altogether avoided.

Try these sources of fruit that are low in fiber:

• Canned fruits without skins (like applesauce, canned peaches, pears and mandarin oranges).
• Apples and pears with skins removed.
• Seedless melon.
• Ripe bananas.
• Fruit juice.

Fruits to avoid include ones like:

• Raw fruit.
• Canned fruit with skins (like cherries and apricots).
• Plums.
• Oranges.
• Berries (like strawberries, blackberries and blueberries).
• Apple or pear skins.
• Kiwi.
• Coconut.
• Rhubarb.

Vegetables

“Eat your veggies” is sound advice for just about anyone. But when you’re living with gastroparesis, being choosy about your vegetables can help your belly works its best.

“We advise eating vegetables that are more easily digested,” Igel says. “Cooked vegetables are better than raw. And your best choices are vegetables without skin, since the skin can contain a lot of fiber.”

Some of the best choices for vegetables on a gastroparesis diet include:

• Well-cooked vegetables without skins, like acorn squash, summer squash, beets, carrots, potatoes, spinach and yams.
• Pureed tomatoes and tomato sauce (strained is best).
• Cooked spinach.
• Finely chopped, well-cooked onions.
• Roasted skinless peppers.
• Cooked and mashed cauliflower.
• Asparagus tips.
• Mashed avocado.

Some vegetables to avoid include:

• Any raw vegetables.
• Cooked vegetables with skin.
• Brussels sprouts.
• Leeks.
• Mushrooms.
• Cabbage and sauerkraut.
• Celery.
• Corn.
• Eggplant.
• Peas and pea pods.
• Water chestnuts.
• Potato skins.
• Asparagus stalks.

Protein

If you have gastroparesis, your best choices for protein are lean sources that are low in fat.

That includes low-fat proteins like:

• Eggs.
• Egg whites.
• Reduced-fat creamy peanut butter.
• Skinless poultry (like turkey and chicken with skin removed).
• Lean fish (like flounder, sole, cod, red snapper, bass and halibut).
• Lean meats (like lean cuts of beef, pork, veal and lamb).
• Pureed beans, as tolerated (like low-fat refried beans, cooked lentils, split peas and hummus).

Highly processed proteins, fatty proteins, seeds, nuts and most whole beans should be avoided. That includes foods like:

• Bacon.
• Sausage.
• Bologna.
• Salami.
• Hot dogs.
• Goose liver.
• Duck.
• Canned beef.
• Spare ribs.
• Organ meats.
• Fish packed in oil.
• Fibrous meats (like steak, roasts and chops).
• Dried beans.
• Garbanzo beans.
• Soybeans.
• Fava beans.
• Navy beans.
• Kidney beans.
• Black-eyed peas.
• Black beans.
• Pinto beans.
• Northern beans.
• Nuts.
• Olives.
• Pumpkin seeds.
• Popcorn.
• Chunky nut butter and full-fat nut butter.

Dairy

Your best choices for dairy products are fat-free and low-fat.

Choose fat-free and low-fat versions of:

• Yogurt.
• Pudding.
• Cottage cheese.
• Cheese.
• Sour cream.
• Cream cheese.

Avoid any dairy products made with full-fat or 2% milk. And stay away from products that use whipping cream (even the light version) or half-and-half.

Soup

The best soups for a healthy gastroparesis diet are made with broth or low-fat dairy products. Avoid soups that use full-fat milk, cream or cheese.

And be careful about other ingredients in your soup, Igel cautions, as soups can contain a variety of vegetables and proteins that should be limited and avoided.

Condiments and spreads

When you’re adding condiments to your food, you’ll want to pay attention to fat content.

That means choosing low-fat and fat-free options for condiments like:

• Salad dressing.
• Mayonnaise.
• Margarine.
• Spreads.
• Gravy.
• Mustard.
• Ketchup.
• BBQ sauce.
• Seedless jams and jellies.
• Syrup.
• Honey.
• Apple butter.
• Marmalade.
• Preserves.

Avoid foods like lard, butter sauces, creamy sauces and full-fat sauces and condiments.

Sweets and desserts

Too much sugar isn’t a good idea for anyone. And especially if you’re living with gastroparesis and diabetes, you want to be particularly careful about your intake of carbs and sugar.

But if your sweet tooth comes calling, some choices are better than others.

Stick to desserts that are low in fat, like:

• Fat-free and low-fat angel food cake, frozen yogurt and ice cream.
• Italian ice.
• Sorbet.
• Gelatin.

Avoid full-fat cakes, pies, cookies and other high-fat sweets.

Beverages

What you drink can have as much of an impact on your belly as what you eat. So, consider your beverage intake an important part of a healthy gastroparesis diet.

Choose drinks that will help keep you hydrated, like:

• Water.
• Sports drinks.
• Decaffeinated teas.
• Decaffeinated coffee.

Limit drinks that will fill your belly and lead to bloating, like alcohol and carbonated beverages.

Tips for eating well with gastroparesis

Of course, the foods you eat matter when you’re living with gastroparesis. But how you eat and how often can make a big difference in how you feel, too.

Igel suggests these tips:

Drink enough fluids

Dehydration can increase symptoms of nausea.

Sip liquids steadily throughout the day. Small sips, that is. Gulping large amounts of fluid can fill your belly too quickly and make it uncomfortable.

“Most adults need about six to 10 cups of fluids a day. But that can vary from person to person,” Igel shares. “Talk with your healthcare provider about your recommended intake. Too little can cause nausea, and too much can lead to bloating and fullness.”

Liquid nutritional supplements such as Ensure® or Boost® may be good choices if you find it’s tough to get adequate calories or protein.

Eat small, frequent meals

Many people find that eating five to six small meals per day can lessen their symptoms.

And timing can matter, too. Some people find they tolerate solids better earlier in the day. Start with solids earlier in the day and finish with a light or liquid meal in the evening when you need to.

Chew your food well

Chew all food to a mashed potato or pudding consistency. And consider grinding or pureeing solid foods to be more easily digested.

If you need to puree your food, many foods can be liquefied in a blender or food processor, but solid foods will need to be cut into pieces and thinned with some type of liquid. (Check out the recipes below.)

Stay upright

Sit up while eating and for at least an hour after finishing your meal. Your body can digest food more easily when you’re upright. Lying down can cause heartburn and other discomforts.

Walking or other light exercise after meals can help to increase stomach emptying and may make you feel better.

Up the lean protein

Add nonfat powdered milk, protein powders (choose whey, soy, pea or rice) or powdered egg to foods to boost protein intake.

A single tablespoon of nonfat powdered milk can add 25 calories and 3 grams of protein to your meal.

Consider adding 2 tablespoons of nonfat powdered milk to:

• Instant or regular mashed potatoes.
• Scrambled eggs.
• Pudding.
• Custard.
• Cream of Wheat or Cream of Rice.
• Soup.

Keep your blood sugar managed

High blood sugar directly interferes with normal stomach emptying. If you have diabetes, keeping your blood sugar in goal ranges (before and after meals) may decrease gastroparesis symptoms.

Talk with a healthcare provider to create a carbohydrate budget that will work for you.

Gastroparesis diet sample menu

No doubt that following a gastroparesis diet can seem like it has a lot of rules. And it’s not always easy to remember which foods are “good” and which you should be cautious about.

Igel shares these sample menus to help get you started:

Breakfast

• 1 cup cooked farina.
• 1/2 cup nonfat milk.
• 1/2 cup orange juice.
• 1 scrambled egg.

Morning snack

• 1 packet instant breakfast mix.
• 1 cup skim milk.

Lunch

• 1 cup chicken noodle soup.
• 6 soda crackers.
• 1/2 cup applesauce.
• 1/2 cup nonfat milk.

Afternoon snack

• 6 ounces nonfat smooth yogurt.
• 1 small banana.

Dinner

• 3 ounces baked fish.
• 1/2 cup mashed potatoes with 1 teaspoon margarine.
• 1/2 cup cooked carrots.
• 1/2 cup nonfat milk.
• 1/2 cup canned fruit, in juice.

Evening snack

• 1/2 cup low-fat pudding.

Gastroparesis-friendly recipes

People with gastroparesis often tolerate liquids better than solid meals. But sports drinks and tea will only take you so far.

These recipes can help you to get the nutrition you need while being easy on your stomach.

Blended meats, fish and poultry

Blend meats with:

• Broth.
• Water.
• Nonfat milk.
• Vegetables or vegetable juice.
• Tomato sauce.
• Low-fat gravies.

Blended starches

Blend pasta or potatoes with:

• Water.
• Tomato juice.
• Broths.
• Strained baby vegetables.

Blended fruits

• Blend with their own juices, other fruit juices or strained baby fruits.

Blended mixed dishes

• Puree lasagna, macaroni and cheese, spaghetti, chili and chop suey by adding an adequate liquid of your choice. Blend well, and strain if necessary.

Hot cereals

Make hot cereal with a caloric beverage instead of water. You can try:

• Nonfat milk.
• Soy milk.
• Rice milk.
• Fruit or vegetable juice.
• Liquid supplement.

Add honey, molasses, syrup or small amounts of fat like butter or margarine for added calories.

Fortified milk

To make 8 ounces: Add 2 tablespoons powdered milk to 8 ounces of nonfat milk. Blend until well dissolved.

Or make a big batch to drink as desired: Use 1 quart of nonfat milk and 1 cup powdered milk.

Yogurt smoothie

• 1 ripe medium banana OR 1 cup canned peaches.
• 1 cup fortified milk.
• 1 cup vanilla yogurt.
• 1 to 2 tablespoons powdered sugar.
• 1/2 cup ice cubes.

Cut fruit into chunks. Combine all ingredients except ice in a blender until smooth. Add ice, one cube at a time. Blend until smooth. Substitute soy or lactose-free milk if needed.

Calories: 500.

Protein: 22 grams.

Strawberry yogurt frappe

• 1 tablespoon strawberry syrup or other flavoring.
• 1/2 cup vanilla yogurt.
• 1/2 cup fortified milk.
• 1/4 cup orange juice.
• Dash vanilla.

Mix in a blender until smooth. Substitute soy or lactose-free milk if needed.

Calories: 250.

Protein: 13 grams.

Tropical smoothie

• 1/2 cup Greek fruit yogurt.
• 1/2 banana.
• 4 ounces orange juice.

Mix in a blender until smooth.

Calories: 240.

Protein: 12 grams.

Peach plus smoothie

• 1/2 cup canned peaches.
• 1/4 cup vanilla Greek yogurt.
• 1/4 cup nonfat milk.
• Dash vanilla.
• Dash nutmeg.

Mix in a blender until smooth. Substitute soy or lactose-free milk if needed.

Calories: 205.

Protein: 8 grams.

Lactose-free banana strawberry shake

• 1 banana.
• 1/2 cup soy OR almond milk.
• 1/2 cup liquid nutrition supplement (such as Ensure or Boost).
• 1/4 cup pasteurized liquid egg substitute or egg whites or 2 tablespoons soy protein powder.
• 2 or more tablespoons strawberry syrup.

Only drink if you are tolerating liquid fat. Mix in a blender until smooth.

Calories: 515.

Protein: 18 grams.

Creamy peanut butter banana shake

• 2 tablespoons creamy peanut butter.
• 1 cup chilled fortified milk.
• 1/2 soft banana.
• 1/2 cup ice cream.

Only drink if you are tolerating liquid fat. Mix in a blender until smooth. Substitute soy or lactose-free milk if needed.

Calories: 550.

Protein: 27 grams.

Mexican chocolate shake

• 8 ounces chocolate liquid nutrition supplement.
• 1 scoop whey protein powder.
• Dash of cinnamon.
• 1/2 teaspoon vanilla.
• 3 ice cubes.

Only drink if you are tolerating liquid fat. Mix in a blender until smooth.

Calories: 440.

Protein: 34 grams.

Standard milkshake

• 1/2 cup nonfat milk.
• 2 cups frozen Greek yogurt OR low-fat ice cream.
• 1 teaspoon vanilla extract.
• 3 tablespoons chocolate syrup, optional.

Only drink if you are tolerating liquid fat. Mix in a blender until smooth.

Calories: 560–790.

Protein: 16–20 grams.

Cauliflower soup

• 4 cups cauliflower.
• 3 cups chicken stock.
• 1 tablespoon extra virgin olive oil.
• 2 garlic cloves, minced.
• 1/2 cup Parmesan cheese.

Heat oil in pot on medium heat. Add garlic and sauté until soft. Add cauliflower and chicken stock. Cook cauliflower until it is tender (about 15 minutes). Using a blender, puree cauliflower until it reaches a desired consistency.

Simple soup

• 3 1/2 cups canned fat-free, reduced-sodium chicken broth.
• 2 (10 1/2 ounces) cans cream of potato soup.
• 1 tablespoon extra virgin olive oil.
• 2 cups nonfat Greek plain yogurt.

In a bowl, combine broth, soup and yogurt, mixing well. Refrigerate for several hours.

Soymilk eggnog

• 1/4 cup pasteurized liquid egg substitute/egg whites OR 2 tablespoons soy protein powder.
• 2 cups soy milk.
• 2 tablespoons sugar or to taste.
• 1/4 teaspoon vanilla.
• 1/4 teaspoon cinnamon.
• 1/4 teaspoon nutmeg.
• 1/4 teaspoon pumpkin pie spice.

Place all ingredients in blender and combine or use a hand whisk. Add spices to taste.

Final thoughts

Getting proper nutrition can be tough when you’re living with gastroparesis. But it’s essential. If you’re having trouble following a diet or eating plan that keeps your symptoms managed, while getting enough calories and protein, talk with a healthcare provider. They can help you create a gastroparesis diet that works for you.