Gastroparesis in Older Adults: Managing Diet and Nutrition

Learn about diet and nutrition for aging individuals with gastroparesis to improve health and manage symptoms effectively.
Published on
March 15, 2024
Written by
Katie Wilkinson
Katie Wilkinson
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Presented by Givers
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As we age, our bodies go through many changes, including changes in our digestive system. For aging individuals with gastroparesis, a condition that slows down stomach emptying, these changes worsen symptoms and make managing nutrition a significant challenge. Family caregivers provide practical guidance on mastering diet and food for their loved ones with gastroparesis for better health.

Understanding gastroparesis

Gastroparesis is a medical condition characterized by partial paralysis of the stomach, resulting in delayed emptying of stomach contents into the small intestine. Usually, strong muscular contractions propel food through the digestive tract. However, in gastroparesis, these stomach contractions are impaired, which can cause food to remain in the stomach for much longer than usual. This can lead to a range of symptoms, including nausea, vomiting, feelings of fullness after eating only a small amount of food, bloating, and abdominal pain.

Causes

The exact cause of gastroparesis is often unknown. Still, it can be associated with several conditions, including diabetes mellitus, viral infections, surgery on the stomach or vagus nerve, medications that slow contractions in the intestine (such as narcotics), and neurological conditions like Parkinson's disease.

Symptoms of gastroparesis

Here are some of the common symptoms associated with gastroparesis:

  1. Nausea: Feeling sick to your stomach, which can be mild or severe.
  2. Vomiting: Especially vomiting undigested food that has been in the stomach for hours after eating.
  3. Early satiety: Feeling full shortly after starting a meal.
  4. Abdominal bloating: Your stomach may feel uncomfortably full and swollen.
  5. Abdominal pain: This can range from a dull ache to sharp, intense discomfort.
  6. Heartburn or gastroesophageal reflux disease (GERD): When stomach acid or, occasionally, stomach content flows back into your food pipe (esophagus).
  7. Changes in blood sugar levels: Fluctuations occur due to the irregular passage of food from the stomach into the small intestine, where sugars are absorbed.
  8. Lack of appetite: A reduced desire to eat.
  9. Weight loss: Unintended weight loss due to reduced food intake because of the above symptoms.

The severity of these symptoms can vary from person to person, and not everyone with gastroparesis will experience all of these symptoms. 

Aging and gastroparesis

Aging can impact the prevalence and manifestation of gastroparesis in several ways:

  1. Decreased gastric motility: The digestive system slows down as people age. The muscles in the gastrointestinal tract, including the stomach, can weaken and become less efficient. While not all elderly individuals will develop gastroparesis, the natural decrease in motility can mimic or exacerbate symptoms.
  2. Increased prevalence of underlying conditions: Aging is associated with an increased prevalence of conditions that can contribute to or exacerbate gastroparesis, such as diabetes mellitus and Parkinson's disease. These conditions can affect gastric motility and increase the risk of developing gastroparesis.
  3. Medication use: Older adults are more likely to use medications that can impact stomach motility, such as anticholinergics and opioids. These medications can contribute to or worsen the symptoms of gastroparesis.
  4. Diagnosis and management challenges: The symptoms of gastroparesis, such as feeling full early, nausea, and weight loss, can also occur with other common conditions in older adults, such as GERD or peptic ulcer disease. This can make diagnosis more challenging. Additionally, managing gastroparesis in older adults can be complicated due to the presence of other comorbidities and the increased sensitivity to side effects of treatments.

Treatment for gastroparesis

While dietary management matters most, a comprehensive approach to caring for aging adults with gastroparesis will improve outcomes. Collaborating with healthcare providers, like gastroenterologists, dietitians, and other caregivers, guarantees a well-rounded treatment plan. Your loved one will need a team of experts around them to encourage them.

In addition to dietary modifications, non-dietary treatments like medications or gastric electrical stimulation alleviate symptoms and improve overall digestive function. Family caregivers work closely with healthcare professionals to provide treatment and support. 

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The gastroparesis diet: what to eat? 

The primary goal of the gastroparesis diet is to alleviate symptoms and promote proper nutrition. It typically involves consuming easily digestible foods that can pass through the stomach quickly, minimizing discomfort and reducing the risk of malnutrition.

The gastroparesis diet emphasizes low-fiber, low-fat, easily digestible options, with small, frequent meals and adequate hydration. Family caregivers support their loved ones by preparing meals that meet dietary guidelines, encouraging proper hydration, and monitoring for signs of malnutrition or dehydration.

However, dietary planning for aging individuals with gastroparesis requires a personalized approach. Doctors consider heart disease or diabetes, medication interactions, and individual preferences and design an effective and sustainable diet.

Recommended foods

Lean proteins

These are easier on the stomach and less likely to delay gastric emptying. Examples include grilled or baked fish, skinless poultry, and eggs. Lean proteins are essential for maintaining muscle mass and overall health without overburdening the digestive system.

Well-cooked vegetables

Cooking vegetables makes them easier to digest. Choose vegetables that are low in fiber, such as carrots, spinach, and zucchini, and ensure they are cooked until soft. Avoid vegetables with skins and seeds, as they can be harder to digest.

Low-fat dairy products

Dairy products can be a good source of calcium and protein. Opt for low-fat options like yogurt and low-fat cheeses, which are easier on the stomach than their full-fat counterparts. Some individuals may find dairy products challenging to tolerate; in such cases, lactose-free products or alternatives (e.g., almond, soy, or rice milk) might be better options.

Refined grains

These grains are processed to remove the bran and germ, making them easier to digest. Examples include white bread, white rice, and regular pasta. While less nutritious than their whole-grain counterparts, they are less likely to exacerbate symptoms of gastroparesis.

Foods to avoid

High-fiber foods

While fiber is essential for normal bowel function, in gastroparesis, it can slow down stomach emptying and exacerbate symptoms. Avoid high-fiber foods like whole grains, legumes, and certain vegetables (e.g., broccoli, cauliflower).

High-fat foods

Fat naturally slows down stomach emptying. Foods high in fat, including fried foods, fatty cuts of meat, and decadent desserts, can worsen gastroparesis symptoms.

Foods that cause bloating and gas

Certain foods, including beans, onions, soft drinks, and cruciferous vegetables, can cause bloating and discomfort in some individuals. Based on individual tolerance, these should be limited or avoided.

Texture modifications

Adjusting the texture of meals to include pureed or soft foods can make eating more comfortable and digestion easier. Smoothies, soups, and mashed vegetables are good options. These modifications can help ensure that food moves more quickly through the stomach.

Nutritional supplements and vitamins

Since gastroparesis can make it challenging to consume a balanced diet, nutritional supplements, and vitamins may be necessary to prevent deficiencies. Options include meal replacement shakes or drinks and vitamin supplements, but choosing those low in fat and fiber is important. Consultation with a healthcare provider or a dietitian is crucial to ensure that the chosen supplements meet the individual's nutritional needs without exacerbating their symptoms.

Hydration

Meal planning benefits aging individuals with gastroparesis. Small, frequent meals and adequate hydration prevent the digestive system from overheating. Drinking enough water prevents dehydration and lessens feelings of nausea. 

However, not all liquids are created equal. Depending on your loved one's specific health needs, their doctor may recommend certain liquids to help manage their condition. Speak with their doctor to confirm the fluids they consume are safe and beneficial. 

Planning and managing meals will help your loved one maintain their health and manage their gastroparesis symptoms. 

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How to calm a gastroparesis flare-up

A flare-up of gastroparesis is a period during which symptoms of the condition, such as nausea, vomiting, abdominal pain, bloating, and delayed gastric emptying, intensify significantly. These episodes can vary in duration and severity and impact daily activities and overall quality of life. They often require immediate attention and adjustments in management strategies to alleviate discomfort and prevent complications.

Here's what to do during a gastroparesis flare-up: 

  • Revert to a basic diet of liquids or soft foods that are easier to digest, such as broth, smoothies, and meal replacement shakes, and avoid hard-to-digest foods.
  • Stay hydrated, especially if vomiting occurs, by sipping clear liquids. 
  • Continue taking any prescribed medications for gastroparesis, and consult your healthcare provider if symptoms worsen or the medication seems ineffective. 
  • Keep a log of your symptoms and dietary intake.
  • Stress can exacerbate symptoms, so engaging in relaxation techniques may provide relief. 

If severe symptoms persist, such as persistent vomiting or pain, contact your loved one's healthcare provider for advice. In cases of severe dehydration, malnutrition, or other complications, seek emergency medical care. 

How can family caregivers help?

Caring for an aging loved one with gastroparesis can present unique challenges. Chewing difficulties, reduced appetite, and medication interactions can all impact dietary adherence and nutritional intake.

Family caregivers prepare meals that meet the dietary guidelines, encourage proper hydration, and monitor for signs of malnutrition or dehydration. Adaptive utensils, plate guards, and other assistive devices aid in the eating process. Your loved one's nutritionist or dietician may have other suggestions to promote healthy eating. 

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