Diet for Gastroparesis

The commonest known cause is diabetes (damage to the nerves that control the stomach, made worse by high blood sugar). Others include a previous viral illness, stomach or oesophageal surgery that injures the vagus nerve, and certain medicines. Opioid painkillers, some anti-spasm and antidepressant tablets and some injectable diabetes and weight-loss medicines slow stomach emptying; never stop a medicine by yourself, but do tell your doctor about all you take. In many people no cause is found (idiopathic gastroparesis). Fat and fibre slow emptying further, which is the reason for the dietary changes below.

Gastroparesis is uncommon but probably under-recognised, and it is more frequent in women and in people with long-standing diabetes. Many people with symptoms of fullness, nausea and vomiting have a different cause, so a proper diagnosis matters before a strict diet is started.

Traditional dishes can be heavy for a slow stomach: rice cooked with ghee and fatty meat (kabsa, mandi), fried samboosa, fatty lamb, and fibre-rich foods such as foul medames with whole beans, whole-grain bread and raw salads. Gentler options include chicken or fish soup, strained red-lentil soup (shorbat adas), well-cooked plain rice with finely shredded chicken, soft harees in a small portion, thin oats or porridge, eggs, yoghurt or laban, and mashed potatoes or pumpkin; tolerance differs from person to person. Dates are rich in sugar and have fibre and skins: try a small portion of soft, pitted dates or date paste and see if you tolerate them. Fasting in Ramadan carries risks (dehydration, unstable blood sugar), so talk to your doctor well before the month starts; the decision depends on your condition and medicines, and illness is a recognised reason not to fast. If your doctor agrees you may fast, break the fast with water and a date or two, wait 15 to 20 minutes, then have a soup or a liquid meal, and eat small meals through the evening and at suhoor rather than one big meal.

Gastroparesis is confirmed by a gastric emptying study, usually a scan after a standard low-fat meal that measures how much remains in the stomach after 4 hours, together with an endoscopy to exclude a blockage and blood tests including blood sugar. Some medicines that affect emptying are paused before the test, only on your doctor’s instruction. A dietitian assesses your weight, intake and vitamin or mineral status.

Simple habits around meals can make a real difference.

• Eat slowly, sit upright and chew each mouthful thoroughly, because the stomach cannot grind food well.

• Stay upright for 1 to 2 hours after eating, and take a gentle 10 to 15 minute walk if you feel able; avoid lying flat after meals.

• Do not smoke and avoid alcohol, both of which slow emptying.

• Weigh yourself weekly and write down what you eat and when symptoms occur; take this to your appointments.

• If you have diabetes, check your blood sugar as advised and share the readings with your diabetes team.

The core idea is to make the stomach’s job easier: less food at a time, less fat and fibre, and softer textures. Fluids and blended foods leave the stomach more easily than solids. How strict you need to be depends on your symptoms, so work with a dietitian.

• Eat 4 to 6 small meals and snacks a day instead of 2 or 3 large ones, and do not skip meals.

• Choose lower-fat foods because fat slows emptying: grilled, baked, boiled or steamed foods instead of fried; skim or low-fat dairy; lean meat, chicken and fish. Small amounts of fat spread through the day are usually better tolerated than a fatty meal. Do not cut fat so much that you lose weight.

• Go low on fibre that is hard to break down: raw vegetables and salads, skins, seeds, whole nuts, bran, tough leaves, the membranes of oranges, and unripe fruit. These can stay in the stomach and, rarely, form a hard mass (a bezoar). Peeled, well-cooked vegetables and ripe soft fruit are better.

• Prefer soft, moist, well-cooked and small-particle foods: mashed or blended vegetables, thin porridge, eggs, minced or finely shredded chicken or fish, well-cooked white rice or pasta, soft bread without seeds, smooth yoghurt, and puréed or strained soups.

• On bad days, rely more on liquids and semi-liquids, which empty more easily: soups, smoothies made without skins or seeds, milk-based or lactose-free drinks, nutritional supplement drinks, and low-fat broths. Return to soft solids as you improve.

• Sip fluids through the day, and include drinks with salts and sugar (oral rehydration solutions, low-fat broths, diluted low-pulp juices) when you vomit or feel dry. Avoid fizzy drinks and alcohol.

• Protect your nutrition: ask your dietitian to check for low iron, vitamin B12, vitamin D, folate and other deficiencies, which are common because intake is low. A liquid or chewable multivitamin may be advised.

• If you have diabetes, do not change insulin or tablets yourself when you change your meals. Delayed stomach emptying can make mealtime insulin act before the food is absorbed, causing low sugar later; your diabetes team can adjust the plan, and may advise the timing of insulin or monitoring that suits you.

Evidence in brief: expert guidance (ACG and AGA 2022) supports small meals, low fat, low fibre and softer textures, but the underlying trials are small. If you cannot keep up your weight with these steps, tell your doctor early; do not wait until you are very underweight. Nutritional support through a feeding tube is considered when you lose significant weight or are admitted repeatedly.

Medicines are described in our article on gastroparesis. In brief:

• Your doctor will first review medicines that slow emptying (for example opioids). Do not stop any medicine on your own.

• Medicines that help the stomach move food on, and anti-nausea medicines, may be used for limited periods; they have side effects and need medical follow-up.

• In diabetes, good blood-sugar control helps the stomach to work better.

Procedures are for people who do not respond to diet and medicine:

• Upper endoscopy and a gastric emptying study to confirm the diagnosis and exclude a blockage.

• Feeding through a tube placed into the small intestine (nasojejunal tube, or a feeding jejunostomy if long-term) when weight loss or admissions continue.

• Specialist treatments such as G-POEM or gastric electrical stimulation for carefully selected people in expert centres; evidence is still developing.

The ACG clinical guideline on gastroparesis (2022) and the AGA Clinical Practice Update on gastroparesis (2022) recommend dietary modification as a first step: small frequent meals, low-fat and low-residue (low-fibre) choices, and a small-particle-size diet, with liquid calories when solid food is not tolerated. They also stress good blood-sugar control in diabetes, a review of medicines that slow emptying (such as opioids), and attention to hydration and nutrition. The evidence is of low certainty: the best-known study, a small crossover trial of a small-particle-size diet (Olausson and colleagues, 2014), showed fewer symptoms than usual advice, but larger controlled trials are lacking. Feeding by a tube into the small intestine is reserved for people who lose significant weight or are repeatedly admitted despite other measures. Procedures on the stomach outlet (for example G-POEM) are still being evaluated and are done in specialist centres only.

Gastroparesis is usually long-lasting, with good and bad periods, and it is rarely cured, but symptoms and nutrition can often be kept under control with a combination of diet, blood-sugar control, medicine review and, for some people, specialist treatment. Post-viral gastroparesis sometimes improves over time. Close work with your doctor and dietitian is the best way to avoid weight loss and hospital admissions.

• Has my diagnosis been confirmed with a stomach-emptying test?

• Are any of my medicines slowing my stomach, and can they be changed?

• How strict does my diet need to be, and can I see a dietitian?

• When should I consider tube feeding or a specialist referral?

• Is it safe for me to fast in Ramadan, and how should I adjust my diabetes treatment?

This guide comes from the Saudi Gastroenterology Association (SGA) patient library, prepared by the Approved for publication by SGA; individual clinician review is ongoing. Last reviewed: 2026-04-24. It is for education and does not replace your doctor's advice.