Information

PURPOSE

 Gastroparesis is the medical term for delayed stomach emptying. During the process of digestion, the stomach must contract to empty itself of food and liquid. Normally, it contracts about three times a minute. This empties the stomach within 90-120 minutes after eating. If contractions are sluggish or less frequent, stomach emptying is delayed. This results in bothersome and sometimes serious symptoms, as well as malnutrition, because food is not being digested properly.

 Gastroparesis may be caused by various conditions such as diabetes mellitus, certain disorders of the nervous system, or certain drugs. Often however, no cause can be found although a viral is suspected in some. Usually, the physician prescribes medication to stimulate the stomach to contract. The purpose of the Gastroparesis Diet is to reduce symptoms and maintain fluids and nutrition. There are three steps to the diet: 

  • STEP 1 DIET: Consists of liquids, which usually leave the stomach quickly by gravity alone. Liquids prevent dehydration and keep the body supplied with vital salts and minerals. 
  • STEP 2 DIET: Provides additional calories by adding a small amount of dietary fat – less than 40g each day. For patients with Gastroparesis, fatty foods and oils should be restricted because they delay stomach emptying. However, patients at the Step 2 level are usually able to tolerate this amount. 
  • STEP 3 DIET: Designed for long-term maintenance. Fat is limited to 50g per day, and fibrous foods are restricted because many plant fibers cannot be digested. 

NUTRITION 

The Step 1 Gastroparesis Diet is inadequate in all nutrients except sodium and potassium. It should not be continued for more than three days without additional nutritional support. Step 2 and Step 3 Gastroparesis Diets may be adequate in Vitamins A and C, and the mineral Iron. A multi-vitamin supplement is usually prescribed. 

SPECIAL CONSIDERATIONS

1. Diets must be tailored to the individual patient. This is because the degree of Gastroparesis may range from severe and long-standing to mild and easily corrected. Patients may also have various medical conditions to be considered. For example, diabetes patients with Gastroparesis are allowed sugar-containing liquids on the Step 1 Diet, because that is their only source of carbohydrate. On the Step 2 and Step 3 Diets, these patients should avoid concentrated sweets. These are noted with an asterisk (*) on the food lists. 

2. On all the diets, liquids and food should be eaten in small, frequent meals. This helps maintain nutrition.

STEP 1 FOOD GROUPS
GroupRecommendAvoid
Milk & Milk ProductsNoneAll
VegetablesNoneAll
FruitsNoneAll
Breads & GrainsPlain saltine crackersAll others
Meat & Meat SubstitutesNoneAll
Fats & OilsNoneAll
BeveragesGatorade and soft drinks (sipped slowly throughout the day)All others
SoupsFat-free consommé and bouillonAll others
SAMPLE MENU STEP 1
Breakfast 
• Gatorade, ½ cup
• Ginger Ale, ½ cup 
• Bouillon, ¾ cup
• Saltine Crackers, 6 
Lunch
• Gatorade, ½ cup
• Coke, ½ cup
• Bouillon, ¾ cup
• Saltine Crackers, 6
Dinner
• Gatorade, ½ cup 
• Sprite, ½ cup
• Bouillon, ¾ cup 
• Saltine Crackers, 6
This Sample Diet Provides the Following
Calories790Fat9g
Protein11gSodium3531mg
Carbohydrates156gPotassium244mg
STEP 2 FOOD GROUPS
GroupRecommendAvoid
Milk & Milk ProductsSkim milk, products made with skim milk, low-fat milk, low-fat yogurt, low-fat cheesesWhole milk products, creams (sour, light, heavy, whipping), half & half
SoupsFat-free consommé and bouillon, soups made from skim milk and fat-free broths containing pasta or noodles and vegetables are allowedSoups made with cream, whole milk, or broths containing fat
Breads & GrainsBreads and cereals, cream of wheat, pasta, white rice, egg noodles, low-fat crackersOatmeal, whole grain rice, cereal and bread
Meat & Meat SubstitutesEggs, peanut butter (maximum 2 tbsp/day)Beef, poultry, fish, pork products, dried beans, peas and lentils
VegetablesVegetable juice (tomato, V-8), well-cooked vegetables without skins (acorn squash, beets, carrots, mushrooms, potatoes, spinach, summer squash, strained tomato sauce, yams)All raw vegetables, cooked vegetables with skins, beans (green, wax, lima), broccoli, brussels sprouts, cabbage, cauliflower, celery, corn, eggplant, onions, peas, peppers, pea pods, sauerkraut, turnips, water chestnuts, zucchini
FruitsApple juice, cranberry juice, grape juice, pineapple juice, prune juice, canned fruits without skins (applesauce, peaches, pears)Citrus juices, all fresh and dried fruits, canned fruits with skins (apricots, cherries, blueberries, fruit cocktail, oranges, grapefruit, pineapple, plums, persimmons)
Fats & OilsAny type of fat, but only in small amountsNone
Sweets & Desserts*Hard candies, caramels, puddings and custards made from skim milk, frozen yogurt, fruit ice, gelatin, ice milk, jelly, honey, syrupsHigh-fat desserts (cakes, pies, cookies, pastries, ice cream), fruit preserves
BeveragesGatorade*, soft drinks*, (sipped slowly throughout the day)All others, except allowed juices
*Concentrated sweets
SAMPLE MENU STEP 2
Breakfast 
• Skim Milk, ½ cup 
• Poached Egg, 1 
• White Toast, 1 slice
• Apple Juice, ½ cup
Lunch 
• Mozzarella Cheese, 2 oz
• Saltine Crackers, 6
• Chicken Noodle Soup, ¾ cup
• Gatorade, ½ cup 
Dinner
•Peanut Butter, 1 tbsp
• Saltine Crackers, 6
• Vanilla Pudding, ½ cup •
Grape Juice, ½ cup 
Morning Snack 
• Ginger Ale, ½ cup
• Canned Pears, ½ cup
Afternoon Snack
• Skim Milk, ½ cup
• Cornflakes, ½ cup 
• Sugar, 2 tsp
Evening Snack
• Frozen Yogurt, ½ cup 
• Saltine Crackers, 6 
STEP 3 FOOD GROUPS
GroupRecommendAvoid
Milk & Milk ProductsSkim milk, products made with skim milk, low-fat milk, low-fat yogurt, low-fat cheesesWhole milk products, creams (sour, light, heavy, whipping), half & half
SoupsFat-free consommé and bouillon, soups made from skim milk and fat-free broths containing pasta or noodles and vegetables are allowedSoups made with cream, whole milk, or broths containing fat
Breads & GrainsBreads and cereals, cream of wheat, pasta, white rice, egg noodles, low-fat crackersOatmeal, whole grain rice, cereal and bread
Meat & Meat SubstitutesEggs, peanut butter (maximum 2 tbsp/day), poultry, fish, lean ground beefFibrous meats (steaks, roasts, chops), dried beans, peas and lentils
VegetablesVegetable juice (tomato, V-8), well-cooked vegetables without skins (acorn squash, beets, carrots, mushrooms, potatoes, spinach, summer squash, strained tomato sauce, yams)All raw vegetables, cooked vegetables with skins, beans (green, wax, lima), broccoli, brussels sprouts, cabbage, cauliflower, celery, corn, eggplant, onions, peas, peppers, pea pods, sauerkraut, turnips, water chestnuts, zucchini
FruitsFruit juices, canned fruits without skins (applesauce, peaches, pears)All fresh and dried fruits, canned fruits with skins (apricots, cherries, blueberries, fruit cocktail, oranges, grapefruit, pineapple, plums, persimmons)
Fats & OilsAny type of fat, but only in small amountsNone
Sweets & Desserts*Hard candies, caramels, puddings, and custards made from skim milk, frozen yogurt, fruit ice, gelatin, ice milk, jelly, honey, syrupsHigh-fat desserts (cakes, pies, cookies, pastries, ice cream), fruit preserves
BeveragesGatorade*, soft drinks*, (sipped slowly throughout the day), coffee, tea, water (note: noncaloric beverages should be limited if patient cannot maintain adequate caloric intake)All others, except allowed juices
*Concentrated sweets
SAMPLE MENU STEP 3
Breakfast 
• Skim Milk, ½ cup 
• Cream of Wheat, ½ cup
• Sugar, 2 tsp
• Orange Juice, ½ cup
• White Toast, 1 slice 
• Margarine, 1 tsp
• Jelly, 1 tbsp
Lunch
• Tuna Fish, 2 oz
• Low-fat Mayonnaise, 2 tbsp 
• White Bread, 2 slices
• Canned Peaches, ½ cup 
• Gatorade, ½ cup
Dinner 
• Baked Chicken, 2 oz 
• White Rice, ½ cup
• Cooked Beets, ½ cup 
• Dinner Roll, 1
• Skim Milk, ½ cup
• Margarine, 2 tsp
Morning Snack
• Low-fat Yogurt, ½ cup
• Sprite, ½ cup 
Afternoon Snack
• Chocolate Pudding, ½ cup
• Ginger Ale, ½ cup 
Evening Snack 
• Ice Milk, ½ cup 
• Pretzels, 2 
This Sample Diet Provides the Following
Calories1822Fat42g
Protein75gSodium2334mg
Carbohydrates286gPotassium2467mg

Breakfast
Fruit: All but Avocado
Cereal: Any
Egg: Egg white allowed ONLY
Beverage: Light tea or coffee or skim milk

Lunch
Soup: No creamy or fatty soups
Vegetable: Cooked vegetables only, such as carrots, string beans, peas, beets, spinach. The following vegetables MUST NOT BE EATEN either cooked or uncooked: cucumbers, corn, radishes, sauerkraut, onions
Beverage: Light tea, skim milk

Dinner
Meat: 1 serving of any lean meat, chicken, or turkey. No fried or fatty meats allowed. Meat may be cooked, broiled or baked. No stews or gravies permitted. No duck or goose allowed.
Fish: Nothing fried. No canned fish, such as salmon, tuna, etc., except water packed. Vegetables: Cooked vegetables as described for lunch ONLY
Salad: Lettuce and tomato salad WITHOUT DRESSING
Cheese: Skim milk or cottage cheese
Beverage: Light tea, skim milk Dessert: Choice of fruits, jell-o or gelatin dessert (without cream), angel food cake

 EAT SMALL OR MODERATE MEALS!!!

THE FOLLOWING FOODS MUST BE AVOIDED 

All fried and fatty foods No eggs, except egg whites 

No fatty soup

No butter allowed 

No canned fish in oil 

No gravies allowed 

No condiments or dressings, such as mayonnaise or russian dressing 

Avoid the following: Asparagus, corn, cucumbers, green peppers, radishes, cabbage, sauerkraut, onions, garlic

Diverticulosis is characterized by the formation of pockets in the lining of the large intestine. 

Diverticulitis is the acute stage of diverticulosis when the pockets are infected and inflamed. 

With the presence of Diverticulosis, it is best to follow a high fiber diet. This keeps pressure on the wall of the large intestine and prevents the accumulation of excess bacteria. Increase fiber gradually in your diet, as a sudden increase may cause increased formation of gas. If Diverticulitis does occur, it is best to switch to a low fiber diet during the acute infection period. After the infection is gone, gradually switch back to a high fiber diet.

RECOMMENDED FOODS FOR DIVERTICULOSIS

Food GroupAmount to Consume DailyHigh Fiber Foods
Fresh Fruit2 or more servingsApples (with skin), oranges, grapefruits, bananas, peaches, pears, plums, cherries, apricots and grapes
Breads and Cereal4 or more servingsWhole grain bread (100% whole wheat, bran, or pumpernickel), dry or cooked cereals (made from whole wheat, bran, oats, unprocessed wheat bran or oat bran), whole grain crackers, bran muffins, brown rice
Vegetables2 or more servingsBroccoli, brussels sprouts, peas, cabbage, carrots, celery, green beans, potatoes, zucchini, tomatoes (without seeds), onions and baked beans Avoid Popcorn!
Food GroupAmount to Consume DailyLow Fiber Foods
Fresh Fruit2 or more servingsFruit juice, fruit drinks pureed fruit, cooked fruit (without skin)
Breads and Cereal4 or more servingsWhite bread, french bread, farina, cream of wheat or rice, melba toast, saltines, corn flakes, rice krispies, puffed rice, white rice and pasta
Vegetables2 or more servingsVegetable juice, lettuce, winter squash, tomato sauce, mashed or cooked vegetables or potato

RECOMMENDED FOODS FOR DIVERTICULITIS

Food GroupAmount to Consume DailyLow Fiber Foods
Fresh Fruit2 or more servingsFruit juice, fruit drinks pureed fruit, cooked fruit (without skin)
Breads and Cereal4 or more servingsWhite bread, french bread, farina, cream of wheat or rice, melba toast, saltines, corn flakes, rice krispies, puffed rice, white rice and pasta
Vegetables2 or more servingsVegetable juice, lettuce, winter squash, tomato sauce, mashed or cooked vegetables or potato
MiscellaneousAll dairy products, meat, poultry, fish, eggs, broth, cream soup

 This diet provides fluids that leaves little residue and are easily absorbed with minimal digestive activity. This diet is adequate in all essential nutrients and is recommended only if clear liquids are temporarily needed. No red or purple liquids should be consumed! 

Food GroupFoods AllowedFoods to Avoid
Milk & Beverages No bright red or dark purple liquidsCoffee, tea (decaffeinated or regular), carbonated beverages, fruit flavored drinksMilk, milk drinks
Meats & Meat substitutesNONEALL
VegetablesNONEALL
Fruits & Fruit juicesStrained fruit juices: apple, white grape, lemonade, Gatorade, crystal light, soda, water, ice teaAll fruit and fruit juices with unstrained fruit
Grains & StarchesNONEALL
Soups (no noodles, rice, veggies, meat)Clear broth, consomméAll others
DessertsClear flavored gelatin, popsicles, Italian ices (no bright reds or dark purple flavors)All others
TreatsNONEALL
MiscellaneousSugar, honey, syrup, clear hard candy, saltAll others

Purpose: The bland or soft diet is designed to decrease peristalsis and avoid irritation of the gastrointestinal tract.

Use: It is appropriate for people with peptic ulcer disease, chronic gastritis, reflux esophagitis or dyspepsia. It may also be used in the treatment of hiatal hernia.

The soft/ bland diet consists of foods that are easily digestible, mildly seasoned and tender. Fried foods, highly seasoned foods and most raw gas-forming fruits and vegetables are eliminated. Drinks containing Xanthine and alcohol should also be avoided.

Food RecommendedFoods to Avoid
MILK & DAIRY (2-3 servings each day)MILK & DAIRY
All milk and milk productsNone
Plain mild cheeses
Cottage cheese
VEGETABLES 3-5 servings each dayVEGETABLES
Mild flavored vegetable juicesRaw vegetables, dried peas and beans, corn
Cooked, frozen or canned vegetables as tolerated (asparagus tips, beets, carrots, green or waxed beans, mushrooms, pumpkin, green peas, white or sweet potato, spinach, summer or winter squashes)Gas forming vegetables such as broccoli, Brussels sprouts, cabbage, onions, cauliflower, cucumber, green pepper, corn, rutabagas, turnips and sauerkraut
Lettuce in small amounts
Salads made from allowed foods
FRUIT (2-4 servings each day)FRUIT
All fruit juicesAll other fresh and dried fruit
Cooked or canned fruit without skins, seeds, or tough fibersBerries and figs
Avocados and bananas
Grapefruit and orange sections without membrane
BREADS AND GRAINS (6-11 servings each day)BREADS AND GRAINS
White, refined wheat, seedless rye breads. Plain white rolls, white melba toast, matzo, English muffin, bagel, pita bread, tortillaSeeds in or on breads, and crackers
Saltine, graham, soda or plain crackersBread or bread products with nuts or dried fruit
Cooked, refined cereals such as cream or wheat, oatmeal, farina, cream of rice. Dry corn and rice cereals such as puffed rice or corn flakesPotato chips, fried potatoes, wild rice
Potatoes
Enriched rice, barley, noodles, spaghetti, macaroni, and other pastas
Couscous
MEAT & MEAT SUBSTITUTES (2-3 servings each day)MEAT & MEAT SUBSTITUTES
All lean, tender meats, poultry, fish and shellfishHighly seasoned, cured, or smoked meats, poultry, or fish. Corned beef, luncheon meats, frankfurters, sausages, sardines, anchovies, strongly flavored cheeses and chunky peanut butter are to be avoided.
Eggs, crisp bacon
Smooth nut butters
Soybean curd (Tofu) and other meat substitutes
Soups
Mildly seasoned meat stock, broth bouillon, or cream soups made with allowed foods
FATS & SNACKS (use sparingly)FATS & SNACKS
Butter or fortified margarineHighly seasoned salad dressings with seeds or pickle relish
Mild salad dressing such as mayonnaise, French or vinegar and oil All fats and oilsAll sweets and deserts containing nuts, coconut or fruit not allowed
Sugar, syrup, honey, jelly seedless jam, hard candies, plain chocolate candies, molasses, marshmallowsFried pastries such as doughnuts
Cakes, cookies, pies, pudding, custard, ice cream sherbet, and Jell-O made with allowed foods
MISCELLANEOUSMISCELLANEOUS
All beverages as toleratedCaffeine-containing beverages (coffee, tea, colas, orange soda, Dr Pepper)
Herb teas, fruit drinksAlcoholic beverages
Iodized salt, flavoringsStrongly flavored seasonings and condiments such as garlic, barbecue sauce, chili sauce, chili pepper, horseradish, pepper, chili, powder and other highly spiced foods
Seedless jams, taffy, sugar, honey, jellyPickles, seed spices, olives, popcorn, nuts and coconut
Marshmallows, molassesAspirin and aspirin-containing medicines
Mildly flavored gravies and sauces
Pepper, herbs, spices, ketchup, mustard and vinegar in moderation

A low fiber or low residue diet limits the consumption of dietary fiber, oftentimes by placing restrictions on foods found to have high amounts, including certain fruits, vegetables, dairy, and whole-grain products. This diet reduces stool size and frequency, particularly helping those suffering from flare-ups caused by Inflammatory Bowel Disease as it relieves the intestines from working as hard.

Low Fiber-Low Residue Diet (4-10 Grams Fiber)

Dietary fiber is the undigestible part of plants that maintains the structure of the plant. Dietary fiber includes cellulose, hemicel­lulose, polysaccharides, pectins, gums, mucilages, and lignins. Although they are chemically unrelated, they all resist digestion by the human body. It is this resistance that makes these fibers important in both the nor­mal functioning and in disorders of the large intestine or colon.

In certain medical conditions, it is important to restrict fiber. These include acute or subacute diverticulitis and the acute phas­es of certain inflammatory condi­tions of the bowel-ulcerative colitis or Crohn’s disease. After some types of intestinal surgery, a low fiber, low residue diet may be used as a transition to a regular diet. A low-fiber diet may also be used for a period of time after a colostomy or ileostomy is performed.

Nutrition Facts

Depending upon individual food selection, the Low Fiber, Low Residue Diet is adequate in all nutrients (National Research Council’s Recommended Dietary Allowance). If the diet must be strict and followed over a long period of time, the intake of fruits and vegetables may not be adequate, and/or on a low residue diet, there may not be enough calcium included. In these cases, a multivitamin supplement or liquid nutritional supplement may be needed.

Special Considerations

If a low fiber or low residue diet results in abdominal cramps or discomfort, notify the dietitian or physician immediately.

Group Recommend Avoid
Milk & milk products (2 or more cups daily) all milk products Low Residue Diet only 2 cups daily of all milk products
Vegetables (2 servings daily) 1 serving = 1/2 cup vegetable juice without pulp; the following cooked vegetables: yellow squash (without seeds), green beans, wax beans, spinach, pumpkin, eggplant, potatoes without skin, asparagus, beets, carrots; tomato sauce and paste vegetable juices with pulp, raw vegetables, cooked vegetables not on Recommend list
Fruits (2-3 servings daily) 1 serving = 1/2 cup fruit-juices without pulp, canned fruit except pineapple, ripe bananas, melons, peeled and cooked apples, orange and grapefruit without the membrane fruit-juices with pulp, canned pineapple, fresh fruit except those on Recommend list, prunes, prune juice, dried fruit, jam, marmalade
Starches-Bread & Grains (4 or more servings daily) bread and cereals mode from refined flours, pasta, white rice, saltines, tapioca whole-grain breads, cereals, rice, pasta; bran cereal; oatmeal
Meat & meat substitutes (5 to 6 oz daily) meat, poultry, eggs, seafood, cottage cheese, other mildly flavored cheeses chunky peanut butter, nuts, seeds, dried beans, dried peas, tough gristly meats, hot dogs, sausage, sardines, fried meats, strongly flavored cheeses
Fats & oils all oils, margarine, butter coconut, fats used for deep frying
Sweets & desserts (servings depend on caloric needs) all not on avoid list desserts containing nuts, coconut, raisins, seeds
Miscellaneous all not on avoid list popcorn, pickles, horseradish, relish