Nutritional recommendations in gastroparesis

Gastroparesis is characterized by delayed gastric emptying (in the absence of mechanical obstruction), nausea, vomiting, postprandial fullness, early satiety, abdominal pain, and, in severe cases, weight loss and dehydration. The prevalence of gastroparesis in the United States ranges from 24.2 to 267.7 per 100,000 people, creating a significant financial burden on healthcare. Aim of the review was to characterize the diet of patients with gastroparesis, to review recommendations for oral, enteral, and parenteral nutrition in gastroparesis to restore nutritional and hydration status. Material and methods . The search for sources was carried out in the peer-reviewed scientific literature databases eLIBRARY, PubMed/ MEDLINE, Google Scholar, CyberLeninka, from 1990 to 2025 using the keywords: gastroparesis, gastric emptying, diet, nutrition, enteral nutrition, bezoar. Results. Nutritional deficiency of patients with gastroparesis: on average 1.4 ± 1.0 meals per day, 64 % of patients have an energy value of the diet <60 % of estimated one, 30–86 % – a deficiency of carbohydrates, proteins, vitamins and minerals. Only 32 % of patients with gastroparesis were consulted by a nutritionist, 2 % of patients followed the proposed diet. Nutritional support for gastroparesis includes initial nutrition screening, nutritional assessment, individualized nutritional recommendations, hydration and nutrient correction. Patients with gastroparesis are recommended: in a sitting position to consume mainly liquid chopped food 4-8 times a day in small portions with low fat content (25-30 % of the total energy value of the diet), fiber (15 g / 1000 kcal), eat slowly (30 minutes), do not lie down immediately after eating, control weight, reduce excess weight, maintain oral hygiene, avoid caffeine, alcohol, tobacco, bezoar-forming products, wearing tight clothing, stress. Exclusive enteral or parenteral nutrition is required in 3.3 % of patients with complications of gastroparesis (sharp weight loss, severe vomiting). Conclusions. The diet for gastroparesis is deficient in energy value and nutrients. Individualized recommendations of a nutritionist are necessary to reduce the symptoms of gastroparesis, prevent complications, and improve the quality of life of patients. Modifications of oral nutrition are preferred, enteral or parenteral nutrition is used for complications of disease.