Dietary Management and Mental Health Considerations in Adult Gastroparesis: A Cross‐Sectional Survey of Dietitians

INTRODUCTION: Gastroparesis is a complex gastric motility disorder for which diet is recommended as a primary management strategy. Gastroparesis is associated with significant physical and psychological burden, with anxiety and depression commonly reported. Furthermore, gastroparesis overlaps with eating disorders (EDs), complicating management. Clinical guidelines for gastroparesis management acknowledge this overlap and recommend screening for EDs, however little is known about current dietetic practice in managing this intersection. This study aimed to explore dietitians' experiences, practice and confidence in managing adult patients with gastroparesis in the context of EDs. METHODS: A cross-sectional online survey of dietitians with experience managing gastroparesis was conducted and distributed via professional networks and social media. The survey explored demographics, dietary strategies, perceived effectiveness, barriers to implementation and mental health support, particularly in relation to EDs. RESULTS: A total of 87 surveys were completed. There was wide variation in dietary strategies used; small-particle diets were the least commonly implemented, while artificial nutrition support was used more frequently and perceived as more effective. Confidence in managing gastroparesis varied, with particularly low confidence in screening for EDs, regardless of years of experience (Mann-Whitney U = 851.4, p = 0.790). Only 20% of respondents screen for EDs more than half the time, and just 8% reported input from a mental health professional in their multidisciplinary teams. CONCLUSION: A variety of dietary strategies are used by dietitians to manage gastroparesis, of which food-first are perceived as less effective in improving symptoms and nutritional status. Screening for EDs is inconsistent, and access to mental health support is limited. This demonstrates a need for improved dietary management of gastroparesis, better mental health resources and standardised practices to improve patient care.