Effect of dietary fat and food consistency on gastroparesis symptoms in patients with gastroparesis

Homko, Carol J.; Duffy, Frank; Friedenberg, Frank K.; Boden, Günther; Parkman, Henry P.

doi:10.1111/nmo.12519

Cited by 67 publications

(38 citation statements)

References 31 publications

(31 reference statements)

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“…A recent study conducted by Ali Abdelhamid et al 16 indicated that lipid absorption in the small intestine was decreased in critically ill patients compared with healthy volunteers by measuring exhaled 13 CO 2 and serum 3‐OMG concentrations. Another study conducted by Homko et al 19 also demonstrated that a high‐fat diet significantly increased the overall symptoms among patients with gastroparesis, whereas a low‐fat diet resulted in the least symptoms. Therefore, one of the possible mechanisms for the high incidence of feeding intolerance was that fat emptying and absorption were severely damaged, perhaps causing poor GI motility and damaged food digestion and absorption in critically ill patients.…”

Section: Discussionmentioning

confidence: 89%

Fat‐Modified Enteral Formula Improves Feeding Tolerance in Critically Ill Patients: A Multicenter, Single‐Blind, Randomized Controlled Trial

Qiu

Chen

Zhang

et al. 2015

J Parenter Enteral Nutr

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Section: Discussionmentioning

confidence: 89%

Fat‐Modified Enteral Formula Improves Feeding Tolerance in Critically Ill Patients: A Multicenter, Single‐Blind, Randomized Controlled Trial

Qiu

Chen

Zhang

et al. 2015

J Parenter Enteral Nutr

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“…Nausea was highest with the high-fat solid meal and lowest with the low-fat liquid meal. This provides support for recommending low-fat and more liquid meals in gastroparesis to reduce symptoms, but longer term diet studies are needed [26].…”

Section: Dietary Interventionsmentioning

confidence: 88%

“…The severity of eight symptoms was rated on a 0-4 scale every 15 min, before and up to 4 h after meal ingestion [26]. Both high-fat meals as well as low-fat solid meal were associated with higher symptom burden.…”

Section: Dietary Interventionsmentioning

confidence: 99%

Gastroparesis

Tack

Carbone

Rotondo

2015

Current Opinion in Gastroenterology

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The relationship between delay in gastric emptying, symptom pattern, and response to prokinetic therapy in gastroparesis is poor. In diabetes, gastroparesis is characterized by loss of ICCs, and this is inversely correlated to the number of CD206+ macrophages. Dietary interventions may help to alleviate symptoms. Tricyclic antidepressants do not provide symptomatic benefit to patients with idiopathic gastroparesis.

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“…29 A high-fat solid meal significantly increased overall symptoms among individuals with gastroparesis. 30 On the other hand, saltine crackers, jello, and graham crackers moderately improved symptoms, and 12 additional foods were tolerated without provoking symptoms. These were: ginger ale, gluten-free foods, tea, sweet potatoes, pretzels, white fish, clear soup, salmon, potatoes, white rice, popsicles, and applesauce.…”

Section: Advances In Dietary Recommendationsmentioning

confidence: 98%

Novel Diet, Drugs, and Gastric Interventions for Gastroparesis

Camilleri

2016

Clinical Gastroenterology and Hepatology

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This review of the pathophysiological basis for gastroparesis and recent advances in the treatment of patients with gastroparesis shows that there are several novel approaches to advance treatment of gastroparesis including diet, novel prokinetics, interventions on the pylorus, and novel forms of gastric electrical stimulation. The field of gastroparesis is likely to advance with further studies, with the help from a guidance document from the FDA on gastroparesis, and with the recent approval of the stable isotope gastric emptying test to ensure eligibility of participants in multicenter trials. Clinical experience and a formal, randomized, controlled trial provide insights on optimizing dietary interventions in patients with gastroparesis. This review addresses the biological rationale of these different treatments, based on known physiology and pathophysiology of gastric emptying. The novel medications include the motilin agonist, camicinal, 5-HT4 receptor agonists such as velusetrag, and the ghrelin agonist, relamorelin. New approaches target pylorospasm by either stent placement, endoscopic pyloric myotomy or laparoscopic pyloroplasty. These approaches offer the opportunity to achieve more permanent reduction of resistance to flow at the pylorus over the intrapyloric injection of botulinum toxin, which typically has to be repeated every few months if it is efficacious. A novel device, deployed in porcine stomach, involved per-endoscopic electrical stimulation. These promising approaches require formal, randomized, controlled trials and deployment in patients. The presence of concomitant antral hypomotility may be a significant factor in the responsiveness to interventions at the pylorus.

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Effect of dietary fat and food consistency on gastroparesis symptoms in patients with gastroparesis

Cited by 67 publications

References 31 publications

Fat‐Modified Enteral Formula Improves Feeding Tolerance in Critically Ill Patients: A Multicenter, Single‐Blind, Randomized Controlled Trial

Fat‐Modified Enteral Formula Improves Feeding Tolerance in Critically Ill Patients: A Multicenter, Single‐Blind, Randomized Controlled Trial

Gastroparesis

Novel Diet, Drugs, and Gastric Interventions for Gastroparesis

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