Close this search box.

August 2021 Diet & Digestive Health (DDHChat) Twitter Chat with IFFGD Neha D. Shah, MPH, RD, CNSC, CHES, and Tina Aswani Omprakash

2021 August DDHChat

2021 August DDHChat: Integrating Diet with Life in Gastroparesis

IFFGD – introductory tweets and remarks:

The views and experiences shared by our participants are their own and do not reflect the official positions of IFFGD. Each patient is different. Always consult with your healthcare provider or a registered dietitian (RD) on a diet treatment plan that is right for you. Information and resources shared during today’s chat should not replace the medical care that you are receiving. And as a reminder, be sure to include #DDHChat in each of your tweets.

IFFGD – welcomes everyone to the chat and introduces co-hosts Neha D. Shah, MPH, RD, CNSC, CHES, and Tina Aswani Omprakash

Welcome to our August #DDHChat on Integrating Diet with Life in Gastroparesis with co-hosts Neha D. Shah, MPH, RD, CNSC, CHES, and Tina Aswani Omprakash. It is estimated that about 5 million people in the United States suffer from #gastroparesis. Many things may contribute to or cause #gastroapresis, but for most people, the cause is unknown and termed idiopathic. Living with #gastroparesis can impact your relationships in the classroom, workplace, or even with friends and family. The symptoms of #gastroparesis can range from uncomfortable to debilitating and, in some cases, life-threatening. Often the symptoms of #gastroparesis can worsen after a meal. It is important to communicate these changes with your healthcare provider whenever you notice changes in your symptoms. It is natural to have some concerns about finding the right treatment plan for you. For some, seeking support from a registered dietitian could help. During the next hour, we’ll discuss how to integrate diet in life with #gastroparesis.

Today, we’re joined by registered dietitian Neha Shah and patient advocate Tina Aswani Omprakash to share their unique insights on Integrating Diet with Life in Gastroparesis

IFFGD and Neha D. Shah, MPH, RD, CNSC, CHES, and Tina Aswani Omprakash Q&A:

Q1: As we begin this month’s Twitter chat series, Neha D. Shah, will you briefly explain what #gastroparesis is? #DDHChat

Neha D. Shah, MPH, RD, CNSC, CHES: Gastroparesis refers to slow motility of the stomach. It involves emptying of foods and fluids from the stomach into the small intestine much more slowly. Gastro=stomach and paresis=paralysis. Idiopathic #gastroparesis is most common, in which the cause is unknown. Other causes may include diabetes and viral infections, which may possibly damage nerves within the stomach that may lead to #gastroparesis. #DDHChat

Q2: Tina Aswani Omprakash, when were you diagnosed with #gastroparesis, and what led you to seek evaluation from a healthcare provider? #DDHChat

Tina Aswani Omprakash: I was diagnosed with #gastroparesis two summers ago but have been suffering from nausea & severe constipation for 6 years now. It was hard for me to get a diagnosis because no one could understand how someone with an #ileostomy from #CrohnsDisease could have #constipation. #DDHChat

Q3: Neha D. Shah, what symptoms are commonly associated with #gastroparesis? #DDHChat

Neha D. Shah, MPH, RD, CNSC, CHES: Symptoms of #gastroparesis include abdominal pain, nausea, vomiting, early fullness, constipation, gas, bloating, and/or cramping. All symptoms could be present, or only some, and can vary from mild to severe in #gastroparesis. Thus, tolerance to diet can vary from person to person. There is no “one size fits all” approach with diet as the symptoms vary. This is why diet needs to be personalized for the individual living with #gastroparesis to help reduce symptoms, as well as for any nutritional consequences of weight loss, nutrient deficiencies, and fatigue. #DDHChat

Q4: Tina Aswani Omprakash, what are common dietary misconceptions for #gastroparesis that you have seen within patients? #DDHChat

Tina Aswani Omprakash: There are many dietary misconceptions we patients face in living with #gastroparesis. I was convinced that I wouldn’t be able to eat solid food or grains anymore, that everything had to be soupy & that I couldn’t touch fiber. These are all workable in moderation. The thing we #gastroparesis patients have to be careful about though is #bezoars, which are undigested food particles or medications that can cause blockages. #Bezoars are a #gastroparesis complication I’ve had to deal with a lot and am still trying to manage. Having a shorter gut and #ostomy complicates my digestive processes as I have no colon to break food down the same way as those who have colons. #DDHChat

Q5: Neha D. Shah, fiber intake is tricky to navigate for many patients. How can an individual living with #gastroparesis incorporate fiber in their diet? #DDHChat

Neha D. Shah, MPH, RD, CNSC, CHES: Traditionally, a low fiber diet has been recommended in #gastroparesis based on the concept that a diet high in fiber delays gastric emptying. Fiber is non-digestible and found in plant-based foods of grains, fruits, vegetables, and legumes. What does this mean? Are we restricting certain types or textures or an amount of fiber? It is not well defined. It is important to include fiber in the diet to bring in plant-based foods for gut health, even in #gastroparesis. The stomach may empty foods of small particle size (e.g., blended, minced, mashed) more rapidly than large particle size. A limited # of studies in diabetic #gastroparesis showed that foods of small particle size reduced symptoms, such as nausea and vomiting. Doing small meals of small particle size vs fiber restriction in #gastroparesis may reduce symptoms while also, expand the variety of other foods, especially plant-based foods in the diet. If not sure where to start, try a few TBSP of one food with fiber at each meal. There is a concern for phytobezoars, which are peels and leaves of fiber that may not empty, thus, may build in the stomach over time. Limit peels and leaves of fruits/vegetables, or celery, figs, oranges, persimmons, and brussel sprouts in whole form. Here are examples of fiber in small particle size for #gastroparesis-oatmeal, polenta, hummus, pureed split pea or lentil soups, scrambled tofu, creamy peanut butter, fruit/vegetable smoothies, guacamole, mashed sweet potato, minced vegetables, and cauliflower rice. #DDHChat

Q5.2: Tina Aswani Omprakash, how do you incorporate fiber into your diet for #gastroparesis? #DDHChat

Tina Aswani Omprakash: Incorporating fiber doesn’t have to be a daunting process. I drink fruit smoothies and do a lot of pureed vegetable soups, which have fiber in them, and also are more easily digested with a #gastroparesis diagnosis. And I agree with Neha D. Shah regarding particle size and I generally stick to many of the foods she’s suggesting for an adequate intake of fiber but also to avoid any #bezoars. #DDHChat

Q6: Neha D. Shah, will you explain why an individual living with #gastroparesis might be placed on a liquid diet and how should they safely transition from liquids to solids? #DDHChat

Neha D. Shah, MPH, RD, CNSC, CHES: A liquid diet of mostly hot cereals, smoothies, and soups are used in #gastroparesis when there is an intolerance to solids in whole form. Liquids may empty more rapidly from the stomach than solids. In #gastroparesis, I start with one small meal in the day that includes solids. The other meals still have liquids. It also depends on my patients’ comfort. This one meal may have one solid or may have multiple solids from various food groups in a few TBSP of each. Here is an example if we choose breakfast as a trial meal protein (one scrambled egg in olive oil), dairy (a pinch of shredded cheddar), chopped fruit (cantaloupe), or a vegetable (minced spinach that is cooked) and a starch (few rice crackers). From experience, a meal that has a mix of solids and liquids, or even one of the meals in the day is an all-liquid meal, has been tolerated well in #gastroparesis. The liquid meal is included in the part of the day that symptoms are more. #DDHChat

Q6.2: Tina Aswani Omprakash, how did you transition from liquids to solid foods while living with #gastroparesis? #DDHChat

Tina Aswani Omprakash: Such an important question! This is another misconception in the #gastroparesis community: yes, we can eat solid food! Important to try to incorporate one new soft food every few days. Doing so can allow us to figure out what our triggers are. And I agree with Neha D. Shah here as well. Try adding a solid to soup meal: sometimes I’ll do crackers or pretzels or I’ll do a few soft pieces of sweet potato. These are simple ways to begin incorporating solids. When I notice that my gut isn’t feeling right, I revert to the safe foods and may do more liquids. But for me the key has been to cook food well, make it soft and chew it well. That way the food becomes that much easier for the stomach to process. #DDHChat

Q7: Neha D. Shah, when dining out, what are some examples of foods from various cuisines that could be potentially well-tolerated for individuals living with #gastroparesis, and what tips should be kept in mind? #DDHChat

Neha D. Shah, MPH, RD, CNSC, CHES: In #gastroparesis, a tip I can share is to review the menu beforehand to learn of foods that you feel you can tolerate well. Even do a trial, order take out prior to going to the restaurant so you can try foods in the comfort of your own home. If eating with friends and family, order items off the menu as family-style to help try different foods in small portions that you feel you can tolerate in #gastroparesis. Asian cuisine (possible options): miso broth with tofu, sushi, Thai curries, ramen/pho (you pick the ingredients). Indian cuisine (possible options): baingan bharta, idli with sambar, khichdi, palak paneer, oat upma, fruit, or cucumber lassi. Mediterranean cuisine (possible options): avgolemono, dolma (without eating the grape leaves), kebabs, baba ghannoush/djajiki/hummus dips, rice pilaf. Mexican cuisine (possible options): guacamole or salsa with tortilla chips, tortilla soup, pureed black beans, spanish rice, mini street tacos (you pick the ingredients). Italian cuisine (possible options): caprese, minestrone/wedding soup, meatballs, ravioli with pesto sauce, risotto. I also like menus that offer customizable entrees that you can pick the ingredients that you want (e.g., such as in pasta, noodle bowl). #DDHChat

Q7.2: Tina Aswani Omprakash, how have you integrated various cuisines and dining out since being diagnosed with #gastroparesis? #DDHChat

Tina Aswani Omprakash: I always, always call the restaurant first just to get an idea of how flexible they are with modifying ingredients and with cooking foods very well. Sometimes it’s reassurance we need from a #mentalhealth perspective that we can eat out and enjoy ourselves. Many ethnic cuisines have curries & soups with softer veggies, tofu & even yogurts & well-cooked lentil soups. I eat a variety with #gastroparesis whether it’s a Japanese miso soup, a Thai coconut curry, or a Vietnamese pho soup, many of these work well for me. This also includes Indian foods which tend to be well-cooked and have a lot of veggies and daals, which pass through more easily. I also find Mediterranean hummus & babaganoush and Mexican guacamole & mild salsa workable for my #gastroparesis. #DDHChat

Q8: Neha D. Shah, what recommendations do you have to enjoy traveling while living with #gastroparesis? #DDHChat

Neha D. Shah, MPH, RD, CNSC, CHES: Bring foods with you. Some foods and fluids that have been tolerated well in #gastroparesis: instant oatmeal packets, microwavable soups, fruit/vegetable smoothie pouches, rice crackers with peanut butter or hummus packets or readymade protein shakes. Learn if your hotel room can put in a small refrigerator and a microwave, or get a hotel room that has a small kitchen so you can store or buy some of your own foods in #gastroparesis. If you are staying with friends or family, discuss with them beforehand the foods that you do tolerate well and not tolerate well in #gastroparesis to build support and so that planning of meals can take place. #DDHChat

Q8.2: Tina Aswani Omprakash, how do you prepare for travel while living with #gastroparesis? #DDHChat

Tina Aswani Omprakash: When I was first diagnosed with #gastroparesis, I thought I’d never been able to travel again but that’s not true. When I travel, I buy liquid smoothie pouches from the grocery store or Amazon, also liquid baby food as snacks along with electrolyte powders to carry. I also look up and call restaurants in advance that may have soups and smoothies, even foods like hash browns, mashed potatoes, scrambled tofu. All of these go down more easily with #gastroparesis. If staying with family or friends, we either order in soft foods I know I can eat or I help out with cooking Indian food in their homes: usually pureed lentil soups with veggies which are very common in #SouthAsian cuisine. #DDHChat

Q9: Tina Aswani Omprakash and Neha D. Shah, how might an individual living with #gastroparesis benefit from adding a registered dietitian to their healthcare team? #DDHChat

Tina Aswani Omprakash: For a #gastroparesis diagnosis, I often tell other patients that working with a #GIdietitian is absolutely key. Everyone’s symptoms are so varied and need to be tailored to address dietary and nutritional needs appropriately. For me, my worst #gastroparesis symptom is food not passing through from the stomach to the small intestine, causing significant #constipation. So, eating foods that help me go while modifying fiber and small particle intake is extremely important alongside meds. In order to get that fiber intake and mincing of foods down to a tee for my #gastroparesis, working with a #GIdietitian has been critical. #DDHChat

Neha D. Shah, MPH, RD, CNSC, CHES: Based on symptoms, tolerance to diet can vary. A dietitian specializing in #gastroparesis can work out options for foods, portions, and textures to reduce symptoms, and other concerns while also aiming to integrate with the various environments’ meals are eaten. I can also add, a #GIdietitian can also help you plan for dining out, for travel, help identify ingredients, and more in #gastroparesis. #DDHChat

IFFGD – final tweets and remarks:

We hope that you all have enjoyed our chat today on #gastroparesis. Remember that August is Gastroparesis Awareness Month and you can help raise awareness all month using #ThisIsGP. Special thank you to Neha D. Shah and Tina Aswani Omprakash for joining us today and sharing their unique insights on #gastroparesis. To learn more about #gastroparesis and other topics from this month’s lead hosts, #GIdietitian Neha D. Shah (Twitter: @nehagastrord) at and Tina Aswani Omprakash (Twitter: @ownyourcrohns) at

Another resource is the Gastroparesis Patient Association for Cures and Treatment (G-PACT) at

Was this article helpful?

IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders.

Our original content is authored specifically for IFFGD readers, in response to your questions and concerns.

If you found this article helpful, please consider supporting IFFGD with a small tax-deductible donation.

Skip to content