Wife on board!

(Charles Keezer ) #1

A couple things… after 10 months and 45 pounds lost, my wife decided to start this way of eating. I am super excited to start this journey with her. But there is an issue; she has Gastroparisis. That basically translates to her stomach is paralyzed and does not move food properly. With that her doctor years ago advised her to eat no more than 40 grams of fat a day.

Anyone have info on gp and keto? A google search has resulted in little results. The good thing, she has been eating my keto meals for about 6 months, just has not excluded the carbs until now.

Thanks

(Richard Morris) #2

Congrats. It’s a LOT easier when you both do it. So glad Jules decided to join me even though she didn’t need it for glucose control - she got control over her diet.

I can’t advise you on that, but we have a few mods who have had WLS and are more expert in abnormal gut behaviour … hopefully a few might jump in.

(Meeping up the Science!) #3

@Chuck, what is the cause of the gastroparesis? Is her vagus nerve intact?

The most common causes I’m aware of are diabetes and also weight loss surgery. Some medications, opiates are notorious for this because they depress the CNS, also cause it. I ask because if it’s diabetes it should possibly improve as the diet is resolved. Usually 50g of fat is the maintenance part of the diet.

So the reason for the fat limitation is that it delays gastric emptying - this is actually part of why keto is high satiety. A common complication of GP is that people get dehydrated or cannot digest food properly. Having said that, I would proceed cautiously if she still has it. You can easily do a modified ketogenic diet that is a little lower in fat and slowly increase the fat weekly to see if side effects return. Caution is key. Dense meats (like pork and red meat) also drastically slow gastric emptying. Has she been able to eat these and tolerate them?

Eventually, it might be best to consult a doctor if it’s been more than 5 years to see what’s up, depending on the cause, too, since it can be progressive (or go away).

Some handy tips:

  1. Eat many small meals a day (this helps the stomach empty faster).
  2. Cutting out veggies might actually cause dramatic improvement. I’d avoid fiber altogether, as fiber exacerbates it more than fat.
  3. Many people also see improvement avoiding all dairy and grain products (these can ferment and also slow emptying, among other issues).

Honestly, based on experience with it, she might do fine eating a super high fat diet, though. It typically moves things through the system faster. However, IANAD and she needs to talk to one. It really depends on the cause of the gastroparesis to a great degree.

(jketoscribe) #4

Part of the issue in gastroparesis is often too little stomach acid. It is addressed very well in this book:

https://www.amazon.com/Why-Stomach-Acid-Good-You/dp/0871319314/ref=sr_1_1?ie=UTF8&qid=1483372534&sr=8-1&keywords=Why+we+need+stomach+acid

I just looked at the book again. It talks about gastric emptying not directly gastroparesis but it has good info. It mentions that fats slow gastric emptying. It emphasizes the importance of getting stomach acid levels corrected for a functioning digestive system.

(Meeping up the Science!) #5

That’s actually a great book! Betaine HCL and pepsin help a lot of there is low acid too, I know.

We were actually taught the two most common causes were diabetes and opiates. Insulin affects the rate of gastric emptying (it also does reduce acid production too), and opiates are notorious for causing gastroparesis. Also, the vagus nerve can get neuropathy, which is what slows the emptying primarily in diabetes. For WLS, the vagus nerve is sometimes damaged or cut, and that also interferes with it. It’s important to figure out the cause first.

The problem with severe gastroparesis is that extra stomach acid doesn’t necessarily help. Discomfort is caused when we cannot empty our stomach as we are supposed to. We can become dehydrated because we can’t drink since, well, we basically still have food there. We need both acid and churning to digest properly. Just acid will not do it (though many people do have low acid). Low acid is scary for a whole host of reasons, though. Low acid and GP can cause bezoars, for instance.

I’d actually argue a zero carb diet would help tremendously with gastroparesis. IANAD though, and all that.

I may also just be rambly and full of trivia today >.>

(jketoscribe) #6

That’s why I hesitated to say “drink acv or take hcl supplements”. It’s a complex topic the book goes into in great detail.

(Joan Hulvey) #7

Dr. Bernstein’s Diabetes Solution devotes a whole chapter to gastroparesis. Some pearls:
“It is worth noting that gastroparesis can be cured by extended periods of normal blood sugars.”
He also discusses various medications that can help as well as exercises that facilitate stomach-emptying.
Having ground meat is better than unground.
There’s so much in the chapter that would be relevant, just buy the book! A keto diet should help her.

(Charles Keezer ) #8

Wow that was a lot to read! Thanks for all the info;
She has had severe GP for about 8 years. She still has symptoms and routinely ends up throwing up sick due to eating to much food or the wrong kind of food. It was caused during a pregnancy. She is not diabetic at all, just gained some weight after last baby.

She takes domperadone (sp?) to help her muscles try to move… at least that is what I think it is for. The best part is that since I have changed my diet, our whole family eats way better and she has not had an episode in a few months that I recall. Although she has complained about just generally not feeling well. But when you live with it for so long, you just deal with it.

We talked and I suggested that she take it easy and do the step up idea, low fats first week or so and increase over time. Today she started and she went full bore. Time will tell if that was a mistake or not. She hit her macros but did consume 117g fat. She also does not eat fiber at all if she can avoid it. That really sets her off.

Thanks and we will keep you all posted

(Charles Keezer ) #9

Well I wish I had better news but after about two days she had to throw in the towel. She ended up really sick and throwing up. So keto was not for her at this point and time. Thanks for all the info

(Nicole Sawchuk) #10

Any update? My mom was just diagnosed with it and I am looking for guidance with her. She is a type 1 diabetic and has been all her life and I now believe type 2 as well. Her blood glucose has always been poor. To me this is a horrible diagnosis! She’s only 64 years old so I believe she still can make improvements to her quality of life!

Any advice is welcome!