A scoping review of dietary management for non-diabetic gastroparesis: Evidence limitations and research gaps.

BACKGROUND Dietary management is essential in gastroparesis, but existing guidelines primarily focus on diabetic gastroparesis, highlighting a lack of evidence-based guidelines for patients with non-diabetic gastroparesis, who experience higher malnutrition and mortality rates. Management is complicated by a suggested bidirectional relationship with eating disorders.

OBJECTIVE To investigate evidence on dietary interventions, patterns and intake in non-diabetic gastroparesis, including effects on symptoms, nutritional outcomes, quality of life (QoL), and their potential role in disordered eating behaviors.

METHODS A scoping review was conducted using the Joanna Briggs Institute methodology. A comprehensive search was conducted across eight databases: Embase, MEDLINE, Web of Science Core Collection, Global Health, CINAHL, Scopus, CENTRAL and PsycInfo, alongside grey literature and citation searching. English-language studies from 2008 investigating dietary interventions, patterns and intake in adults with objectively confirmed non-diabetic gastroparesis (idiopathic, autoimmune-related, post-viral, or eating disorder-associated etiologies) were included. Two reviewers independently screened, extracted data and synthesized findings using a narrative approach.

RESULTS Of 6,212 articles screened by title/abstract, 88 underwent full-text review and 13 met inclusion criteria. Of these, 7 studies examined dietary interventions, 5 assessed dietary patterns, and 2 reported dietary intake. Two were randomized controlled trials (RCTs) including 16 participants with non-diabetic gastroparesis; the remaining 11 observational studies included 679 participants with confirmed non-diabetic gastroparesis and 752 for whom etiology was unspecified or delayed gastric emptying could not be confirmed. All included studies assessed symptom burden; 5 reported nutritional outcomes, and 2 evaluated dietary impact on QoL. No studies explored the role of diet in disordered eating. Considerable variation was observed in dietary management strategies across studies.

CONCLUSION Research on dietary management in non-diabetic gastroparesis is limited, with significant variability in interventions, dietary definitions and study designs, reflecting lack of standardization across intervention protocols and research methodology. Well-designed trials are needed to clarify the impact of diet on symptoms, nutritional status and QoL, considering psychosocial effects and potential disordered eating risks.