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Trying gain weight with gastroparesis
Hi My husband has had Gastroenteritis for the last two and a half years. He has had his downs and has had his ups with this. He is 40y.o. and has lost a lot of weight over the last two years. He is diabetic being the reason he has the Gastroenteritis now. I was wanting to if anyone has found a way to help gain weight with the Gastroenteritis? He is having a very hard time with this. Also if someone could help with the fact that he burps and it smells so bad and I know what it is from and that he can't help it. But is there anything he can do to help the smell? He gets embarrassed when we go out to eat and he is making the place smell around him. Any help would help out so much! Thanks :)  
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Welcome to the gastroenterology community!  You used the word gastroparesis in your title, but then everywhere else you used the word gastroenteritis.  These two things are very different.  I assume you mean gastroparesis (slow emptying of the stomach)?
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Opps didn't even realize I did that yes I did mean gastroparesis.
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I have gastroparesis too, but I have non-diabetic gastroparesis so it is a little different for me.   Is he on any medications to manage the gastroparesis (reglan, domperidone, erithromycin, etc.)?  Is he eating a low-fiber, low-fat diet and eating multiple small meals every day?  Is the problem that he can't get enough calories in because of nausea/vomitting or that he seems to be getting enough calories but he is still losing weight?  Sometimes there is a malnutrition problem along with the gastroparesis and this should be evaluated.  Part of the reason that his burps smell bad might be that because his stomach isn't emptying, food is basically rotting in his stomach causing a bad smell.  If worst comes to worst and he keeps on loosing weight, he can get a J tube to get nutrition.  I am currently 100% fed through a GJ tube and I get IV fluids through a PICC line and it isn't that bad.
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He is taking reglan and has been for some time now they feel with him being diabetic is playing a part in the way he is digesting foods. He flops back and forth between three meals a day if he feels he can eat them to five to six little meals a day if his stomach is upset. He has only lost about 25pounds but on a man that's 6'3" it makes a huge difference. His vomiting has got much better over the last year and the nausea comes and goes. I feel he is not getting enough calories and nor will he try to because of the stomach being too full which I understand. I also understand the bad smell  is coming from the food sitting within the stomach it's almost the same concept as why bowel movements smell.
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Has he ever tried domperidone?  It is not FDA approved in the US, but it can still be bought through certain pharmacies.  He should always eat six little meals a day as this is much easier on his stomach.  What is his current weight?  Has he tried any nutritional drinks (ensure, boost, etc.)?  Has he tried going on a liquid/pureed diet?
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He has not tried the doperidone. I have looked it up before and found that each med just depends on the person taking it. Which you find all the time. ( I work in health care.) Right now he is at 220 which my sound like a lot but to look at him at 6'3" he is starting to look like skin and bone. He has tried the shakes and the liquid diet before. Which I didn't even think of getting more of the drinks and putting them back into the house so I will do that. The liquid diet does nothing for him other then make him feel hungry after about a day and a half.
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You husband is actually considered overweight by his BMI (which takes his height into account).  However, weight loss is concerning.  Personally, I think that reglan has a lot more scary side effects (tardive diskinesia) than domperidone, and for some people, domperidone works a lot better.  Is his diet low-fat?
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Well with 90% of us that work in health know that BMI can be a joke so you really really really can't go by that. Just like with my husband he has next to no fat on his body. If someone was to look at him unless they counted in height they would never think he was over 200 pounds. I may try to talk to the husband and the doctor about the domperidone. His diet does flex between low-fat and not. I would say 80% of the time it is all low-fat. Thanks :)
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I agree, BMI is just a rough way to estimate someone's body weight with relation to height.  Because I cannot see your husband in person, all I have to go off of is his height and weight.  My only point with saying that he is considered overweight is that you don't need to worry that he is becoming underweight.  Has he noticed any correlation with symptoms between when he eats low-fat and when he doesn't eat low-fat?  Your doctor might refuse to perscribe domperidone (because it is not FDA approved) but there are some doctors that will prescribe it.
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I understand that with the BMI. As far as his diet he doesn't find any difference in what he eats. The one food he can see a difference with is red meats. Which is to be expected. I dunno I am going to try to start the drinks again and hope for the best.
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Another thing to try is to puree all of his foods and have him drink them as a milkshake.  However, this gets pretty gross after a few days.
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