She seems to be having quite obvious abdominal bloating. Does anyone have advice that may help? I was thinking of scaling way back on breads, and adding more soups, rice crackers, things that are more low residue. But I actually don't really know if that's best.
She doesn't usually get even those 3 shakes down (prefers food) but we are working on that.
Could certainly be due to delayed emptying, caused by inflammation in her stomach/duodenum. My daughter has moderate-severe gastroparesis, and bloating was one of her symptoms too, with severe nausea. She also got full very quickly and that led to a LOT of weight loss. Typically patients with GP struggle with eating high fiber and high fat foods. So many of the things considered good for Crohn's - lots of fiber, whole foods, healthy fats etc. can be very hard to tolerate with Gastroparesis.
For the bloating, I'd avoid high fiber food - all the good stuff you're supposed to eat, such as whole grains, lots of veggies, nuts, were all off-limits for my daughter for years. She's finally now able to tolerate some fiber, and is thrilled to be eating salad again!!
But for many years, the only veggies she got were in soup form or very well cooked - things like creamed spinach or tomato soup, for example. Nothing raw. We avoided veggies that cause gas, such as beans, since they make bloating worse.
And she also avoided fried, high fat foods. We switched from butter to olive oil since she seemed to tolerate olive oil better. In terms of meats, red meat is hard to digest. She still can't eat that (except ham). She could eat chicken, fish and turkey though, and other kinds of seafood (shrimp).
Liquids are typically easier to tolerate than solids, so for several years, she was on 60% formula and 40% food. Because she was on so much formula, I didn't worry too much about her not getting the right nutrients since she definitely wasn't getting enough servings of fruits or vegetables in a day. Now that she is off formula, I worry a lot more!
She does also have slow motility everywhere - including her colon. So has always been on Miralax.
M struggled with drinking shakes due to her GP - the issue was that she could only tolerate so much formula/food. So if she drank more than 2 shakes, then she'd eat much less at dinner. Some kids with Gastroparesis can tolerate liquids with no issues, because their stomachs empty liquids normally. But others, like M, have delayed emptying even of liquids. Which is why we had to go to a tube - the feeds were done at night, and she ate in the day. That was the only way we could get her to gain weight.
Your GI seems like he/she has a pretty good handle on things and pays close attention to H.
