Nausea and vomiting are common side effects from cancer treatment for a variety of reasons. Nausea tends to be more common than vomiting. It is important to attempt to determine the cause of the nausea and/or vomiting for the best management. Working together with your healthcare team is essential for optimal management. The following are some tips and guidelines to help control nausea and vomiting:
Take anti-nausea medications as prescribed by your healthcare provider.
- It is important to take anti-nausea medications as prescribed.
- Do not wait until the onset of nausea to take medication.
- It is best to attempt to keep nausea managed with medication to allow for consistent eating and optimal nutrition.
- Call your healthcare provider if you are taking the medication as prescribed and it is not providing any relief. A different medication may be needed.
- Do not take over-the-counter medications or supplements without talking to your healthcare team first.
Track nausea to determine causes and trends.
- Some nausea may be directly related to chemotherapy.
- It is beneficial to know how soon after chemotherapy the nausea begins. Sometimes it is immediate and other times the onset is delayed.
- Tracking may help to identify other triggers or causes of nausea.
- Download the LLS Health Manager app to help with tracking.
Keep odors to a minimum.
- Odors can lead to nausea so it is best to choose foods with little or no odor such as oatmeal, cereals, canned fruit, shakes, and smoothies.
- When preparing food at home, opt for foods with short cooking times and minimal odor such as pancakes, scrambled eggs, reheated soup, or other prepared foods that just require reheating.
- Cool and room temperature foods usually have fewer odors than hot food.
- Avoid cooking foods that have long cooking times such as casseroles, meats, and slow cooked meals.
- Ask friends or family members to cook these items in an alternative location like a neighbor’s kitchen.
Eat several small meals or snacks during the day.
- Eating small meals or snacks 5-6 times per day instead of 2 or 3 larger meals may help with nausea management. This keeps the stomach from getting too empty and prevents excess stomach acid.
- Chew all foods very well. The digestion process begins in the mouth.
- Keep bland, odorless snacks on hand for easy meals and snacking. Some examples are crackers, cheese, canned fruit, yogurt, toast, potatoes, rice, and pasta.
- Not all foods are appealing to everyone. The key is to find the foods that are tolerable and stock up on those.
Create a relaxing environment for eating and snacking.
- Lighting, temperature, and other external cues may make nausea worse.
- Dim lighting and cooler temperatures tend to be better for nausea management.
- The use of a fan or ceiling fan may also make a difference.
- It is important to be removed from situations that contribute to anxiety when attempting to enjoy a meal or a snack (i.e. loud voices, arguing, loud music, or non-relaxing television programs).
- Soft relaxing music, a relaxing television program, or another activity that is relaxing in a cool, dim room may be the best environment for meals and snacks.
- Rest after meals but do not lie flat as this may trigger nausea.
Experiment with different foods.
- Everyone is an individual and not all foods work for everyone when nausea is an issue. Try to be patient and experiment with different foods.
- Start with bland foods with minimal odor and introduce them slowly, one at a time.
Avoid foods and behaviors that tend to trigger nausea.
- Some foods are triggers for nausea for unexplained reasons. Some of these reasons may be psychological. It is best to avoid these foods for optimal nutrition. The time that it takes to recover from an episode is time that the body is missing out on good nutrition.
- Foods that are harder to digest and stay in the stomach longer can be triggers for nausea. These foods are usually higher fat foods such as fried foods and foods prepared with a lot of butter or oil.
- Spicy foods are usually not tolerated well.
- Some behaviors such as eating in a restaurant may trigger nausea. If this is the case, order food to carry out and eat it in a more relaxing environment.
- Caffeine and smoking contribute to nausea.
- Limit or avoid smoking, and drink only decaffeinated beverages.
Try foods and drinks containing ginger.
- Ginger is a spice that has shown some promise for relief from nausea.
- Ginger snaps, ginger ale, ginger gum, or ginger tea may be options that can help manage nausea.
- Ginger is also common in some Asian recipes.
- Ginger supplements are available. Ask your doctor before trying a ginger supplement.
Avoid drinking while eating.
- Sometimes excess liquid in the stomach contributes to nausea.
- It is best to drink any beverages at times other than meal times.
- The best beverages to choose are water, 100% fruit juices without added sugar, and caffeine-free soda that no longer has carbonation.
- Ginger ale, specifically, may help with nausea.
Wear loose-fitting, comfortable clothing.
- Clothing that is tight especially around the midsection can trigger nausea.
- Soft, comfortable fabrics tend to be more relaxing as well.
Stay hydrated if vomiting occurs.
- Continue to drink clear liquids including water and other electrolyte containing beverages like sports drinks.
- Attempt to eat bland foods such as crackers or toast.
Ask what to if you vomit soon after taking a medication.
- Call your doctor or pharmacist for instructions.
Call your healthcare team immediately if you experience severe side effects.
- Severe side effects include
- Fever of 100.4°F or higher
- Nausea and/or vomiting with abdominal pain or severe headache
- Vomiting blood (which may look like coffee grounds)
- Inability to keep medication down
- Vomiting for more than two days