NAUSEA and VOMITING

What is nausea and vomiting?

Nausea is a sick or uncomfortable feeling in the stomach. Vomiting is a strong contraction of the stomach muscles that forces the stomach contents out through the mouth. Nausea can occur without vomiting and vomiting can occur without nausea.

Why would I have problems with nausea and vomiting?

Some chemotherapy drugs can cause nausea or vomiting. Nausea and vomiting may start right after a treatment or be delayed for 8 to 18 hours. These symptoms may last a few hours or up to 2-3 days.

Anxiety or extreme worry can cause nausea or vomiting before a chemotherapy treatment even begins; this is called anticipatory nausea.

Other medications may cause nausea or vomiting, including diethylstilbestrol and pain medications.

Radiation, especially to the abdomen (belly) or pelvis, can cause nausea and vomiting.

Cancer itself can sometimes cause nausea and vomiting.

When should I call my doctor?

Call your doctor if you are worried or have questions about nausea and vomiting.

Call the doctor immediately if you have any of these problems:

  • Nausea or vomiting for more than one day so severe you cannot keep liquids down
  • Symptoms of dehydration -- decreased urination, dizziness or light-headedness, dry mouth, increased thirst
  • Vomit that looks like it contains blood or coffee grounds

What can I do to decrease or prevent nausea and vomiting?

Diet

  • Do not eat or drink anything for several hours before getting chemotherapy that causes nausea and vomiting.
  • Avoid sights or smells that make you nauseated. Eat foods cold or at room tempera-ture so they do not smell as strong. Do not eat in rooms with strong cooking odors.
  • Drink liquids an hour before or after mealtime instead of with meals. Drink cold or chilled liquids.
  • Suck on ice cubes, mints or hard sugarless candies. Freeze liquids you like into cubes.
  • Eat smaller meals more often so your stomach does not feel too full. Eat slowly, chewing food completely so it digests easily. If you do not have sores in your mouth or a dry mouth, and you are nauseated in the morning you can try dry foods like cereal, toast, or crackers before getting up.
  • Avoid your favorite foods when you are nauseated. Do not eat sweet, spicy, fatty, or greasy foods while nauseated.
  • Get friends or family members to prepare meals whenever possible. If you must cook, prepare and freeze meals in advance for days when you are ill.

Medication

  • Take medications for preventing nausea and vomiting before you feel bad. Take the dose of medicine your doctor prescribes. Ask your doctor, nurse or pharmacist before changing your dose if you need more or less medicine.

Other Ideas

  • Breathe deeply and slowly through your mouth when you feel nauseated. Open a window and let in fresh air. Avoid eating meals in a stuffy or very warm room.
  • Wear loose-fitting clothes when you eat. Rest in a chair after eating. Wait at least 2 hours before lying flat.
  • Sleep through periods of nausea whenever you can.
  • Do something you enjoy to distract you from your symptoms.
  • Ask about relaxation techniques to prevent anticipatory nausea. Techniques you can try include biofeedback, acupressure, hypnosis, imagery, and rhythmic breathing.

What should I do if I vomit?

Clean your mouth by rinsing with water, brushing your teeth or gargling. Clean your throat by taking a sip or two of water.

Do not eat or drink more than a few sips while you are vomiting and for several hours afterward. Drink small sips of clear liquids when your stomach settles.

Drink liquids instead of eating solid food to let your stomach rest. Try apple juice, clear soups, gelatin water, ginger ale, grape juice, lemon-lime soda, popsicles, or tea. Your stomach may tolerate flat sodas more easily than "fizzy" ones.

Drink more fluids than normal to replace fluid lost when you vomit.

These patient information materials should be used in conjunction with verbal counseling. They are not intended as the sole source of information patients receive about managing cancer therapy complications.

From the Cancer Chemotherapy Manual, © 2001, University of Utah Hospitals and Clinics, Salt Lake City, UT. Published by Facts and Comparisons, St Louis, MO, www.drugfacts.com