How to Manage Nausea and Vomiting

Introduction

Nausea and vomiting are distressing symptoms. Fortunately, there are effective ways to prevent and treat these symptoms. If you feel nauseated or are having episodes of vomiting, please tell your care team. They will work with you and your physician to identify what is causing these symptoms and develop a treatment plan.

Causes

• Medications, such as chemotherapy, antibiotics, aspirin, and pain medications.
• Damage to the stomach and intestinal lining from the disease or treatments for the disease.
• Anxiety
• Uncontrolled pain
• Motion sickness (travel-related)
• Some infections
• Constipation or diarrhea
• Coughing — thick secretions and/or coughing may trigger vomiting
• Some foods and/or strong odors.

What You Can Do

• Eat small, frequent meals
• Try foods such as:
  • Toast and crackers
  • Sherbet
  • Pretzels
  • Angel food cake
  • Chicken without skin (baked or broiled)
  • Fruits or vegetables that are soft or bland (potatoes, canned peaches)
  • Ginger or herbal remedies. Be sure to check with your nurse or pharmacist to be sure herbal remedies do not interact with prescribed medications.
• Try to avoid these foods:
  • Fatty, greasy, and fried foods
  • Spicy, hot foods
  • Dairy products such as milk or ice cream
  • Foods with strong odors
  • Citrus foods such as oranges and grapefruit
  • Foods containing caffeine such as coffee and chocolate
• Eat foods at room temperature or cooler. Hot foods may trigger nausea.
• Suck on ice chips or take frequent sips of a liquid such as ginger ale.
• Use disposable plates, napkins, silverware, and cups.
• Avoid drinking liquids with meals.
• Enjoy a quiet, relaxing, pleasant atmosphere for meals. Avoid eating in a room that is stuffy, too warm, or has cooking odors or smells.
• Try relaxation techniques such as deep, controlled breathing and focusing on pleasant thoughts.
• Don’t eat favorite foods when nauseated. This may cause a permanent dislike of those foods.
• Rest after meals – activity may slow digestion. It is best to rest sitting up, for about one to two hours after meals.
• If nausea is a problem in the morning, try eating dry toast or crackers before getting out of bed (keep a supply next to the bed).
• If nausea occurs during chemotherapy or radiation therapy, avoid eating for 1-2 hours before treatment.
• Ask your hospice nurse about medications to help control nausea. This information will help your nurse and physician determine the most effective treatments.

Managing Nausea and Vomiting

If vomiting occurs:

• If lying down, turn head to the side to prevent choking.
• After vomiting, rinse the mouth out with water, brush the teeth, and/or rinse the mouth with a mouth rinse.
• Place a damp, cool cloth on forehead, neck, and wrists.
• Do not eat or drink anything until the vomiting has stopped.

Once vomiting stops:

• Try small amounts of clear liquids such as apple juice, bouillon, and gelatin. Begin with a teaspoonful every 10 minutes. Gradually increase the amount to 1 tablespoonful every 20 minutes and then try 2 tablespoonfuls every 30 minutes. If unable to tolerate any fluids, call your care team.
• Once able to keep down clear liquids, try non-clear liquids. Gradually work up to a regular diet.
• Ask your hospice nurse or physician about specific medications to help control Nausea.

Call your care team immediately if:

• Vomiting happens more than two times in two hours.
• Vomit looks like coffee grounds or looks like it is bloody
• Symptoms include weakness, dizziness, and/or thirst
• You are unable to keep down or swallow medication prescribed to control nausea and vomiting.

Much can be done to prevent and treat nausea and vomiting. Please talk with your care team about your symptoms.

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