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Nutritional Management of Nausea and Vomiting While Undergoing Cancer Treatment

While undergoing cancer treatment, patients may face many symptoms that can impact their nutritional status such as decreased appetite, taste/smell changes, dry mouth, mouth and throat soreness, gastrointestinal distress including diarrhea, constipation, nausea, and/or vomiting.

Here are a few tips to help with managing nausea and vomiting when trying to eat.

It is important to make sure you stay hydrated.  Drinking plenty of fluids will help decrease the risk of dehydration.  Sipping fluids slowly and frequently throughout the day can help reduce nausea as can drinking through a straw.  Separating fluid intake from solid food can also help to manage nausea.  If plain water is unappealing, try drinking some water with added fruit or drink electrolyte replacement drinks such as Gatorade.  If you are feeling too full, you can also freeze Gatorade into Gatorade popsicles.

If nausea is severe, limit your diet to clear liquids such as broths, gelatin, popsicles, Italian ice, juices, ginger ale, or clear soda to settle your stomach.  If nausea improves, you can slowly transition to a full liquid diet, which includes cream of wheat, oatmeal, grits, yogurt, and milk as tolerated.  When beginning to transition to solid foods, low-fiber foods are typically the most tolerable choices.  Low-fiber items include toast, white rice, crackers, potatoes, cereal, and other bland items.  Avoidance of heavy, greasy foods like cheese, fries, and meats will help to prevent nausea and vomiting.

The smell of foods can also bring forth unwanted symptoms of nausea and vomiting.  Try removing lids from foods if in the hospital or keeping the kitchen well-ventilated while cooking at home.  You can also temporarily eat cold or room-temperature foods to help avoid offensive smells.

It is also helpful to eat small, frequent meals and not skip meals as nausea can also be a problem with an empty stomach.  Avoid eating your favorite foods when feeling sick to avoid any food aversions.

Medications are also important components of symptom management.  Taking nausea medications as directed can help to control symptoms of nausea.  If you are having uncontrolled nausea, talk with your nurse or doctor.

If you are having trouble with your food intake, you can reach out to your doctor and your oncology dietitian to help you manage your nutrition-impact symptoms.

Melissa Jacobs, MS, RD, CSO, LDN, CNSC

Advanced Practice Dietitian 

Johns Hopkins Hospital