Nausea & Vomiting : Vanderbilt-Ingram Cancer Center

Symptoms & Side Effects Management: Digestive Problems

Nausea & Vomiting

What to expect:

Nausea and vomiting may be caused by the following:

Certain chemotherapy drugs
Heartburn or reflux
Radiation therapy
Tumors in the brain
Infections
Anxiety or worry
Some medications such as pain pills
Severe constipation

Why is it important to keep nausea under control?

Nausea and vomiting that continues for too long causes the fluid and chemical balance of the body to be altered. Patients will stop drinking and eating. This causes dehydration. When patients are dehydrated, they feel light headed, weak, and may faint. Chemical imbalances may result in damage to the heart and kidneys.

What can help?

There are many strategies that can be tried to help with nausea.

Often people feel less nauseated in the mornings, if this is so for you, eat your main meal at the beginning of your day.
Try resting or lying down after eating. Activity slows down digestion and can cause discomfort.
Try not to leave your stomach empty. Eat something if possible. Eat small, frequent meals a day (6-8 a day).
Select foods that move through the stomach quickly like high carbohydrate foods. Crackers, toast, gelatin and juices are good choices.
Avoid fried, high fat and heavily spiced foods. Select unseasoned or lightly seasoned baked, broiled or steamed foods.
Eat slowly and chew food thoroughly.
Try to eat more food during times when you feel better and to avoid favorite foods during tie when you experience nausea. This will keep you from being “turned off” by foods you enjoy.
Often, foods with strong odors will cause you to feel nauseated. If so, stay out of the kitchen when these foods are being prepared, or leave the windows open to let odors out of the house.
Try eating cold or room temperature foods because they give off fewer odors.
Drink liquids throughout the day. (8-10 cups per day to avoid dehydration)
Sip fluids during meal time. Drinking large amounts of fluids during meals can cause a full bloated feeling.
Suck on hard candy, such as peppermint or lemon, if there is a bad taste in your mouth.
Resting after eating and keeping your head elevated about 12 inches above your feet helps reduce nausea.
Mild nausea may be relieved by acupressure. Sometime nausea may improve by pressing down hard with a thumb or finger (for a minute or two) on the groove between the two large tendons (two inches up from and on the inside of, your wrist) that run from the base of the palm up to the elbow.

Common medications used to help with nausea:

There are several medications used to control nausea. They may be used singly or in a combination.

Prochloroperazine (Compazine)
Droperidol (Droleptan, Inapsine)
Haloperidal (Haldol)
Metoclopramide (Reglan)
Ondansetron (Zofran)
Granisetron (Kytril)
Dolasetron (Anzemet)
Methylpredisone : corticosteroids
Dexamethasone (Decadron); corticosteroid
Dronabinol (Marinol)
Lorazepam (Ativan)
Midazolam (Versed)
Alprazolam (Xanax)
Promethazine Hydrochloride (Phenergan) (antihistamine)

When to call the clinic:

Nausea and vomiting are caused by many different types of problems. It is therefore very important to contact your physician if you develop unexpected nausea and vomiting so that treatment recommendations can be made

Please call your healthcare provider when:

Nausea has kept you from eating or drinking.
Nausea is not relieved by medications.
Nausea is accompanied by severe vomiting.
Nausea is constantly present.
Nausea is worse.

Additional Resources/Handouts:

Handout about commonly used Medications to Manage Nausea "When You're Feeling Queasy" The American Dietetic Association
Nausea and Vomiting, National Cancer Institute
American Cancer Society
National Comprehensive Cancer Network

Nausea Medications Information Sheet