Nausea & Vomiting

Nausea and vomiting are common causes of weight loss. These symptoms can be caused by a number of things, including infections, fever, chemotherapy, pain, and drug side effects. If you continue to have nausea and/or vomiting for any prolonged period of time then your doctor should be consulted as soon as possible.

It may be that a specific drug is causing the nausea and vomiting, but do not stop taking this medication without advice from you doctor. These symptoms can often be helped by anti-sickness medication (anti-emetics). Your doctor will be able to advise you about this. Certain anti-emetics may need to be taken 30 minutes prior to food (or prior to the medication causing the sickness) so make sure you have discussed this with the pharmacist or doctor. There are several types of anti-emetics so if one does not relieve symptoms ask to try a different type or enquire about symptom control clinics.

Losing weight or becoming dehydrated are common when experiencing nausea and vomiting. Food is vital at this time and choosing the right ones can play an important role in controlling these symptoms.

Coping with nausea:
* Try to eat with a window open and in relaxed surroundings.
* Avoid tight fitting clothes.
* Avoid lying down directly after a meal.
* Eating small, frequent meals is a good idea. Nausea is often worse when there is nothing in your stomach. Six small snacks or meals in a day can be easier to manage than three large meals.
* If the smell of food bothers you try eating cold meals or snacks. Try choosing meals that don’t take long to prepare such as ready meals or convenience foods or ask someone else to prepare food for you.
* Some drugs may cause nausea if taken on an empty stomach - your pharmacist or dietician may be able to offer advice.
* Try drinking in between meals rather than with them.

Foods that may aggravate nausea:
* This is very individual, only avoid foods if they cause a problem to you. The following can sometimes worsen symptoms:
* Very spicy foods
* Rich (creamy), fried or fatty foods
* Strong smelling foods.

Foods that may be better tolerated:
* Start the day with dry foods like cereals, crackers, toast. It may help to put some food by your bed at night and eat it even before you get up.
* Salty foods like crackers, crispbreads, crisps, marmite or bovril may help calm your stomach.
* Cold foods like ice-cream, sorbet, frozen yoghurt, yoghurt/fromage frais, jelly and custard may be easier to take.
* Try cool, clear liquids like fruit juice or cordials drinking them slowly through a straw
* Peppermint teas and mints can help calm symptoms.
* Ginger products can often calm nausea- try ginger biscuits or ginger ale.

Other snack/small meal ideas:
* Cheese and biscuits, crackers, crispbreads, toast (plain, with a scraping of butter or with jam or marmite etc), sandwiches with plain fillings.
* Muffins, crumpets, scones, teacakes, plain cake
* Plain semi-sweet biscuits (e.g. rich tea, digestives, gingernuts, Marie, garibaldi etc)
* Yoghurts/fromage frais, mousse, jelly, custard, creme caramel, ice-cream
* Pieces of fruit (chilled) e.g. melon, apple, banana
* Breakfast cereals (taken dry, with milk, yoghurt or fruit juice)
* Soups (tinned or packet) with dry toast
* Egg on toast, boiled egg, scrambled egg

Fluids:
If you are vomiting it is important to try and keep your calorie and fluid intake up as much as possible. It is very easy to become dehydrated (urine becomes darker and more concentrated), especially if experiencing diarrhoea as well.
* Take frequent sips of fluids or drink slowly from a straw.
* Always try to have something that contains energy rather than just plain water. For example:
* fizzy drinks (not diet/low calorie/slimline), ginger ale, lucozade and isotonic sports drinks (NB: if the bubbles aggravate, stir in a teaspoon of sugar to make the drink go flat).
* squashes, cordials e.g. elderflower, Ribena - can be diluted with soda, tonic water or lemonade.
* fruit juices: often better tolerated if diluted with soda, water or lemonade
* milk: semi-skimmed may be better tolerated than full fat
* drinking yoghurts, Milkshakes & Fruit Smoothies (see Nourishing drinks fact Sheet)

Supplement drinks/sip feeds (available from your dietitian) are concentrated sources of calories and protein.

Oral rehydration solutions (OHS) (available from your doctor or the chemist) can help you replace fluids and electrolytes (salts/minerals) when at risk of dehydration. If symptoms of nausea and vomiting persist, consult your doctor. If weight loss continues, arrange to see a dietitian for further advice.