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Nutritional Management of Nausea During Cancer Treatment

Ms. Christy Brissette, MSc, RD

Ms. Christy Brissette, MSc, RD is a registered dietitian and nutrition communications expert specializing in cancer survivorship. She is the President of 80 Twenty Nutrition, a nutrition and food media and consulting company. Christy is a TV personality, spokesperson, writer and blogger and is regularly interviewed by the media about nutrition and health.

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Dealing with nausea when you are returning to work can be anxiety-provoking and embarrassing. If your nausea is getting in the way of your work, it’s important to speak to your healthcare team about it. That way, they can help identify the rea-sons for any nausea and vomiting and help you manage.

Nausea can be caused by the cancer itself, cancer treatments or medications. Nausea and vomiting can cause electrolyte imbalances, dehydration and malnutri-tion. These side effects may even cause your cancer treatment to be delayed or even stopped .

Controlling your nausea is important to help you stay well nourished, retain your strength and for your quality of life12.

Nutrition Strategies to Manage Nausea

Eat small, frequent meals or snacks throughout the day. You might be sur-prised to know that an empty stomach makes nausea worse. If you aren’t able to eat meals, try to nibble on some plain crackers or toast every hour.

  • Eat small, frequent meals or snacks throughout the day. You might be sur-prised to know that an empty stomach makes nausea worse. If you aren’t able to eat meals, try to nibble on some plain crackers or toast every hour.
  • Chew your food slowly and chew it well. Eating too fast is tough on digestion.
  • Eat foods at room temperature. Hot foods tend to have stronger smells that might upset your stomach. Quinoa, rice or pasta salads with chickpeas or chick-en, chopped vegetables and olive oil and lemon juice dressing are great cold lunch options. So are wraps or sandwiches with hummus, nut butter, turkey or chicken with vegetables.
  • Stay hydrated by having water, broth, flat ginger ale, herbal teas, ginger tea, sports drinks and suck on popsicles, frozen fruit or ice chips throughout the day.
  • Have fluids after and between meals so you don’t fill up on only liquids.
  • Try having smoothies to replace your meals when you don’t feel up to eating. Put a lid on your smoothie and drink through a straw to help avoid any odours.
  • Ginger may help manage nausea 3. To make ginger tea, slice or grate fresh gin-ger into hot water. Add lemon and honey if desired.
  • At work, keep bags of ginger tea and ginger lozenges in your desk drawer in case nausea strikes.
  • Avoid eating your favourite foods when you’re nauseous.
  • If you have chemotherapy coming up, cook and freeze some meals to prepare so you won’t have to cook during that time.

Nausea-Proof Your Environment

  • If food smells seem to make your nauseous, use a fan when cooking and open windows. If you share a kitchen with others, ask them to eat cold foods that don’t require heating to avoid smells.
  • At work, eat away from the lunch room or cafeteria if food smells bother you.
  • Take breaks outside if possible to get some fresh air. If possible, eat your lunch outside too.
  • Make your eating environment as pleasant as possible. Eat your meals on at-tractive plates, light a candle, and put on some relaxing music.
  • Sit up when you are eating and for an hour afterwards to promote better digestion.
  • Wear loose, comfortable clothing. Anything tight around your stomach could make nausea worse.

Limit Foods and Beverages that Could Upset your Stomach

  • Fatty, oily and rich foods should be avoided because they can be difficult to di-gest.
  • Spicy foods are hard on your stomach. Try eating foods plain when you’re feel-ing nauseous.
  • Beverages that contain caffeine can upset your stomach. Limit soft drinks, tea and coffee with caffeine.

Mouth Care

  • Keep your mouth clean and fresh to prevent nausea. Throughout the day, rinse your mouth with 1/2 teaspoon salt or 1/2 teaspoon baking soda mixed in 2 cups of water. Brush your teeth regularly to get rid of any lingering tastes.
  • Rinse your mouth before eating to clean and moisten.
  • Brush your teeth and tongue before a meal.
  • Keep a toothbrush, toothpaste, mouthwash and mints in your desk drawer at work to keep your mouth fresh.
  • Sucking on sugar-free mint or lemon candies can help get any bothersome tastes out of your mouth.

Speak to a registered dietitian specializing in oncology to help you create a healthy eating plan around foods and beverages that will help manage nausea.

What to Do If You Vomit (Throw Up) 4

  • Stop eating or drinking until the vomiting stops. After an hour, start drinking clear fluids such as water, soup broth, gingerale, or fruit juice that doesn’t have pulp such as apple juice. Jello and popsicles are also clear fluids.
  • If you can keep down clear fluids for the next hour, try some plain starchy foods such as pretzels, toast and crackers.
  • Once starchy foods are tolerated, you can add some sources of protein such as eggs and chicken.

When to Seek Medical Attention for Vomiting 5

Call your healthcare provider or go to the nearest emergency room if:

  • You have nausea that lasts for more than a few days
  • You throw up more than twice a day
  • You can’t keep any liquids or food down
  • You can’t keep your medications down
  • You’re throwing up several times and your pee is dark yellow and you’re not going to the bathroom as often as you usually do
  • You’re throwing up and are feeling dizzy or confused
  • You are throwing up something that looks like coffee grounds (this could be blood)

Complementary Therapies

Nausea and vomiting can sometimes be caused by the expectation that your can-cer treatment will make you nauseous. This is called anticipatory nausea. This type of nausea can be managed with relaxation techniques such as guided hypno-sis, meditation, acupuncture and acupressure.

Ask your health care provider about these options or look for a cancer support or-ganization in your community that may offer workshops on relaxation.

Medications

Talk to your doctor about medications that can help with nausea. Your oncologist can al-so take a look at some of the medicines you’re taking already to see if they could be caus-ing your nausea.