Nausea and Vomiting

Many patients experience nausea and vomiting at sometime during the treatment process. It is one of the side effects of chemotherapy and radiation.

Contrary to what most people think, nausea and vomiting have little to do with your stomach. They are actions controlled by certain centers in your brain and are involuntary. Willpower alone cannot stop nausea and vomiting.

A number of things can trigger nausea and vomiting:

• Chemotherapy agents
• Radiation
• Persistent pain
• Poor kidney and liver function
• Medications, such as some narcotics
• Infections of the gastrointestinal tract
• Electrolyte disturbances

Thankfully, just as medicine has advanced against cancer itself, great progress has been made in preventing and treating nausea and vomiting. Some patients have little or no nausea and vomiting and can keep eating during most of the transplant process.

Anti-nausea (antiemetic) medications are often started before radiation and chemotherapy, and then are continued on a regular schedule. The fact that you have not vomited means that the medicine is working.

Many antiemetics can affect people differently--some people may feel sleepy, while others may become jittery and restless.

Your Goals

• Prevent nausea and vomiting, or manage the symptoms well.
• Take anti-nausea medicines.
• Maintain nutrition and fluid intake.
• Call for professional help when needed.

Call the Clinic (206) 288-1000 or the UW Medical Center Operator (206) 598-3300 IMMEDIATELY if

• You are having uncontrolled (constant) nausea and vomiting.
• Blood or "coffee ground" material appears in the vomit.
• You can't keep medicine down because of vomiting.
• You feel weakness or dizziness, along with nausea and vomiting.
• You have severe stomach pain while vomiting.

Important Signs and Symptoms (report any of these symptoms to your doctor or nurse during clinic hours each day):

• Nausea persists without control from anti-nausea medications.
• Vomit shoots out for a distance (projectile vomiting).

What You Can Do at Home

• Prevent nausea and vomiting, or manage symptoms well.
• Take your anti-nausea medicine as instructed before nausea starts.
• Prior to chemotherapy, lie down in a quiet place for 15 to 20 minutes and relax.
• Wear loose-fitting clothes.
• Use distractions (such as tapes), relaxation, deep-breathing, visualization, or hypnosis techniques. Try breathing through your mouth.
• Keep your mouth clean. Rinse with water often.
• Rest in a chair after eating, keeping your head elevated.

Take Anti-nausea Medications

• If you notice that the anti-nausea medicine does not seem to be controlling your nausea, let the nurse know. Different medicine may be used to better control the nausea.
• Do not increase the amount of medicine you take without checking with your nurse, doctor, or pharmacist.
• Do not take any over-the-counter medicines without checking first with your nurse or doctor.
• Some anti-nausea medicines can cause sleepiness. Do not drive a car or operate any dangerous equipment when you are taking them.
• Do not drink alcohol while taking anti-nausea medicines.
• If the medicines seem to make you nervous, jittery, or cause any unusual sensations, let your nurse know.
• Since anti-nausea medicines can make you drowsy, it is advisable to have your caregiver stay with you throughout this treatment period.

Maintain Nutrition and Fluid Intake

• Eat small meals during the day so your stomach is never too full.
• Eat and drink slowly so only small amounts enter your stomach at one time.
• Avoid eating and drinking one hour before and one hour after chemotherapy.
• Stay away from sweet, fatty, or fried foods.
• Drink cool, clear fruit juices.
• Eat dry food, like toast or crackers, to help ease nausea.
• Avoid odors that bother you. If food smells make you sick, avoid being in the kitchen when food is being prepared.
• Avoid extreme temperatures in your food.
• Keep a wide choice of food available.
• Call for professional help when needed.