Managing Nausea and Vomiting at Home

Frequent vomiting can be dangerous because it can lead to dehydration. It can also lead to inhaling food or liquids, which can cause choking and other problems.

Be sure to tell your cancer care team if you have nausea or are vomiting because there are medicines that can help. These medicines should be taken on a regular schedule, or as needed, as prescribed by your doctor. And if a certain drug doesn’t work, your cancer care team may be able to recommend another one. It may take a few tries to find the medicines that work best for you. Talk with your cancer care team about what's causing your nausea and vomiting and what you can do about it.

What to look for

• Changes in eating habits
• Foul mouth odor
• Yellow or green foul-smelling fluids on bedclothes
• Feeling queasy or having an upset stomach
• Increased saliva, clamminess, and sweating that may come before vomiting

What the patient can do

For nausea

• Eat the foods you like and those that sound good to you. For example, some people develop a dislike for red meat and meat broths during treatment. In that case, try other protein sources, such as fish, chicken, beans, and nuts.
• If the nausea only happens between meals, keep something in your stomach. Eat frequent, small snacks throughout the day. Snack ideas include smoothies, trail mix, and fruit.
• Do not skip meals or snacks. If your stomach is empty, your nausea might be worse.
• On chemotherapy treatment days, eat a small meal or snack before treatment.
• Try to avoid eating your favorite foods when you have nausea. If you eat foods you like when you are nauseated, you could find them unappealing when treatment is over because you associated them with feeling sick.
• Sip liquids slowly throughout the day. You may find it easier to tolerate cold and clear liquids (Clear liquids are those you can see through, such as ginger ale, apple juice, broth, tea, etc.)
• Also try popsicles or gelatin. Suck on hard candy with pleasant smells, such as lemon drops or mints, to help get rid of bad tastes. (Don’t eat tart candies if you have mouth sores.)
• Eat bland foods, such as dry toast and crackers.
• Eat food cold or at room temperature to decrease its smell and taste. 
• Avoid fatty, fried, spicy, or very sweet foods.
• Try small amounts of foods high in calories that are easy to eat (such as pudding, ice cream, sherbets, yogurt, and milkshakes) several times a day. 
• Use butter, oils, syrups, sauces, and milk in foods to raise calories. 
• Avoid low-fat foods unless fats upset your stomach or cause other problems.
• Tart or sour foods may be easier to keep down (unless you have mouth sores).
• Try to rest quietly while sitting upright for at least an hour after each meal.
• Distract yourself with soft music, a favorite TV program, or the company of others.
• Tell your cancer team about the nausea, because there are many drugs that can help it.
• Take your anti-nausea medicine at the first signs of nausea to help prevent vomiting.
• While waiting for your nausea medicine to work, relax and take slow, deep breaths.
• Try some non-drug treatments for nausea and vomiting

Complementary or alternative (non-drug) treatments for nausea and vomiting

What to eat or not eat on days that you have nausea*

	Eat	Foods that may cause problems
Protein foods	Boiled or baked meat, fish, and poultry; cold meat or fish salad Well cooked eggs Cream soups made with low-fat milk Non-fat yogurt Juice-type commercial protein supplements (for example, Ensure Clear) blended with ice and eaten with a spoon Cottage cheese Cold sandwiches	Fatty and fried meats, like sausage or bacon Fried eggs Milk shakes (unless made with low-fat milk and ice cream)
Breads, cereals, rice, and pasta	Saltines, soda crackers, bread, toast, pretzels, cold cereal, English muffins, bagels Plain noodles, white rice	Doughnuts, pastries, waffles, pancakes, muffins
Fruits and vegetables	Potatoes (baked, boiled, or mashed)   Canned or fresh fruits, vegetables as tolerated (do not eat if appetite is poor or nausea is severe)	Potato chips, fried potatoes such as french fries or hash browns Breaded, fried, or creamed vegetables; vegetables with strong odor
Drinks, desserts, and other foods	Ginger ale, cold fruit drinks, caffeine-free and noncarbonated soft drinks such as fruit punch and sport drinks, caffeine-free iced tea Sherbet, fruit-flavored gelatin Angel food cake, sponge cake; vanilla wafers Pudding made with low-fat milk Popsicles, juice bars, fruit ices Pretzels   Salt, cinnamon, spices as tolerated	Alcohol Coffee Tea Pie, ice cream, rich cakes Spicy salad dressings Olives Cream Pepper, chili powder, onion, hot sauce, seasoning mixtures

*Adapted from The Academy of Nutrition and Dietetics; 2013

For vomiting

• If you are in bed, lie on your side so that you won’t inhale the vomit.
• Ask that medicines be prescribed in the form that would be easiest for you to tolerate, such as dissolving tablets or suppositories, if possible. To prevent vomiting, take the medicine at the first hint of nausea.
• Wait for the vomiting to stop before eating or drinking anything. After vomiting stops, start taking in small amounts of clear liquids slowly and increase as tolerated.
• Sit upright after vomiting.
• Try liquids in the form of ice chips or frozen juice chips, which can be slowly dissolved in your mouth.

What caregivers can do

• When the patient feels nauseated, offer to make meals or ask others to make meals to reduce bothersome food odors. Use kitchen vent fans to reduce smells.
• Cover or remove foods with strong or unpleasant smells.
• Use plastic forks and spoons rather than metal ones, which may cause a bitter taste..
• Ask about medicines to help prevent vomiting.
• Watch the patient for dizziness, weakness, or confusion.
• Try to help the patient avoid constipation and dehydration by encouraging them to sip on clear liquids slowly throughout the day. Either of these can make nausea worse.

Call the cancer care team if the patient

• Might have inhaled some of the vomited material
• Is vomiting over a period of days,
• Vomits blood or material that looks like coffee grounds
• Cannot take in more than 4 cups of liquid or ice chips in a day or hasn’t eaten for more than 2 days
• Can’t take medicines
• Becomes weak, dizzy, or confused
• Loses 2 or more pounds in 1 to 2 days (This means they are losing water quickly and might be getting dehydrated.)
• Has dark yellow urine and doesn’t urinate as often or as much