The Family Care Research Program

Information for Patients and Caregivers

Nausea

Definition:

Nausea is an unpleasant feeling in the back of the throat and stomach that may or may not result in vomiting.

How do people describe nausea?

Individuals describe nausea as an unpleasant sensation related to food, smells or situations. This sensation may be accompanied by an acidic or bitter taste in the mouth or an abdominal fullness during eating. Some terms people use to describe nausea may include "sick to my stomach", "queasy", or "butterflies". Increased saliva, lightheadedness, dizziness, difficulty swallowing, skin temperature changes and fast heart rate are other symptoms that may also occur with nausea.

What causes nausea?

Nausea can be caused by stimulation of the intestinal tract, a zone in the brain, stimulation in the ear, or irritation in the brain. Nausea and vomiting are two of the most feared side effects of cancer treatment. Today there are many effective medicines to control nausea so that you don’t have to suffer. Chemotherapy, biological and radiation therapy can all cause nausea. Some medicines also have a side effect of nausea. Even taste changes can make you nauseated when foods don’t taste like you’d expect them to.

How do people cope with nausea?

Nausea is different for every person who experiences this symptom. The key is to prevent nausea from occurring. Here are some tips other persons have found helpful:

Get plenty of rest.

Try soda crackers or dry toast.

Eat smaller, more frequent meals to help maintain calories without overfilling the stomach.

Eat foods that are cold or room temperature.

Take anti-nausea medications as directed.

Decrease unnecessary motion.

Sip fluids slowly, such as ginger ale or ginger tea no sooner that 2 hours after the last vomiting episode.

Brush you teeth after meals.

Use non-alcohol containing mouthwashes to improve the taste in your mouth.

Chew gum or suck on hard candy.

Avoid highly acidic foods such as salsa, tomatoes, citrus fruits and citrus fruit juices.

Avoid fatty or fried foods or very sweet foods when you are nauseated.

Try using television or music as a distraction.

Modify your diet to include cool, bland foods.

Avoid milk or products that contain milk.

Decrease the temperature in your home environment.

Avoid foods that you know no longer "taste right" or have strong odors.

Try giving yourself, or have someone give you a foot massage.

What can family members and friends do to help with nausea?

Ask family members and friends to give you a back rub or foot massage to help you relax.

Ask family members and friends to go with you to your chemotherapy treatments to help distract you.

Ask family members and friends to prepare foods for you ahead of time that you can warm up in the microwave later.

Ask family members and friends to prepare bland foods that don’t have strong odors for you to eat.

Ask family members and friends not to smoke around you; the smell of smoke can also worsen nausea.

Ask family members or friends to remind you to take your anti-nausea medicines.

How can I talk to my family about nausea?

Be open with your family members about how the nausea makes you feel.

Ask your family members what they think may be causing your nausea.

Ask for ideas to help deal with your nausea.

Ask you family members how the nausea if affecting them.

What should I report to my doctor or nurse?

Telephone your doctor if vomiting accompanies the nausea and is:
- the color of coffee grounds.
- more than 3 episodes an hour for more than 6 hours
- projectile
- blood-tinged or frank blood
Weight loss of more than 2 pounds in a day.
If you vomit more than once a day for 2 days.
Unable to eat solid foods for 24 hours.
Unable to retain fluids for more than 12 hours with or without the use of anti-nausea medicines.
Stomach pain with nausea.
Persistent weakness or dizziness, or if you are confused (mixed up).
Nausea that lasts for more than a few days
Your urine is dark yellow and you are not going to the bathroom as much as you normally do.

Where can I get more information?

Contact your healthcare provider.
Contact the American Cancer Society at 1-800-ACS-2345 or on the Internet at http://www.cancer.org/docroot/MBC/MBC_2x_OtherEffects.asp?sitearea=MBC
Contact the National Cancer Institute at 1-800-4-CANCER or through the Internet at: http://www.cancer.gov/cancer_information/coping/
Contact the National Institutes for Health on the Internet at: http://www.nlm.nih.gov/medlineplus/nauseaandvomiting.html
Contact the National Comprehensive Cancer Network on the Internet at: http://www.nccn.org/patient_gls/_english/_nausea_and_vomiting/1_introduction.htm
Visit the Oncology Nursing Society’s symptom management website at: http://www.cancersource.com, click on reference center, general cancer information.
Visit the Family Care Research Program on the Internet at: http://www.cancercare.msu.edu/

References:

Grealish, L, Lomasney, A & Whiteman, B. (2000). Foot massage: A nursing intervention to modify the distressing symptoms of pain and nausea in patients hospitalized with cancer. Cancer Nursing, 23 (3): 237-43.
Van Fleet, S. (2000). Relaxation and imagery for symptom management: improving patient assessment and individualizing treatment. Oncology Nursing Forum, 27(3): 501-10.