To Puke or Not to Puke – That is the Question

Some people receiving chemotherapy experience nutritional associated side effects. Nutritional associated side effects influence what or how much we can eat, the way the body uses the food that is eaten and also body size. This can be quite debilitating and worrying. Nutritional problems associated with chemotherapy include: nausea and vomiting, taste changes, a sore or painful mouth, diarrhoea, constipation, weight loss, weight gain, fatigue and fluid retention. But let’s start with the most common one.

Nausea and Vomiting

Discuss nausea with your doctor! Anti-nausea medication has come a long way and works best when it is taken regularly about half an hour before meals. Try not to take any of your other medication on an empty stomach. Using a mouthwash before and after meals, as well as after vomiting, may help.

What to Eat

• An empty stomach can make nausea worse. Try to eat 6-8 small meals during each day.

• Don’t lie down directly after eating. Try to stay upright for one hour after eating. If you must lie down, raise your upper body with pillows or sit in a chair with your feet raised.

• Cold foods may be better tolerated than warm foods.

• Avoid sweet, spicy, rich and greasy foods if they upset you. Avoid the smells of food cooking and try to eat in a well-ventilated room or outdoors to reduce odours.

• Bland tasting dry foods may be better tolerated and help to settle your stomach.

• Suitable bland foods to try: provita, plain toast, cream crackers, ryvita, plain biscuits, dry cereal. These foods are useful when taken early in the morning when you wake up or as mid-meal snacks during the day.

• The following foods have reportedly helped some individuals: English marmalade,* ginger tea, ginger beer, ginger ale, grated fresh ginger, candied ginger, ginger nuts, sardines, salty crackers, peppermint tea, fresh lemon or lime.

What to Drink

• Don’t drink an entire cup or glass of liquid down all at once! Take it slowly. Sip liquids slowly but consistently during the day.

• Add 1⁄2 -1 cup of liquid for every episode of vomiting. In other words: if you normally drink 8 glasses of water per day and you have vomited twice today then you will have to drink a total of 9-10 glasses of water today.

• Wait 30 – 60 minutes after eating before having a drink.

• Fizzy drinks may be better tolerated if drunk slowly through a straw.

• You may not feel like a “nice cup of tea”! Drink beverages cool or chilled. You may also try freezing juices in ice cube trays and sucking them like ice.

• Suggestions: water or ice cubes to suck, frozen ice lollies, regular or herbal teas, tea with lemon, diluted fruit juices or cordials, soda water, mineral water, ginger ale or Lucozade*.

* Diabetic patients should use diabetic marmalade, diet cordial juices and sugar-free drinks.

TRY

AVOID

PROTEIN

Grilled steamed or baked fish or chicken, cold meats, tuna in brine, low fat yoghurt, cottage cheese, boiled or scrambled or poached egg

Fatty and fried meats, pies, bacon, fried eggs, sausages

STARCHY FOODS

Plain crackers, unbuttered bread or toast, cold cereal, plain pasta, boiled rice, boiled or baked potatoes

Fried chips

FRUIT AND VEG

Fresh fruits: paw paw, grated apple, banana or tinned fruit. Soft vegetables e.g. squash, pumpkin, butternut, soft carrots, beetroot, baby marrow

Spicy seasoned or fried vegetables and those with strong odors

GENERAL

Diluted fruit juice, sports drinks, fizzy drinks, ginger ale, lemon tea, ice suckers. Sour sweets, jelly, low fat custard. Marie biscuits, plain sponge cake. Diabetics should substitute with diet cordial juices / cold drinks and diet jelly.

Alcohol, coffee, pastries, cream cakes, chocolate and chocolate cake.

For more information or advice please contact ADSA (Association of Dietetics in South Africa) on 011 789-6621 or go to www.adsa.org.za for details of a registered dietitian in your area.

Written by Nadia Bowley

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