Medical Nutrition Therapy: Problems with Nausea and Vomiting, Loss of Appetite, Altered Taste and Difficulty Swallowing HF#347

Nausea and vomiting:

Medicines, HIV and other infections, tumors and emotional stress are some typical reasons you may experience nausea and vomiting. Persistent vomiting can lead to serious medical problems, including dehydration, electrolyte imbalance, and even tearing of the windpipe.  Tips to reduce nausea and vomiting include:

• Eat and drink slowly, relax. 
• Eat small amounts throughout the day
• Avoid overly sweet, greasy, hot or spicy food or food with strong odor.
• If liquids are tolerated, provide liquids 1 hour after meals (to decrease fullness in the stomach).  Sip slowly and drink liquids you can handle.
• Wipe face with cool water, loosen tight clothes, eat in well-ventilated room
• Stay out of the kitchen when food is being prepared if strong food odors are unappealing.
• Try cold foods—they provide protein and good nutrition and lack in overpowering aroma. Use cold meat plates, sandwiches, cottage cheese, yogurt and cheese.
• Try high calorie shakes or nutritional supplements.
• Select foods lower in fat; avoid fried foods, gravies, cream, and use fats in small amounts.
• Use chilled beverages, popsicles, and gelatin.
• Peppermint, chamomile or ginger tea can help calm the stomach.
• Use salty foods such as nuts, pretzels, crackers, olives or tart foods such as lemon to help control nausea.
• Keep your head elevated when lying down.  Wait 1-2 hours after eating before going to bed.
• Before getting out of bed in the morning, eat a few dry crackers and wait a few minutes.
• Eat colorless, odorless foods such as oatmeal, pasta, mashed potatoes, cottage cheese, applesauce, and rice puddings.
• If you are receiving chemotherapy or radiation treatments, eat a small meal at least 2 hours before treatment.
• Experiment with food to determine your individual tolerances.
• Ask your doctor or pharmacist to help find a medication regimen to control nausea and vomiting.
• Take medicines after meals.
• If vomiting occurs, replenish fluids with broth, carbonated beverages, juice, gelatin, or posicles.
• Call your doctor if nausea or vomiting persists.

 

Poor Appetite:

Some of the reasons for poor appetite include sore mouth or throat, difficulty swallowing, altered sense of taste, fatigue, shortness of breath, depression, anxiety, fever, infection, and medications.  Tips to improve food and nutrient intake when appetite is poor include:

• Eat frequent small meals or snacks
• Engage in mild exercise before meals.
• Use low fat convenience foods requiring little preparation.
• Select high-protein, high calorie foods. You may want to use supplements such as Ensure®, Boost®, or Carnation Instant Breakfast®.
• Eat with friends and/or listen to music during meals.
• Experiment with ways to increase the flavor of foods.
• Ask others to prepare food for you. Package in single serving portions and keep some extra in the freezer. Check into home delivered meal programs.
• Keep in mind adequate nutrition is very important for maintaining strength and health. Try to prepare larger amounts of food and freeze portions for later use. Eat as suggested by the My Plate guidelines (ChooseMyPlate.gov).
• Avoid caffeine, alcohol, cigarette smoking, and recreational drug use.
• Get adequate sleep and relaxation.
• Talk to your doctor about treatment for anxiety or depression.

 

Altered Taste:

Sore mouth and throat, dry mouth and throat, and medications can contribute to altered sense of taste.  Tips to improve the taste of food include:

• If meat is not well tolerated, use meat substitutes such as eggs, cheese, fish and legumes, poultry, yogurt, tuna, peanut butter. Try marinating meat in soy sauce, wine, and fruit juice.
• Add flavorings to milk. Add fruit to milkshakes and ice cream
• Serve protein foods cold or at room temperature.
• Smell is a stronger sense than taste. Try foods that smell good to you.
• Use herbs, sugar, lemon, vinegar, salt and wine to season foods. Try different textures and food temperatures.
• Rinse your mouth frequently to keep it clean and put a fresh taste in your mouth.
• Use liquids, hard candy, mints or gum to limit a bad aftertaste from foods.

 

Difficulty Swallowing:

Some of the reasons for difficulty swallowing may be sore mouth and throat due to candidiasis, herpes, or dry mouth and throat.  Tips to improve your ability to swallow foods include:

• Moisten foods with cream sauce, gravy, broth, cheese sauce, margarine, yogurt or salad dressing.
• Drink liquids with meals and between meals.
• Practice good oral hygiene: flossing, brushing, and rinsing.  Use fluoride gels and mouthwashes or mouth moisturizing products, such as Biotene®
• Avoid rough, coarse, sticky, sharp, spicy, salty, sour or dry foods.
• Use mints, lemon drops, and gum to stimulate saliva.
• Eat semi-liquid, soft textured foods such as cream soups, plain ice cream, pureed fruit, sherbet, mashed potatoes with gravy, creamed tuna, scrambled eggs, pudding, ripe fruits, macaroni and cheese and canned fruit.
• Use a straw. Rinse your mouth frequently, especially after eating.
• Cut foods into small pieces.
• Avoid acidic foods and drinks and carbonated drinks.
• Experiment with the temperature of foods.
• Eat nutrient and energy dense foods to maximize intake.
• Consider asking your doctor about preventative antifungal medicines.

 

If you need more information please contact UW Health at one of the following locations:

 

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 01/02/2013

Copyright © 01/02/2013 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#347

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