Managing Nausea and Vomiting at Home
Nausea is having a sick or queasy feeling in the stomach, and vomiting is throwing up food or liquids from the stomach. Nausea can happen when a person isn’t even thinking about food. And a person can vomit even if they haven’t eaten anything. Sometimes they vomit even if they haven’t had any nausea.
Nausea or vomiting can be caused by eating something that disagrees with you, by bacteria in food, by infections, or by radiation or chemo treatments for cancer. Many people have little or no nausea or vomiting with these treatments. For others, just thinking about going for one of the treatments can cause nausea or vomiting. Cancer by itself can also cause nausea and vomiting.
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. Talk with your cancer 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
- If the nausea only happens between meals, eat frequent, small meals and have a snack at bedtime.
- Drink clear liquids served cold and sipped slowly. (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.
- Eat the foods you like. Many people develop a dislike for red meat and meat broths during treatment. Try other protein sources, such as fish, chicken, beans, and nuts.
- 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.
- If you have nausea just before chemo or other appointments, ask about medicines, hypnosis, relaxation, or behavioral treatment to lessen this problem.
- 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 of dissolving tablets or suppositories, if possible. To prevent vomiting, take the medicine at the first hint of nausea.
- Try liquids in the form of ice chips or frozen juice chips, which can be taken slowly.
- After vomiting stops, start taking in 1 teaspoon of cool liquid every 10 minutes. Gradually increase to 1 tablespoon. If you are able to keep that down after an hour or so, try larger amounts.
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.
- If the patient is vomiting over a period of days, weigh them at the same time each day to help decide if dehydration is getting severe.
- Ask about medicines to help prevent vomiting.
- Watch the patient for dizziness, weakness, or confusion.
- Try to help the patient avoid constipation and dehydration. Either of these can make nausea worse.
Call the cancer team if the patient:
- Might have inhaled some of the vomited material
- Vomits more than 3 times an hour for 3 or more hours
- 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 can’t eat 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.)
- Develops dark yellow urine (pee) and doesn’t have to urinate as often or as much
Fauci AS, Braunwald E, Kasper DL, et al (Eds). Harrison’s Principles of Internal Medicine, 17th ed. New York: McGraw-Hill Medical, 2008.
Camp-Sorrell D, Hawkins RA. Clinical Manual for the Oncology Advanced Practice Nurse, Second Ed. Pittsburgh: Oncology Nursing Society, 2006.
Cope DG, Reb AM. An Evidence-Based Approach to the Treatment and Care of the Older Adult with Cancer. Pittsburgh: Oncology Nursing Society, 2006.
Houts PS, Bucher JA. Caregiving, Revised ed. Atlanta: American Cancer Society, 2003.
Kaplan M. Understanding and Managing Oncologic Emergencies: A Resource for Nurses. Pittsburgh: Oncology Nursing Society, 2006.
Kuebler KK, Berry PH, Heidrich DE. End-of-Life Care: Clinical Practice Guidelines. Philadelphia: W.B. Saunders Co. 2002.
National Comprehensive Cancer Network. Palliative Care. Version 1.2015. Accessed at www.nccn.org/professionals/physician_gls/pdf/palliative.pdf on March 19, 2015.
Oncology Nursing Society. Cancer Symptoms. Accessed at www.cancersymptoms.org on April 3, 2013.
Ripamonti C, Bruera E. Gastrointestinal Symptoms in Advanced Cancer Patients. New York: Oxford University Press, 2002.
Varricchio CG. A Cancer Source Book for Nurses, 8th ed. Sudbury, MA: Jones and Bartlett, 2004.
Yarbro CH, Frogge MH, Goodman M. Cancer Symptom Management, 3rd ed. Sudbury, MA: Jones and Bartlett, 2004.
Last Medical Review: June 9, 2016 Last Revised: February 13, 2017