Help wanted re diet for someone with nausea.

My sister has secondary breast cancer and is experiencing acute back pain, loss of appetite and nausea which is being investigated. She is struggling to force some food down but, because she suffers awful constipation, she is concentrating on high fibre foods like bran flakes, wholemeal bread and fresh fruit but can only manage very small amounts with difficulty. This seems like very hard work to me and I wonder if this is current good practice or could I encourage her to try a light diet, fruit purees, milk puddings etc. It’s what we would have done when I trained as a nurse but I haven’t worked on a ward for years so am completely out of date and don’t know what to suggest. Many thanks. Lillybet.

It might be worth seeing if she could have some domperidone for the nausea. For nausea and vomiting, it’s two tablets taken 15 minutes to half an hour before a meal. I had it throughout my chemo when my nausea was terrible and it did help me to eat something.

I should think that anything she is able to eat more comfortably would be better. How hard to force down things like bran flakes when you feel nauseous. I used fruit purees during chemo, vegetable soups and the like but also light meals such as grilled fish and scrambled egg.

If she’s very constipated having high fibre things may be making her feel really uncomfortable in the tummy. So finding something to help with her constipation is important too. As you will be aware, having bad constipation can also make you feel sick. I suffer from this due to some of my medication and can’t tolerate things like Movicol which give me stomach cramps. I have found that the old fashioned syrup of figs by califig really helps. Obviously check with the doctor first.

take care
Elinda

Hi there, when reading the first post on this thread I did a double take as it exactly describes what I am suffering from at the moment. I get the results of a bone scan on Monday. Meanwhile I drafted in my Macmillan nurse (who is fabulous) to help me manage the pain control. She has proved a godsend as she looks at all the symptoms and impact on daily living in a very holistic way. We will review my meds - morphine sulphate for pain;cyclizine as anti-emetic and omperazole for stomach acid etc. My appetite however remains non-existent - I can’t even bear the sight, smell or discussion of food!The GP has prescribed a liquid food supplement once a day which seems to work well (straws provided!) but I’d dearly love to know what the root cause of it is. Anyone who knows me would tell you that to have lost interest in food is most unusual! The only good thing is that I’ve lost a stone in weight (this loss is now slowed down).I had domperidone through both my chemo’s which proved effective too.Movicol works for me but you have to be ever vigilant about the constipation as it’s the pits! I can understand why your sister is desperate to resolve this. Please pass on my sympathy and good wishes. I hope there’s a useful nugget concealed amongst this account.

Not diet related, but I’ve found smelling peppermint oil helps. My Macmillan lady who does aromatherapy suggested getting a little bottle of the essential oil and dabbing it on a tissue. Apparently Ginger oil good too. Both my oncologist and my nutritionist advised me to go easy on fruit ( especially fruit juice) and of course dairy isn’t a good idea with any tummy probs as it’s hard to digest. My tummy seems happiest with just veggies and veggie juices.

Hi there… I hope i can offer a little help. If you are taking opiate type medication for pain, this includes codeine/morphine etc, it will make you extremely constipated and affect your appetite. Severe constipation will cause nausea and just generally make you feel lousey. Ondansetron 2 times a day for max 5 days will help with the nausea…you might need some dexamethasone too…(check with your GP first) but you need to tackle the constipation at same time. Also if you are currently having chemotherapy, this affects your stomach and bowel,…tends to slow things down a bit.
You will need a diet which is high in protein to help cell growth and repair and with enough fats and carbs to give you the energy you need to recover.
I suggest the following,which is working for me and I am currently 1/2 way through my 6 courses of AC chemo for secondaries.

Constipation
Ensure you get enough water/fluids around 3/4 pints per day. Ask your GP for Dulcolax Pico Perls (small capsules)which are easier to manage than Movicol which I found to be too slimy. A warm hot waterbottle on the lower stomach can also help. Ask your DN if she thinks you might need an enema. Although if you are not eating this may not be apropriate.If you can manage and are not bed bound try to get a little gentle exercise, a little walk everyday in will be beneficial and helps with 'movement’and will improve your apetite. Try not to sit around too much unless really fatigued. Get some sunshine if possible.

Eating/drinking
Important to get a balance of foods and extremely difficult when feeling nauseus. Try the following:

V8 vegetable juice - good source of minerals and tasty too or plain tomato juice.
Fruit drinks from the chiller cabinet (not squash as too sugary and slimy) (not orange or other citrus, bad for stomach acid)with a dash of soda water can be very refreshing.
Home made broth, keep in managable portions in the freezer and much better than tined variety.
Baked potato (make in microwave)with cottage cheese and dollop of butter makes a light nourishing meal.
Prepared toasted cheese sandwich - keep in the freezer and pop in toasty bag when needed.I just make it with one slice of bread and half it.
Mince and potato pureed and some pureed veg might tempt some.Add a large dash of worcester sauce.
Eggs in any form are a good source of nourishment.
Beans on wholemeal toast are a good source of fibre.
Risotto, Morrisons do a good one from the chiller cabinet. Easy to digest and tasty.
Nibble slices of apple, pears, mango or grapes for refreshment.
I hope you get sorted as feeling sick is no fun…
take care
jane