Nausea, Diarrhea, Constipation

Nausea and vomiting

There are many different causes of nausea. It’s a response to intense pain. It’s side effect of chemo therapy. It can be caused by something as simple as the flu. Or as complex as a blockage in the bowels. Talk to your doctor to learn more about the reason for your nausea. There may be treatments that are specific to the cause. Below are general tips and remedies for calming the stomach.

To ease nausea:

• Eat smaller meals spread over the day
• Focus on bland foods
• Eat slowly
• Eat food that is cool or room temperature rather than hot or cold.
• Rest in an upright position, or with the head at least 12″ above the feet. Avoid lying flat when nauseated.

Foods to avoid:

• Milk or dairy products
• Fried, greasy or high fat foods
• Spicy foods
• Raw vegetables
• Citrus or other acidic foods

In terms of liquids

• Avoid alcohol and caffeine
• Drink liquids between meals rather than during meals
• Drink only clear liquids (broth, non-caffeinated tea, jello or juices—no citrus)
• Try ice chips

Other nausea remedies

• Massage
• Progressive relaxation
• Guided imagery
• Cannabinoids
• Acupuncture
• Ginger

If vomiting occurs

• Let the stomach stay empty for a few hours until the nausea passes
• Suck on ice chips, or take sips of water ever 15 minutes for 3-4 hours.
• Add clear liquids (broth, non-caffeinated tea, jello or juices—no citrus)
• Avoid citrus juices and milk.

As the stomach settles

Start with the “BRAT” diet first,

• Bananas
• Rice
• Apple sauce
• Toast (no butter) or crackers

If the stomach feels better, graduate to soft solids with little to no spice or fat

• Cooked cereals
• Scrambled or soft boiled eggs
• Chicken
• Cooked vegetables
• Stewed fruit

Constipation

Constipation is frequent and uncomfortable problem with serious illness.  There are several possible causes.

Pain medicines
Certainly those on pain medicines experience constipation as a side effect. Opioids slow muscle movement, including the muscles of the intestines. Stool sits in the bowel longer, so more water gets absorbed. The stool then gets hard and difficult to pass.

Not eating much
When people don’t feel well, they often lose their appetites. It’s a natural reaction. Without much input, there’s very little output. Going infrequently is not a problem in and of itself. Having a bowel movement once every 1-3 days is still normal. The issue is when there is bloating or discomfort. Or when it’s painful to pass what stool there is. The remedies below will help.

Not enough exercise
The intestines are a muscle with nerves that cause coordinated ripples to push stool towards the rectum. Exercise and movement stimulate those nerves and muscles. Consider walking, or the yoga pose described below. If illness is causing the person you care for to spend a lot of time in bed, then a stimulant might be needed.

A mass or blockage
This could be a tumor in the intestine. In that case, surgery would be in order. The more common physical blockage is a build-up of stool that has become too hard to pass. Sometimes the remedies below can help with impaction. Often an enema will help to soften the stool and provide lubrication for a smoother passage. If that is not successful, the blockage may have to be removed manually.

Here are ways your loved one can avoid or prevent constipation:

• Drink plenty of fluids. 8-10, eight-ounce glasses of water or nonsugar, noncaffeinated beverages per day.
• Ask for a stool softener or laxative. Find out what preparation the doctor recommends.
• Eat high-fiber foods when possible. These include vegetables, uncooked fruits (with the skins), and whole grains.
• Sprinkle bran on food. Adding 1-2 tablespoons per day (along with drinking lots of liquid) can help keep the bowels moving.
• Exercise when possible. Walking is the easiest aerobic exercise.
• Try a simple yoga pose. The “Gas-Releasing Pose” is very effective with constipation. Lie on the bed and bring the knees to the chest. Rotate the knees in a circular fashion. Lift the forehead to the knees if possible and hold for 30 seconds. Any movement that stimulates the abdomen will help.
• Sit upright to go. People who use a bedpan have more trouble with constipation than those who can walk to the toilet and sit upright. Consider a bedside commode if walking is too difficult.
• Call the doctor if more than 2-3 days pass without a bowel movement.

Diarrhea

Diarrhea may be caused by the illness. Or it may be a side effect of medication or treatment. Talk with the doctor about appropriate responses. In the meantime, you want to guard against dehydration which can lead to fatigue, confusion, and bed sores. Try the following strategies:

• Drink plenty of clear liquids (e.g., water, juice, and broth), especially between meals.
• Eat foods that are low in fiber and high in potassium and protein (e.g., rice, bananas, eggs, toast, crackers, applesauce, mashed potatoes).
• Avoid spicy or fried foods and most milk products (although some people respond well to yogurt).
• Reduce or eliminate caffeine (e.g., coffee, black tea, chocolate, and many kinds of sodas).
• Talk to the doctor about medications that can help firm the stool.