Nausea is an uneasiness of the stomach that often accompanies the urge to vomit. Nausea does not always lead to vomiting (also called throwing up, emesis, and informally, barfing). 

Nausea and vomiting can be caused by a health condition or by a treatment such as chemotherapy.There are different areas in the body that are responsible for causing nausea. This is why nausea is often treated with a variety of different medications and strategies.

Preventing Nausea and Vomiting

Prevention is the first line of defense against nausea and vomiting. Preventive medications intefere with triggers that can cause nausea and/or vomiting. These medications can be used before treatment. Speak with your doctor about available medications for your situation and when to take them. Consider asking the doctor if it is okay to record the conversation so you are sure to get all the information correct. If not, consider taking notes.

How To Treat Nausea and Vomiting

Nausea should be treated early and aggressively to help prevent nausea becoming vomiting. Vomiting can lead to dehydration and other medical difficulties.

Anti-nausea medicines are very effective in relieving or preventing nausea and vomiting. Talk with your doctor about which medication is right for you. If a particular medication doesn't work, talk to your doctor about trying something else. Non-drug techniques also help with nausea.

• For treatments featuring medications, click here.
• For non-medication teatments to consider, click here. 
• For a list of foods and liquids that are easier on the system during periods of nausea and vomiting, click here. 
• For a list of foods and liquids to avoid, click here. 
• What to do and not do if you just had a bout of vomiting, click here.

Tell your doctor or nurse if: you are very nauseated, if you have been vomiting for more than a day, or if your nausea is so bad that you cannot keep liquids down.

Some helpful tips:

• If you have a nausea prescription, do not wait to experience nausea before filling the prescription. Fill it now - and carry the medication with you whenever possible "just in case."
• Carry a bag with you in the event that you become nauseous while outside the home. A plastic bag will do. For creative ideas about bags, click here.
• Keep track of your symptoms to help facilitate a discussion with your doctor or other health care provider. Survivorship A to Z provides a symptoms diary to help you keep track. When you are ready to see a doctor, a click of a button changes your diary into an easy to read, time-saving, graph. 
• When you are feeling okay, eat bigger meals with extra calories. Ask your doctor if there are foods to avoid.
• Consider avoiding your favorite foods while feeling nauseous. You may end up associating those foods with treatment and side effects so the favorite foods could end up triggering a negative physical response post-treatment.

Some common triggers that may result in nausea or vomiting are:

• Drugs: Prescription, over the counter and/or chemotherapy
• Motion or sea sickness
• Early pregnancy
• Intense Pain
• Exposure to toxins
• Fear
• Viral infection
• Infection, injury or food irritation of the stomach and intestines
• The inner ear (dizziness and motion sickness)
• The brain (head injury, brain infections, tumors, and migraine headaches)
• Food poisoning
• Indigestion
• Certain smells or odors

The following non-drug methods help with nausea and vomiting. Consider experimenting with each to see which do, and do not, work for you. It is advisable to keep track of when nausea occurs and the apparent causes for it. In to helping you figure out how to cope with your situation, you can report accurately to your medical team.

Food and Drink Do's 

• Overall: Eat and drink slowly.
• Food
  • Eat frequent, small meals 6 - 8 times throughout the day instead of 1, 2, or 3 large meals.
  • Eat your largest meal of the day at the time when you feel your best.
  • Eat light, bland foods such as plain bread.
  • Prepare and freeze meals in advance.
  • Chew your food well for better digestion
  • After eating, rest in a chair. 
  • Avoid strong smells
    • Eat foods cold or at room temperature (warm)
    • Limit foods with strong odors such as onions, broccoli, or cauliflower
  • If nausea is a problem in the morning, try eating dry foods, such as cereal, toast, or crackers, before getting up.
    • Keep them by the bed so you can eat them before getting up. 
    • Don't try this if you have mouth or throat sores or are troubled by a dry mouth.
• Drink
  • Drink liquids at least an hour before or after mealtime instead of with your meals.
  • Drink cool, clear liquids, such as apple juice, tea, ginger ale that has lost its fizz, flavored gelatin, popsicles.
  • If you have difficulty drinking enough liquids, suck on ice cubes, juice popsicles, mints, or tart candies. (Do not eat tart candies if you have mouth or throat sores.)
  • According to Deborah Christensen, BSN, RN, OCN, NNB-BC: "Fatigue, dizzines, dark yellow urine, and feeling thirsty are signs that more fluid (preferably water) is needed. Sipping water throughout the day can help improve absorption."
• Try ginger. Ginger is a natural anti-nausea agent.  For example:
  • Put a few drops of ginger extract into a glass of fizzy water
  • Ginger in tablets 
  • Flat ginger ale.
  • Steep ginger as tea for the soothing warmth.
  • Ms. Christensen provides the following recipe for ginger tea: Make a ginger tonic by peeling and cutting fresh ginger into half-inch pieces and steeping in hot water for 5 to 10 minutes.  Ginger tea can be consumed hot or cold.
  • For additional ways to use ginver to prevent nausea, see Home Remedies For Life
• Consider using Queasy Pops or Queasy Drops which come in several different flavors and were developed by healthcare professionals.

Food And Drink Don'ts

• Food 
  • Do not eat big meals so your stomach will not feel too full. 
  • Do not lie flat for at least 2 hours after you've finished your meal.
  • Don't eat sweet, fried, spicy, heavy or fatty foods.
  • Don't undertake physical activity right after eating.
• Drink
  • Don't drink fizzy drinks and acid juices (such as orange juice).
  • Don't drink caffeinated drinks such as tea, coffee, and many sodas.

Pressure On Your Forearm

Pressure to a particular point on the forearm (P6 acupoint on the wrist) has been shown to combat nausea and vomiting. Pressure can be applied by your fingers or by bands.

To find the pressure point, hold one arm out in front of you with the palm up. Locate the nausea pressure point by placing the middle three fingers of the other hand across the wrist, with the ring finger at the crease. The point is just after the index finger in the center of your forearm, between the two tendons you can feel through your skin.

To use your fingers: Using your thumb, place firm (but not uncomfortable) pressure on the point. It may take up to five minutes to experience relief.

Nausea bands: Are available in drug stores and on line (search in your favorite search engine on "Nausea bands"). While bands are convenient to use, they may not apply enough pressure to be effective but may be worth the try if you are having difficulty with using your fingers.

General

• Try to avoid odors or any smell that bothers you, such as cooking smells, smoke, or perfume.
• Distract yourself. For examle:
  • Talk with friends or family members 
  • Watch a movie or TV show.
  • Listen to soothing music.
• Try aromatherapy, for example with essential oil of ginger or the nonprescription product QueaseEASE.
• Breathe deeply and slowly when you feel nauseated.
• Consider music therapy either under the guidance of a certified music therapist or on your own.
  • To do music therapy on your own, listed to your favorite soothing music in a relaxed setting.
  • To find a certified music therapist, ask at your treatment center or look at the web site of the organization known as The Certification Board for Music Therapists,www.cbmt..or g. Click on "Find a Board Certified Music Therapist" or call 800.765.2268.

Relaxation techniques may be especially helpful with anticipatory nausea and vomiting. They are best used along with anti-emetic drugs. For example:

• Biofeedback
• Deep breathing
• Guided imagery
• Hypnotherapy (including self hypnosis)
• Massage therapy
• Music therapy
• Progressive muscle relaxation

NOTE: 

• Try to eat foods from the various food groups for good nutrition.
• Try to drink liquids to keep hydrated. Dehydration is a common problem that accompanies vomiting.

The key to effective control of nausea and vomiting is to prevent it before it occurs whenever possible. Drugs used to preventnausea are called anti-emetics. 

Drugs used alone or in combination to prevent or decrease nausea and vomiting include the following in alphabetical order (generic name first, brand name second):

• Aprepitant (Emend)
• Corticosteroids such as dexamethasone (Decadron)
• Dolasetron (Anzemet)
• Granisetron (Kytril)
• Lorazepam (Ativan)
• Metoclopramide (Reglan)
• Ondansetron (Zofran)
• Palonosetron (Aloxi)
• Prochlorperazine (Compazine)
• Promethazine (Phenergan)

The following lists of foods are from the National Cancer Institute (NCI):

• A list of full liquid foods that are easier during periods of nausea and vomiting. 
• A list of foods and liquids that are easy on the stomach.

FULL LIQUID FOODS

FOODS AND LIQUIDS THAT ARE EASY ON THE STOMACH

Avoid:

• Greasy and processed foods, and foods that contain a lot of salt. Some of these are white breads, pastries, doughnuts, sausage, fast-food burgers, fried foods, chips, and many canned foods.
• Foods with strong smells.
• Caffeine, alcohol, and carbonated drinks.
• Very spicy foods.

It is helpful to carry a vomit bag with you 24/7 “just in case.”  

A gallon size plastic baggie will do. If you want more elegant solutions, consider the following ideas:

• A bag from an airplane
• Chick sick sacks from www.chemochicks.com
• A sporty bag at www.redebag.com
• Convenience bags from Walgreens (www.walgreens.com )
• A no frills bag at www.SickSaver.com

Consider the following helpful tips. If you have additional tips, please share the information at Survivorship A to Z

• After about an hour after vomiting, help settle your stomach and rehydrating by taking small sips of clear liquids such as broth or apple juice. You can also suck on ice chips.
• Eat mild foods such as crackers or toast.
• Use relaxation techniques such as:
  • Deep Breathing
  • Meditation
  • Techniques For Coping With Stress
  • Visualization
• Once you have gone at least 8 hours without vomiting, you can start eating solid foods. It is recommended that you start with one food at a time and that you eat small amounts to get started. For foods that are easier to eat, click here.   For foods to avoid, click here.