The Triple Threat: Nausea, Vomiting & Diarrhea — What you need to know
Article at a Glance
- 4 Myths related to the trio: nausea, vomiting and diarrhea during treatment.
- Effective and sustainable tactics you can learn and apply throughout your treatment journey to minimize the challenges.
“If you don’t become the ocean, you will be seasick every day.”
— Leonard Cohen
I’ve heard some cancer patients describe the start of their treatment journey feeling as if they were “a cork in the ocean”. And I can attest to this feeling, especially as you try to initially cope and stabilize your body through often severe ailments. One of the biggest and I do mean biggest, obstacles to get your head around and develop techniques to effectively overcome from the outset is the management of what I call the triple threat: nausea, vomiting and diarrhea. It is not only the fact that any one of these in and of itself can be terribly debilitating to the body, even for a person without cancer, but also the fact that often, especially with the first few treatments of chemotherapy, the side effects of the treatment can cause the combination of these ailments to occur at the same time. That is why I called it the triple threat.
That said, in this article, we will share a few effective and sustainable tactics you can learn and apply throughout your treatment journey to minimize the challenges. It is our intention that these tips build your toolkit and allow you to be in better control of how you feel and therefore enable you to become and stay stronger.
First, let’s eliminate a few myths as these tend to cloud the thinking and knowledge-building process. You already have enough to deal with regarding the cancer itself; there is no need and no room for information that does not serve you well.
So, what are these “myths” you ask?
Myth # 1: The notion that NOT EATING will help alleviate nausea, vomiting or diarrhea.
This is absolutely NOT the case, and I cannot stress this enough. While you will not have the appetite or desire to eat the immediate days following your treatments, you will need to think of food the same way you think about medicine. Meaning, your body does not have the “appetite or desire” for medicine, you simply take medicine as prescribed. Therefore, look at food like medicine (because it actually servers a healing purpose too) and take or eat small amounts of food “as prescribed” -- usually three to four times a day.
Why is this so important?
The biggest irritation you can cause to your stomach in the immediate days following your treatment is to have it be empty. Again, even if it is a small amount of food (a piece of toast, a banana, a few tablespoons of steamed rice, a few unsalted crackers, a cup of Pedialyte), any and all of these will at least provide your body with nourishment and keep your stomach acids in check, so that it prevents the stomach from causing further issues. It once took me twenty minutes to eat a cracker and a third of a banana, but I did it because I knew if I could at least have something mild and binding in my stomach it would help…and it did.
Myth # 2: The notion that you can JUST drink A LITTLE BIT of water throughout the day and be fine.
NO, you can’t, and you won’t. Hydration is not only critical, it’s lifesaving. Setting a daily goal of how much water you should drink is very helpful in keeping you hydrated. In the immediate days following your chemotherapy drinking more water than your usual amount will also help you flush the medications with more ease and will allow your body to recover faster.
Why is this so important?
Hydration is essential to prevent you from having to go to the emergency room or urgent clinic due to losing too many fluids. This is especially key if you are experiencing vomiting and/or diarrhea. Whether you drink plain water, or water enriched with electrolytes or Pedialyte, you will need to challenge yourself to drink at least sixty to seventy ounces a day or more. This will not be easy, especially if you have not made it a habit to drink a lot of water in the past, but it will need to become a habit to help you get through the treatment journey and be healthy.
Myth #3: The notion that you should ONLY take your prescribed anti-nausea medication “if needed” versus proactively taking it BEFORE the nausea starts.
NO, just take it, please! One of the best pearls of wisdom my first chemotherapy nurse gave me about anti-nausea medicine was to “just take it”. Her point being, if you wait for the nausea to hit, it is too late.
Why is this so important?
You do not want to be chasing nausea....it is faster than a cheetah. Again, proactively taking it before, during and after your chemotherapy days allows your body to better process the chemotherapy, to continue eating and staying nourished, and to prevent the complications nausea and vomiting can unleash. Just take it, please!
Myth #4: The notion that certain foods will STOP your diarrhea in the days following treatment.
If only! The harsh reality is that most patients will experience strong and even severe diarrhea in the immediate days following their chemotherapy treatment. This is normal, at least, normal for chemotherapy patients. While it is an unpleasant topic, you are not alone. And while some foods can help, you should be prepared that unfortunately diarrhea is a common and almost inevitable part of the process. But what you can do, is to continue to eat (small meals) and hydrate (often), because diarrhea is not only debilitating; it is also hugely dehydrating.
Why is this so important?
If you experience severe diarrhea (more than four times a day), you should consider having your doctor prescribe you a stronger medication or try some over the counter medication to help manage the number of episodes.
So now that we have cleared the clutter, let’s focus on a few helpful tips to combat the “trio”.
Threat: Nausea
Symptoms
Bad/acidic taste in mouth
Gagging/back of throat
Acidic/rolling feeling in stomach
Tips (what to eat or drink)
Anti-nausea medication that dissolves under tongue (Zofran or similar);
Ginger-based/sugar-free hard candy
Breathing exercises — for full examples, please visit our Breathing Room and our article Cancer Management 101: Using your breath for more than breathing!
Anti-nausea medication
Water
Pedialyte (either in frozen pops or liquid),
Room-temperature clear broths,
Unsalted crackers, toasted bread
Bananas
Threat: Vomiting
Symptoms
Multiple episodes per day
Dry heaves
Tips
Anti-nausea medicine that dissolves under tongue (Zofran or similar)
Ginger-based/sugar-free hard candy
Yogurt — 1 tablespoons of dairy-free, low fat taken after small meals will help coat your stomach and is a good probiotic
Breathing exercises — for full examples, please visit our Breathing Room and our article Cancer Management 101: Using your breath for more than breathing!
Threat: Diarrhea
Symptoms
Multiple episodes per day
Mostly liquid
Tips
Anti-diarrhea medicine (Imodium or similar)
Yogurt — 1 tablespoons of dairy-free, low fat taken after small meals will help coat your stomach and is a good probiotic
Pedialyte (either in frozen pops or liquid)
Water
Bananas
Above all, you should always consult with your doctor and seek immediate help if any symptoms worsen.
Key Takeaways
Right now, you too may feel like a cork in the ocean, but know this: your objective is to build the right internal strength points and tactics that allow you to “get out of that ocean”. And once you overcome it, and you will, you indeed won’t be seasick every day.
With love,
Amelia O.
