Nausea
Nausea is one of the more common side effects from Gleevec treatment. It may also be accompanied by an urge to vomit and by loss of appetite. Thirty-eight percent of patients experience this side effect while on Gleevec according to our Life Raft Group Survey (October, 2001). Nausea may be caused by a local irritant effect of the drug in the stomach.
Recommendations:
- Take Gleevec with food and plenty of water –around eight ounces (preferable during or after breakfast or supper).
There are certain foods that tend to help quell the nausea. Some patients report chocolate as one of them. This also helps minimize cramping. Sweet potatoes have also been reported to be helpful. - Spread out Gleevec during the meal if you take multiple capsules or tablets (i.e., eat a little, take a Gleevec, eat a little more, take another Gleevec, etc.).
- In severe/continuing cases, your doctor might divide the dose—half in morning and half in evening. This has reduced nausea and other side effects in some patients.
- Anti-nausea medications may help. Typical medications include Compazine or Zofran. These must be prescribed by your doctor and are taken approximately one hour before the meal.
- Eat bland, lower fat foods such as: crackers, dry unbuttered toast, Jell-O, applesauce, plain baked potatoes and plain rice.
- Eat slowly and chew foods well.
- Eat small quantities of food at any one time, but eat more frequently—small meals and lots of snacks.
- Sip liquids, that are cool or at room temperature, between meals. Try not to sip too much
liquid during the meal. - Take the tablets with non-carbonated, non-caffeinated water or tea. Excessively carbonated drinks may make gas and bloating worse, however flat cola or gingerale is often well tolerated.
- Eat foods served at room temperature. This helps decrease the amount of aroma the food gives off.
- Avoid foods with strong odors and aromas. Also avoid the kitchen and any places that food is cooked.
- Do not worry about getting a completely balanced diet during episodes of nausea.
- Start the day, even before you get out of bed, with a few Saltine crackers. These crackers can be kept next to the bedside. In the night if you wake up nauseated, you will have something to snack on.
- If you notice a pattern to your nausea and/or vomiting, avoid any potentially problematic foods that you might have thought triggered nausea in the past. You may even want to consider avoiding your favorite foods until the time of nausea has passed.
- Try to sit upright for at least two hours after a meal. This is especially important if you have a history of esophagitis, GERD or hiatal hernia.
- Loosen any tight or snug fitting clothing.
- Open nearby windows for fresh air. Step outside and take several slow deep breaths, breathing through your mouth and not your nose.
- Rest comfortably in a quiet, pleasant, well-ventilated environment.
- Seek a pleasant distraction—soft music or a favorite TV program. Ask your physician about relaxation techniques.
- Maintain good mouth care. Having a clean mouth may help to remove unpleasant tastes.
- Take calcium antacids (like TUMS) to alleviate discomfort from eating certain foods. Some over-the-counter medications such as Imodium and Creon 10000 (digestive enzymes) can help but it is recommended to ask a doctor before taking these medications.
- Take Paspertin or MCP Ratiopharm drops or Mylicon 30 min before taking the tablets.
- PPIs (proton pump inhibitors) such as Nexeum or Prevacid help reduce stomach acid secretion and acid reflux symptoms, but still check with your physician.
- Do not ingest grapefruit or its juice.
- Sleep on your back, elevated with extra pillows under your upper torso
- Keep in close contact with your health care team.
Thank you to Alice Sulkowski, Monica Davey, and LRG members for providing these tips.
Gleevec and Nausea:
Gleevec.com Side Effects and Safety Information
NCH Healthcare System - Nausea and Vomiting
Oncolink:
MD Anderson Guidelines for nausea and vomiting
How to avoid nausea post-surgery:
By Richard Palmer
"Folks react quite differently to GI surgery. Me, I do best on foods with lots of fiber, like fruit, beans and potatoes. I've learned to stay away from steaks. Other folks are the opposite. Fruit goes right through them. They do better with hard-to-digest food like meat that moves more slowly through the GI tract.
You could stick with one type of food for a day, and see how your body reacts. In a few weeks, you'd have a good idea of what works for you and what doesn't .
And there are adhesions. A majority of people who have GI surgery get adhesions. You know where they stitched the plumbing back together? Those areas grow back together. Problem is, they also grow into whatever they're touching. Before surgery, your innards were like a bowl of slippery spaghetti. Everything slip-sliding around. Now your gut is like a bowl of slightly dried out spaghetti that sticks to each other in spots. Eat too much of the wrong thing, and you can get a blockage. That means 100 percent constipation and vomiting, and terrible, cramp-like pain. (One lady Life Rafter told me its worst than labor pain.) Anti-nausea meds, painkillers, Ducolax and an enema or two will usually clear things up over several hours."
For more on adhesions, see www.adhesions.org.
