Approximately 40% of cancer patients periodically suffer from nausea, regurgitation (leaking of stomach contents into the oral cavity), vomiting.
The cause of nausea can be:
- delaying the evacuation of food from the stomach, accompanied by heartburn, hiccups, a feeling of overcrowding;
- swelling of the stomach and intestines or indirect pressure of an adjacent tumor;
- medication provoking gastrointestinal irritation (non-steroidal anti-inflammatory drugs, for example, diclofenac, cytotoxic drugs, antibiotics – with their long-term use);
- fear, anxiety;
The cause of vomiting can be:
- increased intracranial pressure due to cerebral tumor;
- gastric compression syndrome; stimulation of the pathways of the vagus nerve as a result of pharyngeal irritation (candidiasis, sputum);
- intestinal obstruction (stool retention, neoplasms that create direct or indirect pressure on the intestines and cause vomiting with a small amount of fecal fluid);
- body reaction in the process of chemotherapy.
The reason regurgitation may be obstruction of the esophagus as a result of a tumor of the esophagus or indirect pressure of the tumor in the lungs and bronchi. The patient regurgitates a fairly abundant amount of viscous substance.
First of all, it is necessary to conduct a thorough analysis of the situation, think over and plan actions aimed at eliminating the symptoms.
There are a number of drugs prescribed by the doctor individually, alleviating the symptoms of nausea and vomiting. But a number is also known. non-medical measures to combat nausea and vomiting.
- Create patient peace and tranquility, reduce the influence of factors that can cause unpleasant symptoms.
- Release the patient from all household duties (cooking, cleaning, etc.).
- Eliminate the impact on the patient harsh and unpleasant odors (food, perfume, detergents).
- Convince the patient to eat and drink a little, but often.
- Exclude from the menu products, the use of which increases nausea and vomiting.
- Prevent the appearance of gagging, prepare a special container for collecting vomit.
- Give your patient antiemetic drugs prescribed by a doctor, monitor their effectiveness.
When vomiting in a patient lying down, it is necessary:
- turn the patient’s head to the side, remove the pillow;
- attach oilcloth and a container to collect vomitus;
- hold the patient’s head during vomiting;
- prepare a glass of water for rinsing the mouth after vomiting, a napkin for wiping the mouth;
- soothe the patient and create maximum comfort;
- change the soiled bed and underwear.
When vomiting in a patient in a sitting position, it is necessary:
- put a container to collect vomit between the legs of the patient;
- tie up the patient with a napkin covering the chest;
- stand to the left of the patient, clasping his head with his right hand from behind and holding his head in the forehead with his left hand;
- give a glass of water for rinsing the mouth after vomiting and a napkin;
- calm the patient, create a calm environment for him.
When vomiting in an unconscious patient, it is necessary:
- as far as possible, in order to avoid aspiration (vomit ingress into the respiratory tract), turn the patient to the side or turn his head to the side;
- remove the pillow;
- remove dentures (if any);
- put oilcloth and bring to his mouth a container to collect vomitus;
- support the patient’s head during vomiting;
- carry out oral care after each act of vomiting;
- wrap the index finger of the right hand with a napkin;
- keep the mouth open with the index and thumb fingers of the left hand;
- try to remove vomit residues from the mouth;
- with the index finger of the right hand, rinse the oral cavity with a pear-shaped cartridge in the position of the patient lying on its side, holding the oral cavity open;
- monitor the patient’s condition constantly;
- inform the attending physician about the number and frequency of emetic desires in a patient.
For a patient experiencing nausea and vomiting, oral hygiene is of great importance. Daily monitor the condition of the mouth, tongue, ask if the patient has discomfort in the mouth. In the presence of dryness of the mucous membrane of the tongue, it is necessary daily, 2-3 times a day, using a soft toothbrush and 4% sodium bicarbonate solution to clean the tongue. When dryness of the oral mucosa is recommended to drink often, in small sips, 1/3 cup, suck on small pieces of ice, lollipops, eat a piece of fresh pineapple, which contains special enzymes that help clean the mouth. Vaseline lip lubrication also reduces the sensation of dry mouth. An important part of palliative care is teaching the patient and his family to keep a diary, where the causes of pain, nausea and vomiting, and their duration are recorded. Such a diary will help draw up a plan of medical care, give recommendations.
To reduce the symptoms of nausea, vomiting, with a decrease in appetite, to prevent constipation, it is necessary to switch to health food. Nutrition of the patient in the late stages of cancer has a number of features. There is a decrease in the patient’s need for food, water. In some cases, food intake is poorly tolerated, the patient suffers from lack of appetite (anorexia). Persistent nausea and vomiting force the patient to stop eating and drinking. If there is a problem of choice between water and food, preference is given to fluid intake. It is necessary to be guided by the following principles:
- do not force the patient to take food by force;
- feed only when the patient is hungry, give food in small portions;
- offer the patient his favorite foods;
- eliminate forced feeding of the patient, provoking increased nausea, vomiting and pain.
The patient may change taste. Habitual foods may seem bitter, sour, sweet. In this case, it is necessary to abandon the use of meat, sour juices, tomatoes, coffee, tea, chocolate. It is recommended to include poultry meat, fish, dairy products, eggs. If food to the patient seems too sweet, sugary, include sour juices in the diet. When cooking, use lemon juice, vinegar, spices, mint, pickled or salted vegetables. If the food seems to the patient tasteless, salty and pickled vegetables, salted fish, herring can be recommended as a snack (if there are no contraindications).