Diet Strategies for Possible
Side Effects of Chemotherapy

Robin Kassel Belmonte, RD
Nutrition Services Coordinator
Saint Vincents Comprehensive Cancer Center

Nausea and vomiting, diarrhea or constipation, sore mouth and taste changes can all be possible side effects of chemotherapy.  Depending on your type of treatment, you may experience them separately, all at once, at different times throughout your illness, or not at all.

In the last few years, health professionals have learned a great deal about controlling nausea and other side effects.  There are several medications that available which can help relieve symptoms. 

There are also things you can do to help limit symptoms.  I hope the following list can help:

Nausea:

    • Ask your doctor about medicine to help control nausea and vomiting.  These drugs are called antiemetics.
    • Eat small amounts often and slowly.
    • Avoid eating in a room that's stuffy, too warm, or has cooking odors that might disagree with you.
    • Drink fewer liquids with meals.  Drinking liquids can cause a full, bloated feeling.
    • Eat foods at room temperature or cooler; hot foods may add to nausea.
    • Try these foods:
      • toast and crackers
      • pretzels
      • sherbet
      • oatmeal
      • fruits and vegetables that are soft or bland, such as canned peaches
      • clear liquids, sipped slowly
      • ice chips
         
    •  Avoid:
      • fatty, greasy, or fried foods
      • very sweet foods, such as candy, cookies or cake
      • spicy or hot foods
      • foods with strong odors
         
    • Don't force yourself to eat favorite foods when you feel nauseated.  You may associate this food with being nauseaous, and you may create a food aversion!
    • Rest after meals, because activity may slow digestion.  It's best to rest sitting up for about an hour after meals.  Do not lie down flat for at least two hours after eating.
    • Wear loose-fitting clothes.
    • Avoid eating for 1 to 2 hours before treatment if nausea occurs during chemotherapy.
    • Sucking on a lemon drop or peppermint or chewing gum can reduce nausea during chemotherapy administration.
    • Try to keep track of when your nausea occurs and what causes it (specific foods, events, surroundings).  If possible, make appropriate changes in your diet or schedule.

Vomiting:

    • Do not drink or eat until you have the vomiting under control.
    • Once you have controlled vomiting, try small amounts of clear liquids.  Begin with 1 teaspoon every 10 minutes, gradually increase the amount to 1 tablespoonful every 20 minutes, and finally try 2 tablespoons every 30 minutes.
    • When you are able to keep down clear liquids, try to eat small amounts of food every thirty minutes or so until you are sure that things will stay down.  Eat slowly.  Try plain, high-carbohydrate foods, such as toast and crackers.  Avoid high fat foods such as butter or peanut butter.  Gradually advance your diet as tolerated.

Diarrhea:

    • Drink plenty of liquids.  Fluids are important because your body may become dehydrated from water loss in diarrhea.
    • Eat small amounts of food throughout the day instead of three large meals.
    • Eat plenty of foods and liquids that contain sodium and potassium.  These minerals are often lost during diarrhea.  Include things like bouillon or fat-free broth, bananas, peach and apricot nectar, boiled or mashed potatoes.  Anumber of commercial beverages are available to replenish fluids and electrolytes; these can be useful dealing with diarrhea. (Ex. Gatorade or Pedialyte)
    • Try these low-fiber foods:
      • rice
      • Farina or cream of wheat/rice
      • ripe bananas
      • toast
      • applesauce
      • smooth peanut butter
      • skinned chicken or turkey, lean beef or fish (boiled or baked, not fried)
         
    • Avoid:
      • greasy, fatty, or fried foods
      • raw vegetables and fruits
      • high fiber vegetables such as broccoli, corn, beans, cabbage, peas, and cauliflower.
      • strong spices, such as hot pepper or curry
         
    • Limit beverages that contain caffeine, such as coffee, strong tea, some sodas, and chocolate
    • Avoid dairy products; diarrhea may be exacerbated by a lactose intolerance.
    • Limit supplements or foods which contain sorbitol and lactose
    • Avoid very hot or very cold foods and beverages; drink liquids that are at room temperature.
    • Avoid magnesium containing antacids such as Maalox and Mylanta; try Amphogel or Alternagel instead.

Constipation:

    • Drink plenty of liquids—at least eight 8-oz glasses every day.  This will help to keep your stools soft.
    • Take a hot drink about one-half hour before your usual time for a bowel movement.
    • Eat high-fiber foods, such as whole-grain breads, cereals, and pastas; fresh fruits and vegetables; dried beans and peas, whole-grain products such as barley or brown rice.  Eat the skin on fruits and potatoes.
    • Get some exercise, such as walking, every day.
    • Add unprocessed wheat bran to foods such as cereals, casseroles, and homemade breads.

If these suggestions don't work, ask your doctor about medicine to ease constipation.  Be sure to check with your doctor before taking any laxatives or stool softeners.

Sore Mouth and Throat:

    • Try soft foods that are easy to chew and swallow, such as:
      • low-fat milkshakes
      • bananas, applesauce, and other soft fruits
      • peach, pear and apricot nectars.
      • cottage cheese
      • mashed potatoes, macaroni and cheese
      • custards, puddings, and gelatin
      • scrambled eggs
      • oatmeal or other cooked cereals
      • pureed or mashed vegetables such as peas and carrots.
      • pureed meats
         
    • Avoid foods that can irritate your mouth, such as:
      • citrus fruit or juice such as oranges, grapefruits, tangerines
      • spicy or salty foods
      • rough, coarse, or dry foods such as raw vegetables, granola, toast, crackers
         
    • Try foods cold or at room temperature.  Hot and warm foods can irritate a tender mouth and throat.
    • Rinse your mouth with water often to remove food and bacteria and to promote healing
    • Tobacco and alcohol can increase mouth pain.  Avoid them.
    • Don't use commercial mouthwashes; most contain alcohol and should be avoided.
    • Ask your doctor about anesthetic lozenges and sprays that can numb the mouth and throat long enough for you to eat meals.

Dry Mouth:

    • Try very sweet or tart foods and beverages such as lemonade; these foods may help your mouth produce more saliva.  (Do not try this if you also have a sore mouth or throat).
    • Suck on sugar-free candy or popsicles or chew sugar-free gum.  These can help produce more saliva.
    • Keep lips moist with lip salves.
    • Have a sip of water every few minutes to help you swallow and talk more easily.
    • Eat foods with sauces, gravies, and salad dressings to make them moist and easier to swallow.
    • If your dry mouth is severe, ask your doctor or dentist about products that coat and protect your mouth and throat.

Taste Changes:

    • Choose and prepare foods that look and smell good to you.
    • If red meat tastes or smells strange, use chicken, turkey, eggs, dairy products, or fish that doesn't have a strong odor instead.
    • Help the flavor of meat, poultry or fish by marinating it in sweet fruit juices, Italian dressing or sweet-and-sour sauce.
    • Try using small amounts of seasonings such as basil, oregano, or rosemary.
    • Try tart foods such as oranges or lemonade that may have more taste.  (Don't try this if you have a sore mouth or throat.)
    • Serve foods at room temperature.
    • Stop eating foods that cause an unpleasant taste.

Presented with Author's permission

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