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Nausea and Vomiting (PDQ®): Supportive care - Patient Information [NCI] - Chronic Nausea and Vomiting in Advanced Cancer

Nausea and vomiting in advanced cancer has many causes.

Patients with advanced cancer commonly have chronic nausea and vomiting, which can decrease the quality of life. Nausea and vomiting related to advanced cancer may be caused by the following:

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  • Opioids, other pain medicines, and antidepressants.
  • Constipation (a common side effect of opioid use).
  • Brain and colon tumors.
  • High or low levels of certain substances (such as calcium and salt) in the blood.
  • Dehydration.
  • Stomach ulcers.
  • Infections in the mouth or upper airway.

Treatment of nausea and vomiting in advanced cancer includes ways to keep bowel habits regular.

In patients with advanced cancer, constipation is one of the most common causes of nausea. To prevent constipation, it is important that a regular bowel routine be followed, even if the patient isn't eating. Laxatives that soften the stool or stimulate the bowel may help prevent constipation, especially if the patient is being treated with opioids for cancer pain. Patients with advanced cancer usually cannot handle high-fiber diets or laxatives with psyllium or cellulose that need to be taken with a lot of fluids.

Enemas and rectal suppositories are used for short-term, severe episodes of constipation. Patients who have a loss of bowel function because of nerve damage (such as a tumor pressing on the spinal cord) may need suppositories for regular bowel emptying. Enemas and rectal suppositories are not used in patients who have damage to the bowel wall. (See the Constipation section in the PDQ summary on Gastrointestinal Complications and the Side Effects of Opioids section in the PDQ summary on Pain.)

Nausea and vomiting are sometimes caused by a blocked bowel.

Patients who have advanced cancer may have a blocked bowel caused by a tumor. If the bowel is partly blocked, the doctor may put a nasogastric tube through the nose and esophagus into the stomach to make a temporary passage. If the bowel is completely blocked, the doctor may insert a gastrostomy tube through the wall of the abdomen directly into the stomach to relieve the build-up of fluid and air. Also, medicines and liquids can be given directly into the stomach through the tube.

Sometimes, the doctor may create an ileostomy or colostomy by bringing part of the small intestine or colon through the abdominal wall to form an opening on the outside of the body. For certain colorectal blockages, an expandable metal tube called a stent may be put in, to open the blocked area.

Medicines may also be used to treat nausea and vomiting and relieve pain.

    This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.

    WebMD Public Information from the National Cancer Institute

    Last Updated: September 04, 2014
    This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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