GIST Support Wiki

 

Nausea is a common problem for GIST patients. It is one of the common Gleevec Side Effects. Nausea may also result simply from surgical changes to the GI tract during the first months after surgery.

Prescription Drugs for Nausea

Protonix and Carafate can be prescribed for nausea which also help to reduce the acidity problem when taking either Gleevec or Sutent.

Lorazepam, which is a sedative, lessens nausea too. It is probably to take the antinausea med ahead of time before there is opportunity for the nausea to arise.

I also had a bad bout of nausea and vomiting. I was unable to keep down even water for quite awhile. Like you I went to doctors and the ER and they couldn't find anything. But they did put me on saline and potassium IVs and also Remeron and Ativan. For some reason the combo did help. I am now able to eat and drink again.

I tried various nausea meds, but seemed like eventually each one made me feel "jumpy" and I had trouble sleeping. So now I take nausea medicine at 2 in the afternoon, Gleevec before bed, and some nights a Pepcid too. Seems like without it I'm always up about 3am with terrible heartburn. Finding that combination changed everything for me. I now can eat good, feel good, can take vitamins again, and all that gives me more energy.

Meclizine is given by many doctors still for dizziness and it also helps with nausea. It used to be prescription under the trade name of Antivert, but is available over the counter now in many motion sickness products like Dramanine, Bonine etc... I still take it when I get vertigo attacks.

Aside from Zofran I also found Kytril very effective. It used to be available only through IV but its now comes in tablet form too. It's more expensive than Zofran but it gave me instant relief with nausea.

My daughter was prescribed Marinol (synthetic THC, I believe), to help her with nausea. If she really wants to eat something and not have it come back up on her, she takes the Marinol. It does make her feel strange, she says, but works well on the nausea.

My husband is currently on 400mg Zofran with no feeding tube. He has had nausea problems and has found that he does better taking the Gleevec late in the evening on an empty stomach. He stops eating around 8-9:00pm, takes his Gleevec around 11pm & falls asleep immediately . Compazine -- possible problems with anxiety on this. May have helped nausea, but he was agitated and restless. Zofran --This helped with vomiting, but there was still some, but less nausea. Seems like a good medication per most reports. Reglan -- This also seemed to help nausea indirectly by reducing the food reflux caused by surgery. I experienced the same feelings for a long time, but one of the listmates suggested that I eat a piece of dark chocolate. It really helped I took my first Gleevec capsules in January 2001, at lunch with two Gleevec veterans. Judy Orem, a CML patient who'd been on Gleevec for nearly two years, said the leukemia patients found that eating a bit of chocolate with Gleevec quelled any nausea. I immediately went out and bought some "medicinal" chocolate! Hershey's Miniatures..

Gleevec also causes nausea and loose bowels at times (gleevec trots). So when I start to feel nauseous I lie down on my right side and if it doesn't resolve in a few minutes, I found that taking Reglan for the nausea and taking Immodium for the loose bowels helps. If you have an onging severe problem with nausea, I've heard that using a daily suppository for nausea prevention is helpful, but I don't know what medication is in the suppository. I take an "anti-nausea" pill before taking daily dose of Gleevec or Sutent. I take 1 tablet of PROCHLORPERAZINE - 10 MG as prescsribed by my oncologist 1/2 hour before taking my Gleevec, whic I take at dinnertime.

They use three shots of Reglan per day sometimes with three Cisapride pills until it goes away.

Compazine might also be worth asking about. And these can be taken in suppository form until things are under control & you can keep food/medicine down.

My daughter has bouts of this on and off since her complete gastrectomy over a year ago. She takes Zofran ODT (dissolves in the mouth) and sometimes I give her a shot of Zofran. I have learned how to give her the shot and it works pretty good when she is in this kind of distress. I have also learned that she needs to be watched very carefully when she gets this bad. I am worried that you will get dehydrated Occasionally we have to go to the emergency room to get hooked up to and IV for fluids and this actually seems to help stop the nausea. It is a cycle that is made worse when they get dehydrated. They can put Zofran into an IV.


Non-Prescription Strategies

During the Gleevec trials, the instructions told people not to lie down for some period of time (maybe 30-60 minutes?) after taking Gleevec. It is a local stomach irritant, so the idea is to not let it sit on one spot (also the reason for drinking lots of water with it). So you might be less likely to get the heartburn or nausea if you took it 30-60 minutes before bedtime rather than right at bedtime.

Food: Many GSI members report that taking Gleevec with a meal or food greatly reduces nausea. Some patients have reported that out of medical necessity they needed to spread the Gleevec pills over the course of the day in order to avoid severe nausea and vomiting.

Dissolving in water or juice: One strategy suggested by manufacturer Novartis is to dissolve the dose in a large glass of water or apple juice and drink it immediately.

Chocolate: Some people eat their entire meal, then take their Gleevec dose with a mini chocolate bar (such as Hershey's).

Queasy Pops and Queasy Drops: These are made from natural ingredients and can be carried in your pocket or purse. They are available from www.threelollies.com and come in several flavors. One person says "It has worked better for me than the anti-nausea meds did. These are made with all natural herbs, flavors, and things that naturally help nausea. They aren't that expensive either and it shouldn't react with any meds but you might ask the doctors just to make sure."

Licorice tea: I finally discovered that licorice tea made me feel better. I started drinking some everyday, and my suffering really subsided. I still drink some whenever I feel sick (Stash Licorice Spice in tea bags, specifically.)


GINGER CANDY RECIPE: "Ginger is a home remedy for nausea and motion sickness. This is an easy recipe for crystallized ginger. You can pack some ginger pieces in an airtight sandwich bag and carry them around with you."


Prep Time: 35 minutes Cook Time: 5 minutes Ingredients: 1 cup peeled, thinly sliced ginger 3 cups water 1 cup sugar Additional sugar to coat (optional)

Preparation:In a covered saucepan, bring the water to a boil. Add the ginger pieces and sugar and cover. Reduce the heat and allow it to simmer for five minutes.

Remove from heat and allow it to sit for 20 minutes.

Heat the oven to 200 degrees F. Place the ginger slices in a glass pan. Place the pan in the oven until the slices are almost dry but still chewy. Allow it to cool.

Toss the cooled ginger in sugar to lightly coat it, if desired.

Store the crystallized ginger in an airtight container for up to two months.

Variation:

If you do not want to use sugar in this recipe, boil the ginger in water without adding the sugar. Instead of tossing the cooled ginger in sugar to lightly coat it, sprinkle stevia or another sugar substitute over the ginger pieces to taste.

http://altmedicine.about.com/od/healthykitchenrecipes/r/crystallizedgin.htm


Putting Evidence Into Practice: Evidence-Based Interventions to Prevent, Manage, and Treat Chemotherapy-Induced Nausea and Vomiting by Janelle M. Tipton et al http://www.ons.org/publications/journals/CJON/Volume11/Issue1/pdf/110169.pdf


http://www.cancernausea.com/symptom_relief/symptom_relief_alter.asp suggests alternative therapies which can relieve nausea and vomiting by: Encouraging relaxation, increasing feelings of control and reducing thoughts of helplessness.


Alternative therapies may include:

  • Acupressure for nausea can be done immediately when the symptom occurs. With your fingernail, press the indentation above your upper lip, midpoint between the bottom of your nose and upper lip and hold. Also massage the points located on the inside of either wrist, measure three fingers from your wrist to find the point.
  • Self-Hypnosis is a mental state in which you create a feeling of total body relaxation. Becoming more aware of your breath coming in through your nose and exiting your mouth (with the exhalation being slightly longer) will help you relax.
  • Progressive Muscle Relaxation teaches you to relax by gradually tensing and relaxing different muscles. As with anything, practice makes perfect! For your benefit, please follow this progressive relaxation exercise as often as possible: http://www.lessons4living.com/how.htm
  • Guided Imagery uses all your senses — hearing, sight, taste, smell, and touch — to "mentally relocate" you to a relaxing environment of your choice.
  • Cognitive Distraction such as music (especially with headphones), video games, and other distractions may focus your attention away from nausea and vomiting.

Personal Experiences

"I had a total gastrectomy and I had the gagging and vomiting about 2-3 months after surgery. It became so bad that I couldn't keep anything down. Without anyone's knowledge my potassium became so low that I was falling. I became very, very weak. I was dehydrated. Eventually feel down our basement stairs and went to the ER to check for any breaks and that's when they found the potassium levels to be "deathly low".(their words not mine). They tried every med you can think of for nausea, ulcers, acid reflux, anxiety etc. Eventually with IV fluids adn potassium, I regained my strength and ability to eat and keep things down."


Since I began taking Ginger root tablets and / or grated ginger in my food about 5 months ago, my nausea has all but diminished. It is a welcome reprieve the herbal way!