Crohn's and Nausea

Nausea: Tips to Make it Better

By: SHARON DOERRE
WEDNESDAY, AUG. 27, 2014, 7:47 am
 

Nau­sea is never fun! Almost every­one with IBD will expe­ri­ence it at one time or another. Nau­sea can reduce appetite and lead to dehy­dra­tion and weight loss as well as make daily life mis­er­able. Don’t suf­fer needlessly.

Check your med­ica­tions. Metho­tex­trate, aza­thio­prine, and iron sup­ple­ments can cause nau­sea. Often tak­ing such a med­ica­tion right before bed­time can let you sleep through the effect. Steroids can also impact the stom­ach if pro­tec­tive med­ica­tions like omepra­zole (Prilosec) or ran­i­ti­dine (Zan­tac) are not taken. Ask your phar­ma­cist if a new pre­scrip­tion can cause nau­sea and ways to avoid it.

Ask your doc­tor for an anti-emetic med­ica­tion. Zofran (ondansetron) and Reglan (meto­clo­pramide) can often help reduce the nau­sea pro­duced by IBD medications.

Think about your trig­gers. Motion, dairy, greasy foods, stress, and sinus drainage can all cause nau­sea. Dehy­dra­tion can inten­sify the impact and IBD can lower your thresh­old to var­i­ous trig­gers, even ones that never both­ered you before.

Stay hydrated. Meclizine and dimenhydrinate(Dramamine)areavailable over the counter and can help with motion sick­ness. Lac­taid can ease the nau­sea from too much dairy; Tums can help soothe a stom­ach irri­tated by greasy foods. Gin­ger candy and even nib­bling on slices of raw gin­ger root can set­tle the stom­ach and com­bat nau­sea. Aller­gies and colds that cause sinus con­ges­tion can cre­ate nau­sea when drainage hits the stom­ach. Over the counter allergy med­ica­tions such as cet­i­rizine (Zry­tec) as well as decon­ges­tants and expec­to­rants like guaife­n­esin (Mucinex)can reduce and thin con­ges­tion and can keep it from caus­ing stom­ach problems.

Nib­ble. An empty stom­ach almost always makes nau­sea worse. Find a sim­ple food that is safe for you – IBD is such an indi­vid­ual dis­ease that it is impos­si­ble to make uni­ver­sal rec­om­men­da­tions — but­saltines or GF crack­ers, apple­sauce , or cooked rice are often safe,and nib­ble often.  If there is an imme­di­ate increase in nau­sea with nib­bling, add a Tums, gin­ger cap­sule, or water with lemon and keep eating.

Add cooked veg­eta­bles to your diet. This is a long-term strat­egy for those not flar­ing but expe­ri­enc­ing nau­sea, gur­gling, and burp­ing after eat­ing. Cooked veg­eta­bles, (and raw veg­eta­bles if tol­er­ated,) can reduce the over­all acid­ity of the diges­tive tract.

Con­sult your GI. Peo­ple with Crohn’s dis­ease in the upper GI tract can expe­ri­ence almost con­stant nau­sea as part of a flare. This type of nau­sea needs to be man­aged by a GI doc­tor. Ask about adding or increas­ing the dose of a proton-pump inhibitor (PPI).PPIs like Prilosec can help reduce stom­ach acid and can be taken sev­eral times a day under a doctor’s super­vi­sion. Other med­ica­tions like sucral­fate (Carafate) can coat the stom­ach and let the lin­ing heal. While these long-term med­ica­tions are tak­ing hold, anti-emetics med­ica­tions like Zofran can keep the nau­sea away.

Go to the ER. Stric­tures and obstruc­tions in the small bowel can also cause nau­sea if the stom­ach can’t empty. If your nau­sea is accom­pa­nied by vom­it­ing, a swollen hard belly, con­sti­pa­tion and the inabil­ity to pass gas along with abdom­i­nal pain seek med­ical atten­tion. Nau­sea is often the first symp­tom of an obstruc­tion to appear. So take per­sis­tent nau­sea that doesn’t respond to treat­ment and is accom­pa­nied by wors­en­ing symp­toms and pain seriously.

But don’t for­get non-IBD causes of nau­sea! Hav­ing CD or UC doesn’t pro­tect you from get­ting preg­nant, eat­ing spoiled food, or catch­ing a virus. Stom­ach viruses, the flu, food poi­son­ing, and preg­nancy can all cause nau­sea and vom­it­ing. So ask and see if a stom­ach virus is going around your school or office or if any­one else who ate the same dish is feel­ing ill. If preg­nancy is even a remote pos­si­bil­ity, take a preg­nancy test!

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