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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Back to ER, Round 3 of Stricture

Ended up coming back to the ER. I haven't eaten in days. I have no appetite at all and im nauseous.  I forced myself to eat a little soft food but couldnt keep it down. The pain is just as bad too. I came to the ER around 830pm and its 130am now and I JUST got meds and an iv.  And then I waited this entire time for the dr to not even bother doing a ct scan or xray,  only blood work and thats pointless considering my labs have been looking great this entire time but I still had a small bowel obstruction!  This is why I didn't want to come back to begin with. Theres always a chance I get a dr who doesnt take anything seriously. I have a GI appointment Thursday so looks like im going to be waiting to find out more.  On a lighter note, I had a hot nurse lol.

Waiting to be discharged now. Praying it'll happen quickly!

Finally Home, Still Sick

I was discharged friday after 5 days in the hospital again. Got home and in still sick. I have no appetite.  Im throwing up everything I get down. Im in pain. I called my GI last night and he said I could wait until Monday and go in to the office or go to the er and let them do a ct scan. He recommended the er, but I dont want to be admitted again so I tried to sleep it off. Im so so right now. Hopefully ill be feeling better by tomorrow and won't need to go in at all. Ugh!! Not fun!!

Hospitalized

I was discharged monday and less than a week later, im admitted again.  I started throwing up this morning and havent stopped. My best friend brought me to the er and they admitted me. The xray didnt show an obstruction but the dr said it may be that I threw up so much it decompressed it. My veins suck so bad ive been stuck 8 times and the iv I had has slipped out and they're calling ICU to try to put in a new one...until then no pain or nausea meds and its been 2 hrs since nausea meds and 5 hours since pain meds. Needless to say, im miserable.