Nausea doesn’t always involve vomiting. Even if the patient doesn’t vomit, they may feel sick. Nausea can cause or worsen other symptoms, such as fatigue or loss of appetite, as well as have a negative impact on quality of life.
Nausea in palliative care
Nausea is a common symptom experienced by patients receiving palliative care. While nausea can be a highly interfering symptom, there are good treatment options available, including both medications and other techniques that provide symptom relief. The choice of treatment depends on what’s causing the nausea.
In the case of an advanced illness, nausea is often caused by decreased motility of the gastrointestinal tract and/or constipation. Other underlying causes include the patient’s medication (especially strong pain medicines and medicines used to treat cancer), untreated pain, mucus in the airways, infections, a build-up of fluid in the abdomen (ascites), a cancer patient’s brain metastases, or anxiety.
Treatment plans for nausea in palliative care are unique to each patient, depending on the cause. Nausea is relieved by treating the cause and taking anti-nausea medication regularly. Sometimes several anti-nausea medicines are needed before the nausea gets better.
In most cases, vomiting a lot requires further examination. If the vomiting persists, the patient becomes dehydrated, which makes the situation worse. That’s why it’s important not to wait for too long before contacting the unit responsible for the patient’s care. If the vomiting is large in volume or associated with decreased general condition or pain, seeking acute medical attention is warranted. Usually, the cause of vomiting can be determined, and symptom relief can be provided.
It’s important to take anti-nausea medicines as instructed. It’s also important to make sure that the patient is having regular bowel movements, since constipation often leads to feeling full and experiencing nausea.
The patient may want to try and identify factors that make their nausea worse or better. For example, if the nausea is associated with eating, the patient can take anti-nausea medicine before meals. Cool foods eaten in small portions according to the patient’s preferences are less likely to provoke nausea than hearty meals served hot. Good mouth care may decrease infections in the mouth and thus reduce nausea. Letting in fresh air, for example by airing out the room, may also be helpful.
Updated 4.4.2025