Nausea and vomiting

Problems and possible causes

Nausea and vomiting can be an important problem for people with AIDS. These symptoms may be caused by:

· medicines
· infections
· a problem with the stomach or intestines
· Kaposi sarcoma in the intestines
· HIV infection itself.

In some people with AIDS, nausea and vomiting are very short-lived, and go away by themselves or after treatment of the cause. In others, they are chronic or long-lasting and become a part of daily life.

What to do at home

If a person is having trouble with nausea and vomiting advise them to:

· avoid cooking smells if possible

· watch out for dehydration (see the section on diarrhoea in this chapter)

· talk to a health care worker, who may prescribe medicine to control the symptoms if they are very severe, in order to allow the person to eat. See the section on medicines for nausea and vomiting in Chapter Seven for further details.

If someone is vomiting severely they should:

· not eat any food or drink any fluids for one or two hours

· then gradually start drinking room-temperature water, oral rehydration solution, weak tea, or other clear liquids (about two tablespoonfuls an hour for two to three hours), or suck ice in small amounts

· then increase the amount of fluids to four to six tablespoonfuls an hour for two to three hours; the amount can be increased as desired but people should force themselves to keep taking fluids to make up for what they have lost.

As the nausea decreases, people should increase the amount and types of foods they eat. It may be best to start with small quantities of dry, plain foods such as bread, rice or cassava.

Frequent care of the mouth will remove the foul taste and freshen it. This can include rinsing the mouth with water, or gently scrubbing the tongue and gums with a soft toothbrush or cloth at least three or four times a day, then rinsing with dilute mouthwash or lemon water rinse.

Ventilating or freshening a room may make a person feel better and less nauseated.

It is also a good idea for people to identify and reduce the things that seem to make them feel nauseated, such as specific odours, medicines, or foods (high-fat foods, for example).

A cool compress applied to the forehead, or other things which help someone to relax, may be useful.

When sick people and their families must seek help

· If vomiting occurs repeatedly and fluids cannot be kept down - in such cases the sick person is at risk of becoming severely dehydrated.

· If regular vomiting lasts more than 24 hours, particularly if it is accompanied by pain in the abdomen.

· If the person has a fever in addition to the vomiting.

· If the sick person is vomiting violently, especially if the vomit is dark green, brown, or smells like faeces.

· If the vomit contains blood.

Notes on nausea and vomiting
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