Step 1. Gatorade and Boullion-
Diet: Patients with severe nausea and vomiting should sip small volumes of salty liquids such as Gatorade or boullion in order to avoid dehydration. Any liquid to be ingested should have some caloric content. A multiple vitamin supplement should be prescribed.
Goal: To ingest 1,000 to 1,500 cc per day in multiple servings, e.g. twelve 4 oz servings over the course of 12-14 hours.
Avoid: Citrus drinks of all kinds and highly sweetened drinks.
Step 2. Soups
Diet: The diet may be advanced to include a variety of soups with noodles or rice and crackers. Peanut butter, cheese, and crackers may be tolerated in small amounts. Caramels or other chewy confections may be tried. These foods should be given in at least six divided meals per day. A multivitamin should be prescribed.
Goal: To ingest approximately 1,500 calories per day. Patients who can accomplish this will avoid dehydration and will hopefully ingest enough calories to maintain their weight.
Avoid: Creamy, milk-based liquids. The fat in the meal will delay emptying of the stomach.
Step 3. Starches, chicken, and fish
Diet: Starches such as noodles, pasta, potatoes and rice are easily mixed and emptied by the stomach. Thus, soups, mashed potatoes or baked potatoes, pasta dishes, rice and baked chicken breast and fish are usually well tolerated sources of carbohydrate and protein. These solids should also be ingested in six small meals per day. A one-a-day vitamin should be prescribed.
Goal: To find a diet of common foods that the patient finds interesting, satisfying, and that evoke minimal nausea/vomiting symptoms.
Avoid: fatty foods which delay gastric emptying and red meats and fresh vegetables which require considerable nutrition. Avoid pulpy fibrous foods that promote formation of bezoars.
It is important to remember that the diet is trial and error and what works for one may not work for another. This is simply a basic guideline.
*Diet created by Dr. Ken Koch, M.D., Director of GI at Wake Forest University Baptist Medical Center