What non‑pharmacological treatments are recommended for managing nausea?

Non-Pharmacological Treatments for Nausea

Lifestyle and dietary modifications are the cornerstone of non-pharmacological nausea management, with eating small frequent meals being the most universally recommended intervention across all clinical contexts. 1

Dietary Modifications

Core Dietary Strategies

• Eat small, frequent meals throughout the day rather than three large meals, as this is the most consistently recommended non-pharmacological intervention by the National Comprehensive Cancer Network 1
• Choose bland, room-temperature foods to minimize triggering nausea through strong odors or temperature extremes 1
• Control portion sizes to avoid gastric distension that can worsen nausea 1

Foods to Avoid

• Eliminate fatty and fried foods (such as fried chicken, sausage, bacon, and roast beef), as these significantly worsen gastroparesis and nausea symptoms 2
• Avoid spicy foods including peppers, salsa, and heavily seasoned dishes 1, 2
• Limit acidic foods such as orange juice, tomato juice, oranges, and coffee 2
• Reduce roughage-based foods including cabbage, lettuce, broccoli, and high-fiber vegetables 2
• Identify and avoid specific trigger foods with strong odors that provoke symptoms 3

Foods That May Help

• Bland, starchy foods such as saltine crackers, graham crackers, pretzels, white rice, and potatoes are generally well-tolerated 2
• Simple carbohydrates including jello, popsicles, and applesauce can be consumed when nausea is severe 2
• Eating dry crackers or toast before rising in the morning may help with morning nausea 4, 5
• Sweet potatoes, white fish, salmon, and clear soups are typically tolerable options 2

Hydration Management

• Maintain adequate fluid intake of at least 1.5 liters daily to prevent dehydration 3
• Ginger ale and tea are generally well-tolerated beverages that can help with hydration 2
• Sip fluids slowly rather than drinking large volumes at once 6

Herbal and Supplemental Approaches

• Ginger 250 mg capsules four times daily may provide adjunctive benefit for nausea 3
• Vitamin B6 (pyridoxine) 10-25 mg every 8 hours can be considered, particularly in pregnancy-related nausea 3
• Note that while many clinicians recommend herbal supplements, midwives and physicians often lack awareness of appropriate dosing and potential side effects, so these should be used cautiously 4

Behavioral and Environmental Modifications

• Avoid strong odors from cooking, perfumes, or other environmental sources 5
• Rest after meals to allow for proper digestion 6
• Consider alternative therapies such as acupuncture, hypnosis, or cognitive behavioral therapy for refractory nausea, as suggested by the National Comprehensive Cancer Network 7
• Hot showers may provide temporary relief, particularly in Cannabis Hyperemesis Syndrome 3

Nutritional Counseling

• Dietary consultation may be useful for patients with persistent nausea to develop individualized meal plans 1
• The National Cancer Institute provides specific resources on eating well during cancer treatment that can be adapted for various causes of nausea 1

Critical Considerations

• These non-pharmacological measures work best when implemented preventively rather than waiting until severe nausea develops 6
• Fluid and electrolyte replacement is essential when vomiting accompanies nausea 6
• Thiamin supplementation should be provided in patients with persistent vomiting to prevent Wernicke's encephalopathy 3
• For gastritis or gastroesophageal reflux causing nausea, H2 receptor antagonists or proton pump inhibitors may be needed as adjuncts to dietary modifications 7