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Suggestions
for Coping with Specific Eating Problems
Nausea or Vomiting
Diarrhea Problems Chewing or Swallowing
Poor Appetite
Nausea or Vomiting HIV-infected individuals
commonly experience nausea and vomiting as a result of
certain opportunistic infections--or as a side-effect of
medications. Most people don't even want to think about
eating when they feel nauseated. But not eating will just
make you sicker, and may interfere with the absorption of
your medications, so it's important to make every effort to
get some nourishment into your body. The following
guidelines may help you eat even when you're experiencing
nausea:
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To calm your stomach and relieve
nausea, cut a lemon in half, rub it between your hands and inhale the lemon's
aroma.
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Eat while watching TV. You might
forget about your nausea.
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Foods that may be easier to
tolerate include clear soups or broth; rice, noodles, oatmeal, or cream of wheat
without butter or sauce; mashed potatoes; plain eggs, cottage cheese, or yogurt;
pudding or jello; plain crackers, pretzels, or unbuttered popcorn; and canned
fruit, fruit ices, or a chilled supplement. Try your personal comfort foods.
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Eat and drink slowly. Breath
deeply. Relax. Take your time.
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Eat small meals throughout the
day. Try six or eight small meals instead of three big ones.
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AVOID situations, people or
places that get you upset.
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AVOID drinking before or during
meals as liquids will fill you up too fast.
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Drink fluids that are high in
nutrients, like juices and electrolyte replacement drinks between meals.
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Avoid carbonation. If you drink
soda occasionally, open it and let it sit for 10 minutes to remove the bubbles.
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AVOID greasy or fried foods.
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AVOID foods with strong odors.
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AVOID sweet or spicy foods.
Instead try foods that are either salty or bland. Plain crackers,pretzels,
toast, or dry cereal may help relieve your nausea.
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Choose cool foods rather than
hot. A sandwich may be a better bet than a hot meal.
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Use a blender and be creative.
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Wear loose-fitting clothing while
eating and rest afterwards. But stay seated--don't lie down.
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If you have to cook for others,
be sure your cooking area is well ventilated so the cooking odors don't get you
nauseous. If you do get nauseous, you may not want to try and eat right after
you cook. Wait 30 minutes or so until your stomach calms down.
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AGAIN, BE SURE TO TELL YOUR
DOCTOR ABOUT YOUR NAUSEA. THESE ARE MEDICATIONS THAT CAN HELP RELIEVE YOUR
SYMPTOMS. AND IF YOUR MEDICINE IS MAKING YOU SICK TO YOUR STOMACH, IT MAY BE
POSSIBLE TO RESCHEDULE YOUR MEALS AROUND SPECIFIC MEDICATIONS.
Diarrhea Diarrhea is a common problem for people with HIV and
AIDS and one that can rapidly affect your nutritional status--causing weight
loss and dehydration. Anyone experiencing diarrhea for more than two days or
unusually severe diarrhea should see a doctor as soon as possible.
Causes of diarrhea can range from medications, infections, food poisoning, food
intolerance, and emotional stress. Try to pinpoint the cause or causes. Consider
that there may be several small problems contributing to your diarrhea rather
than one large one. Find out if you are lactose intolerant or have trouble with
any other food such as bread or pasta. Ask to be tested for parasites, bacteria,
mycobacteria, viruses, or fungi. Often a specific reason is difficult to
determine. But whatever the cause, the important thing is to maintain your
intake of food and fluids in order to prevent weight loss and dehydration.
Some foods that may be easier to tolerate include plain rice or noodles;
oatmeal, cream of wheat,or farina with no milk or butter; potatoes without
butter or gravy; or plain bread, toast, or crackers. You can add sugar, jelly,
or syrup to these foods if you like. You might also try skinless chicken or
turkey; low-fat meats and fish; hard-boiled eggs; smooth peanut butter; low-fat
cheese or yogurt; applesauce, bananas, and pureed vegetables; canned fruits and
grape, orange, cranberry, peach, and apricot juices and nectars. Eat foods at or
near room temperature.
AVOID eating in places that cannot or will not cook according to your needs.
When someone else is cooking, you may be eating something that contributes to
your diarrhea.
AVOID high-fiber foods like raw fruits and vegetables (especially those with
skins and seeds), nuts, whole grains, and corn. Instead eat fruits like bananas,
appleasauce, canned or cooked fruits--or even baby food.
AVOID spicy foods such as chili, pizza, hot sauce, and black pepper.
REPLACE essential body fluids. Drink beverages such as juices, nectars, cera
lyte, Gatorade, or Kool-Aid to replace viatmins and minerals your body may be
losing. Try to drink eight to ten glasses of these fluids a day (at room
temperature). Non-fatty soups or broths without cream can also help replace
fluids.
AVOID alcohol and caffeine, including coffee, black tea, chocolate, and
caffeinated sodas.
AVOID fatty, greasy, fried foods and fatty meats, such as hot dogs, bacon
sausages, bologna, fried chicken, fried fish, or other fried meats. Limit your
intake of butter, margarine, mayonnaise, salad dressings, and other oils. Fats
often make diarrhea worse.
AVOID whole milk and milk products such as dips, cream sauces or soups, whipped
cream, etc. Stick to low-fat products such as skim milk and low-fat cheese and
yogurt. You might also try avoiding milk and milk products altogether for a few
days to see if your diarrhea subsides. Many people cannot tolerate milk products
but are able to eat low-fat yogurt and buttermilk. Speak to your nutritionist
about "lactaid" if you are lactose intolerant.
Eat frequent small meals. Six or eight small meals will be easier to digest than
three big ones.
Use the BRAT diet as model for combating diarrhea.
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BRAT Diet for
Diarrhea
The BRAT diet is used to help slow down or stop diarrhea. It is
not meant to be used for more than a couple of days at a time because it does
not contain all the nutrients you need to stay healthy.
And always drink lots of clean water.
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If you are allergic to any
food on this list, don't eat it. All foods are to be eaten plain.
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B - bananas, boiled potatoes without skin, baked sweet potatoes
without skin.
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R - rice (steamed),*
cream of rice cereal, rice water.**
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A - apple sauce, baked
apple without the peel.
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T - tea without caffeine
and white bread toast, unsalted plain crackers.
While on this diet, don't eat
or drink anything with caffeine like chocolate, cola, coffee, tea, hot
chocolate or chocolate soda. Don't eat synthetic fats like olestra or Olean
at any time.
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*Cooked, plain white rice is very
easy to find when you are out in the world making your rounds. Any Chinese
restaurant has it for take-out. Small containers are very cheap.
**Rice water is made by cooking white rice with more water than it needs. For
example, four cups of water to ½ cup of rice. When the rice is soft, pour the
extra water into a container that can be covered, and put it into the
refrigerator until it cools off. Refrigerate the rice in a closed container
until you need it. Drink the water and eat the rice. Rice water is easier to
drink when cold. |
REMEMBER, DIARRHEA AFFECTS EVERYONE DIFFERENTLY. TRY THE SUGGESTIONS
NOTED ABOVE AND SEE WHAT WORKS BEST FOR YOU.
Problems Chewing or Swallowing Many people with HIV suffer from
oral thrush or ulcers in the mouth or throat that can make chewing and
swallowing painful or difficult. The dental problems that HIV-infected
individuals commonly experience can also complicate eating--particularly in the
case of missing teeth or poorly-fitting dentures. There are medications that can
help heal certain oral infections, and if you're experiencing mouth sores, you
should definitely consult your dentist. The following guidelines may help you
eat if you're experiencing mouth pain.
CHOOSE soft foods that you don't have to chew much, such as cooked cereal,
mashed potatoes, chopped meat, cottage cheese, macaroni and cheese, tuna or egg
salad, stews, soups, applesauce, mashed bananas or other fruits, scrambled eggs,
canned fruits, puddings, jars of baby food, or foods made with silky tofu.
If possible, use a blender to puree foods.
Try cutting food into small bit-sized pieces for easier chewing.
Add gravy, broth, yogurt, reduced fat mayonnaise, or evaporated skim milk to
foods to help make them moister.
Soak dry foods like bread, crackers, cake, and cookies in milk or other
beverages before eating.
Use a large straw for both beverages and pureed foods.
AVOID salty or spicy
foods.
AVOID acidic foods like tomatoes and sauce, oranges and other citrus fruits and
juices if they bother you.
AVOID rough foods like raw fruits and vegetables, nuts, corn, and rice.
CHOOSE cool and cold foods that can help soothe your mouth and throat. Avoid
very hot foods.
AVOID carbonated beverages if the bubbles hurt your mouth.
Practice good dental hygiene. Brush your teeth with a soft-bristled toothbrush
in the morning when you wake up, in the evening before bedtime and after every
meal. If it isn't possible to brush, rinse your mouth with warm salt water after
a snack. Avoid commercial mouthwashes that irritate your mouth. See a dentist
who specializes in HIV/AIDS every three months. If you don't know where to find
one, ask your health care provider, your hospital, or a local AIDS service
organization.
REMEMBER TO INFORM YOUR PRIMARY HEALTH CARE PROVIDER, DENTIST, AND
NUTRITIONIST IF YOU HAVE MOUTH SORES OR EXPERIENCE PAIN WHEN SWALLOWING. IN
ADDITION TO RECEIVING MEDICATION TO CLEAR UP THE SORES, YOU MAY NEED A
NUTRITIONAL SUPPLEMENT IF YOU HAVE LOST WEIGHT.
(See
HIVDent.)
Poor Appetite Try to make meals as
appealing and attractive as possible, e.g., garnishes, spices, etc. Eat every
hour even if you are not hungry.
Try to eat small portions of various foods all day long instead of trying to eat
large meals. Eat with friends. Eat in front of the TV. Go to a congregate meal
program like The Momentum Project. Ask your primary health care provider for an
appetite stimulant.
See also How
to Change Your Eating Habits.
HIV Plus,
Managing Side Effects
AIDS Community Research Initiative of America
Community Forum,
January 13, 2000 Living with it: Recent Advances in Side Effect Management
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