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:

  • To calm your stomach and relieve nausea, cut a lemon in half, rub it between your hands and inhale the lemon's aroma.

  • Eat while watching TV. You might forget about your nausea.

  • 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.

  • Eat and drink slowly. Breath deeply. Relax. Take your time.

  • Eat small meals throughout the day. Try six or eight small meals instead of three big ones.

  • AVOID situations, people or places that get you upset.

  • AVOID drinking before or during meals as liquids will fill you up too fast.

  • Drink fluids that are high in nutrients, like juices and electrolyte replacement drinks between meals.

  • Avoid carbonation. If you drink soda occasionally, open it and let it sit for 10 minutes to remove the bubbles.

  • AVOID greasy or fried foods.

  • AVOID foods with strong odors.

  • 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.

  • Choose cool foods rather than hot. A sandwich may be a better bet than a hot meal.

  • Use a blender and be creative.

  • Wear loose-fitting clothing while eating and rest afterwards. But stay seated--don't lie down.

  • 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.

  • 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.

 

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.

If you are allergic to any food on this list, don't eat it. All foods are to be eaten plain.

 

  • B - bananas, boiled potatoes without skin, baked sweet  potatoes without skin.

  • R - rice (steamed),* cream of rice cereal, rice water.**

  • A - apple sauce, baked apple without the peel.

  • 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.

 

*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