Nausea, Vomiting, and Loss of Appetite
People with lupus may experience gastrointestinal problems including nausea, vomiting and loss of appetite. There may be many causes for these symptoms: These symptoms may be side effects to certain medications. In particular, steroid pills such as prednisone or methylprednisolone (also known as Medrol) can cause acid reflux, nausea or pain in the upper abdomen. Other medications used to treat lupus, such as mycophenolate mofetil or methotrexate, can be associated with nausea or diarrhea. Ibuprofen or naproxen can cause stomach pain or burning due to irritation of the stomach lining, known as gastritis. Other causes for these symptoms might include the viral gastroenteritis (also known as the "stomach flu"), pregnancy, overeating, emotional distress, food allergies, food poisoning, motion sickness, and other medications.
Diarrhea, Constipation, and Abdominal Pain
People with lupus have higher rates of irritable bowel syndrome (IBS). Symptoms of IBS include chronic abdominal discomfort that may improve with passage of a bowel movement and may be associated with diarrhea or constipation. IBS symptoms are also associated with depression and pain from fibromyalgia. Rarely, lupus can cause inflammation in tissues in the gastrointestinal system which would cause abdominal pain.
Seeing a Doctor for Nausea, Vomiting, and Loss of Appetite
People should see a doctor if they have experienced nausea for more than several days or vomiting for more than one day that does not respond to home treatment.
Anyone should seek immediate medical attention if they experience vomiting with:
- Blood in vomit (bright red or black)
- Diarrhea
- Rapid breathing or pulse
- Fatigue or confusion
- Severe headache or stiff neck
- Severe abdominal pain
If you suspect your symptoms are related to a medication, you should contact your doctor before stopping the medication. As you prepare to see your doctor for nausea or vomiting, you may want to keep a log of the foods, drinks, and medications you consume to help your doctor determine whether certain foods trigger your symptoms.
You should see your doctor about your loss of appetite if you have lost more than 5% of your body weight in the past 3 months. If you are underweight or have an underlying condition, you may need to speak with a dietitian.
Self-Care for Nausea, Vomiting, and Loss of Appetite
To prevent nausea, you should:
- Eat small, frequent meals that are low in fat
- Eat slowly
- Consume clear, cool liquids such as water, soup, carbonated beverages, or popsicles
- Drink 30 or 60 minutes after eating instead of during mealtime
To prevent vomiting while nauseous, you should:
- Gradually sip a sugar-sweetened beverage such as soda or fruit juice (but not grapefruit or orange juice, which are too acidic)
- Sit or lie down with your head elevated to rest
- Consume bland starches such as crackers, rice, or bread and avoid greasy, sugary, or fried foods
If you are vomiting:
- Rest
- Avoid solid foods until the vomiting episode has passed
When you experience a loss of appetite, it is still important to eat regularly. Try to consume 3 snacks and 3 small meals a day that are high in protein. High energy foods include:
- Whole wheat and whole grain bread
- Bananas
- Dairy products
- Seeds, nuts, and nut butters
- Chicken and fish
- Oats
- Lentils