26 Protein and ginger for the treatment of chemotherapy‐induced delayed nausea and gastric dysrhythmia

Abstract

Background: Delayed nausea occurs in many cancer patients during the three days following administration of a cytotoxic agent. Meals high in protein content decrease the nausea of motion sickness and pregnancy, possibly by enhancing normal gastric myoelectrical activity and/or by reducing gastric dysrhythmias. Ginger may also have anti‐nausea properties. The aim of this study was to explore the use of a nutritional intervention consisting of high protein meals and ginger for the management of delayed nausea experienced by chemotherapy‐naïve cancer patients. Method: Twenty‐eight cancer patients receiving emetogenic cytotoxic agents were assigned to one of three groups. During the three day study period following their first chemotherapy session, Control Group patients ( n = 9) continued with their normal diet, Protein Group patients ( n = 9) were provided with a protein drink (ProSure ® ; 15 g protein) and 1 g of dried ginger root to consume twice daily, and High Protein Group patients ( n = 10) were provided with a protein drink with additional protein powder (ProSure ® and ProMod ® ; 31 g protein) and 1 g of dried ginger root to consume twice daily. All patients were asked to complete a symptom diary over the three days to assess the severity, frequency, and bothersomeness of the nausea they experienced, as well as their use of antiemetic medication. Gastric myoelectrical activity was assessed by electrogastrography as five patients ingested a protein meal with ginger on the first morning of the study. Results: Reports of nausea, of nausea being experienced often, and of nausea being bothersome were significantly less frequent in the High Protein Group than in the Control and Protein Groups ( ps < 0.05); the Control and Protein Groups were not significantly different from each other. Furthermore, significantly fewer patients in the High Protein Group elected to use antiemetic medication than patients in the other two groups ( p < 0.05). A significant increase in normal gastric myoelectrical activity, and a significant decrease in gastric tachyarrhythmia, the gastric dysrhythmia that frequently accompanies nausea, occurred with ingestion of the protein meals and ginger ( ps < 0.05). Conclusions: High protein meals with ginger reduced the delayed nausea of chemotherapy, and reduced the use of antiemetic medications. Anti‐nausea effects of high protein meals with ginger were associated with enhancement of normal gastric myoelectrical activity and decreased gastric dysrhythmias. High protein meals with ginger represent a novel, nutritionally based treatment for the delayed nausea.