Hep C Discussion Forum

 It's important to eat a good, healthy diet while you are on treatment and afterward, even if you want to lose a few pounds. Your body needs good nutrition and healthy foods to fight the hepatitis C infection and repair damage that it has caused over time. This can be difficult because treatment can cause problems with your mouth and stomach. What follows are tips for coping with these side effects.

http://www.hepatitis.va.gov/patient/treat/side-effects-single-page.asp

Poor appetite

Interferon treatment can cause you to lose your appetite. This can cause poor nutrition (not eating right), which can contribute to weakness and your not feeling well.

Quick Tips: Poor appetite

• Take a walk or do stretches before a meal. This may increase your appetite.

• Eat 5 or 6 small meals each day, instead of 3 large meals. For example, eat an 8:30 AM breakfast, 10 AM snack, 12:30 PM lunch, 3 PM snack, 5:30 PM dinner, and a 7:30 PM snack.

• Eat your favorite food, even if just a little bit.

• Drink homemade fruit shakes of nutrition supplements (such as Ensure and Carnation Instant Breakfast) instead of skipping a meal. Drink liquid supplements with a straw if you find that their smell makes them less appealing.

• Keep snacks handy, such as hard-boiled eggs, cheese, and peanut butter. Keep snacks that don't require refrigeration near your bed or by the television.

• Pack foods that don't need to be refrigerated for snacking when you are away from home.

• Stock up on frozen meals in single-portion packages. These are quick and easy to prepare.

• Try different food textures (add chopped nuts, seeds, or water chestnuts to dishes) to make eating more interesting.

• Watch cooking shows and keep cookbooks around.

• Make eating enjoyable--eat with others, eat in a pleasant place, light a candle.

• When possible, do not drink fluids with your meals. They can make you feel full sooner.

Bad taste in mouth

Interferon can cause a bitter or metallic taste in your mouth. Ribavirin can cause mouth sores and dehydration, which can make your mouth feel dry and have a bad taste.

Quick Tips: Bad taste in mouth

• Tart food can "mask" a metallic taste. Drink orange, cranberry, and pineapple juice, and lemonade. Add vinegar, lemon juice, pickles, or relish to your food.

• Marinate meat, chicken, turkey, fish, or tofu in vinegar, wine, salad dressing, or soy sauce. Add fresh herbs, dried herbs, or condiments to your food (such as onion, garlic, chili powder, rosemary, thyme, basil, oregano, cumin, mustard, catsup, and mint). For example, try sweet and sour pork with pineapple.

• Eat cold food, such as sorbet, sherbet, fruit slushes, ice chips, or frozen yogurt to numb your taste buds. Eat frozen grapes, orange slices, or pieces of cantaloupe and watermelon. Or create frozen popsicles out of sports drinks.

• Chew lemon drops, zinc lozenges, mints, or gum, which can help get rid of bad or "off" tastes that linger after eating. (If you have diarrhea, go easy on your use of sugar-free candies and gum.)

• Eat dark chocolate.

• Rinse your mouth with tea, ginger ale, salted water, or water with baking soda before eating. This will help clear your taste buds.

• Use plastic utensils instead of metal utensils.

• Eat fresh or frozen foods instead of canned foods.

• Dry mouth and thick saliva

Ribavirin kills red blood cells. As a result, you don't have as much blood in your blood vessels, and you get dehydrated. This can cause dry mouth or thick saliva.

Quick Tips: Dry mouth and thick saliva

• Use sugar-free candy or sourballs, popsicles, ice cubes, or sugarless chewing gum to moisten your mouth.

• Start and end each day with a glass of water.

• Moisten food with sauce, gravy, yogurt, or salad dressing.

• Dunk bread, crackers, and cookies in soup, milk, juice, or hot chocolate.

• Drink plenty of beverages, such as lemonade or tea with lemon.

• Rinse your mouth with club soda or warm, salted water.

• Keep fluids by your bed so you can drink during the night if you are thirsty.

• Ask your doctor about mouth rinses and other products to treat your dry mouth.

Sore mouth and sore throat

Ribavirin can cause you to have an allergic reaction that might show up as a rash on your skin. It can also show up as an irritation in your mouth and throat. If you normally get mouth ulcers, they may get worse while you are on treatment.

Quick Tips: Sore mouth and sore throat

• Eat soft or pureed foods. Baby foods or toddler foods may be good substitutes.

• Drink nectars instead of juices.

• Drink instant breakfast formulas or milkshakes instead of eating solid food.

• Use a straw.

• Eat lukewarm or cool foods, not foods at hot temperatures.

• Gargle or rinse your mouth out often with warm, salted water.

• Talk to your doctor about a prescription for lidocaine mouthwash. It can ease discomfort from mouth sores.

• Try to stay away from:

  • foods that are spicy, salty, acidic, or high in citrus content (such as oranges and grapefruits)

  • rough food like dry toast, granola, and pretzels

  • chili powder, cloves, curry, hot sauces, nutmeg, and pepper

  • carbonated beverages (such as colas)

• Nausea and vomiting

Nausea is a common side effect of hepatitis C therapy. It can be caused by both interferon and ribavirin. Vomiting repeatedly can lead to dehydration and chemical imbalances in your body. Tell your doctor if you vomit frequently, or if nausea and vomiting stop you from taking your ribavirin.

Quick Tips: Nausea and vomiting

What to try:

• Try the BRATT diet (bananas, rice, applesauce, tea, and toast).

• Eat small, snack-sized meals every 2 to 4 hours, instead of 2 to 3 big meals during the day.

• Take your ribavirin with food.

• Eat foods cold or at room temperature. Fruit or a sandwich with cold cuts or cheese is fine. Hot food can contribute to nausea and vomiting.

• If you've vomited, be sure to "refuel" your body with broth, carbonated drinks, juice, Jell-O, or popsicles.

• Leave dry crackers by your bed, and eat a few before getting up in the morning.

• Foods that may help your nausea and vomiting:

  • Salty foods, such as crackers, pretzels, and unbuttered popcorn

  • Dry foods, such as dry ready-to-eat cereal, crackers, melba toast, and cookies; keep these foods close to your bed or favorite chair so they are within easy reach

  • Peppermint, chamomile, and ginger tea; they can calm the stomach

  • Cold carbonated drinks such as ginger ale, 7-Up, and Sprite

• Talk to your health care provider about whether you should take medicine for your nausea.

What to avoid:

Don't lie flat for at least 1 hour after you eat.

• Avoid smells and foods that trigger nausea (use boiling bags, microwave ovens, or covers for pots). Open the windows to decrease food odors when you are cooking.

• Avoid eating if nausea is extreme.

• Avoid very sweet foods and foods that are hot, spicy, strong-smelling, or greasy.

Diarrhea

While you are on therapy, you may experience diarrhea at times. For some people, diarrhea can be the main side effect of treatment. It's important to replace lost fluids, which can lead to dehydration and weakness.

Quick Tips: Diarrhea

What to try:

• Try the BRATT diet (bananas, rice, applesauce, tea, and toast).

• To replace lost fluids, drink plenty of mild, clear liquids throughout the day. These include sports drinks (Gatorade, Powerade, All Sport), chicken or beef broth, herbal tea, or water. Drink liquids at room temperature.

• Eat foods high in soluble fiber. This kind of fiber can slow diarrhea by soaking up liquid. Foods high in soluble fiber include oatmeal, cream of wheat, grits, toast (not whole grain), bananas, rice, and applesauce. A tablespoon of Metamucil mixed with juice may also help.

• Try psyllium husk fiber bars, available in health food stores. Two bars eaten 1 hour before bedtime with a large glass of water can help.

• Eat small, frequent meals and snacks throughout the day.

• Drink and eat high-sodium foods, such as broth, soups, sports drinks, crackers, and pretzels.

• Choose foods and drinks high in potassium, a mineral that you lose with diarrhea. These include bananas, potatoes (without the skin), fish, chicken, and meat, and juices such as orange, apricot, mango and peach, V-8, and Gatorade.

• Drink at least 1 cup of liquid after each loose bowel movement.

• Ask your doctor about antidiarrheal medications such as Lomotil, Kaopectate, Imodium, and Pepto-Bismol.

What to avoid:

• Avoid greasy, fried, spicy, or very sweet foods.

• Limit drinks with caffeine, such as coffee and cola.

• Avoid dairy products (avoid for at least 3 days after symptoms resolve).

• Avoid food and drinks that may cause cramps or bloating, such as beans, cabbage, broccoli, brussels sprouts, onions, green peppers, and carbonated drinks.

• Limit use of sugar-free gums and candies made with sorbitol.