Some GVHD GI symptoms can be treated with medications, but there are also many ways to help manage these issues through diet.
Diarrhea
GVHD attacks the lining of the digestive tract and can disrupt the nerves that move food and drinks through the body. “Diarrhea can be caused by the ineffective absorption of nutrients and fluids, and instead of it taking 24 to 72 hours to digest food, it rushes through,” says Martin.
To minimize its impact, follow a clear liquid diet, which includes items such as broth, ginger ale, and diluted juices without pulp. “This is a nutrition plan that allows your gut to heal so all those good digestive cells can regenerate and grow,” says Martin. It’s also good to opt for room-temperature food and drinks, which are easier to absorb, and to eat small amounts every two hours. Lying down can also help slow your digestion. “After you feel better, you can also eat soft foods like rice, applesauce, bananas, toast, and soft pretzels to help your body start to process easy-to-break-down foods,” she adds.
Nausea and Vomiting
For people with GVHD, nausea and vomiting are common problems, according to Bratton. “Eating small, frequent meals throughout the day is very important, as is minimizing liquids while you eat,” she advises. Stick to room-temperature fluids in between meals. If you’re sensitive to smells and someone is cooking in the house, take a walk outdoors. And while lying down is good for diarrhea, sitting upright is better for nausea to help move foods into the small intestine.
Make sure you’re taking your anti-nausea medications as you’ve been instructed. “If you are, you might want to ask your healthcare team if there’s a medication they can add on or change. Finding that right kind of cocktail of anti-nausea meds can really work wonders sometimes,” Bratton adds.
Mouth Sores
Mouth sores are annoying and painful but often can be managed with simple techniques. Choose soft, moist foods, such as mashed potatoes or oatmeal, over those with a dry, rough texture, such as toast or tortilla chips, Bratton suggests. When possible, choose lukewarm or cold foods over hot ones. If you’re limited in what you can eat, drink milkshakes or smoothies so you can get adequate calories and protein. “Getting those nutrients in is really important to heal those sores,” she adds.
“If you’ve followed some of these tips and the pain is still limiting your ability to eat, your physician may be able to prescribe pain meds that help numb the tissues in the mouth,” Bratton says.
Dry Mouth
Alcohol and tobacco products can worsen dry mouth, so it’s best to avoid them, says Bratton. Instead, keep your mouth moist with gum, ice chips, ice pops, or hard candy.
There are also over-the-counter moisturizing sprays for easing dry mouth, but you may have to use them frequently, she adds.
Weight Loss
Although we’re bombarded by messages about how healthy it is to lose weight, it’s not good when you’re dealing with GVHD. “Think about what you eat that works well, which you can digest with the least amount of discomfort,” Martin suggests.
Think about when you naturally tend to be hungriest and eat more at that time, whether it’s at breakfast or later in the day. “Plan to eat more to match that hunger,” Martin says.
When you eat, choose higher-calorie foods first, such as proteins and starches, followed by vegetables and fruits. You can also bump up the calories in your meal without having to make an extra dish by adding “calorie boosters”: butter, margarine, vegetable or olive oil, sour cream, maple syrup, melted cheese, chopped meat, gravy, and sauces.
Taste Changes
Many people struggle with taste changes when dealing with GVHD. A common complaint is that meat tastes bitter, says Bratton. “You can marinate it in something a little sweeter like a teriyaki sauce,” she suggests.
If you’d rather skip meat altogether, try other protein sources, such as cottage cheese or yogurt. “There is not one strategy that can ameliorate all taste changes. Using strategies like marinating meats and choosing foods that taste better can help you meet your nutrition needs until the taste changes subside, which can be after treatment is done,” Bratton says.
Dry mouth can also cause taste bud changes. “When you’re able to manage dry mouth, taste can actually improve,” Martin says.
