Why does pancreatic cancer cause nausea and vomiting?
There are a few things that can cause sickness if you have pancreatic cancer.
Blocked duodenum
The cancer can block the duodenum, which is the first part of the small intestine. You can see the duodenum on this diagram. The blockage can stop food passing out of the stomach into the duodenum. The food builds up in your stomach and makes you feel and be sick. If the duodenum is blocked, you might vomit large amounts, especially after food.
How is a blocked duodenum treated?
You may have a hollow tube called a stent put in to open up the blockage and stop the sickness. If you are having long term treatment and are well enough, you may have bypass surgery to treat the blockage, rather than a stent. This is an operation that connects the stomach to the small intestine below the blockage, so food can pass through. This should stop the sickness.
If you have a blocked duodenum, your doctor will talk to you about the best treatment for you.
If you have a stent put in, you should start to feel better quite quickly. Sometimes there can be problems with stents including blockages. You will need to be careful about what you eat to stop the stent getting blocked. A blocked stent can mean you vomit a lot, especially after food.
Stomach emptying slowly
Pancreatic cancer can affect the nerves and hormones that control the stomach. If this happens, food passes through the stomach more slowly. This is called delayed gastric emptying or gastroparesis. It can make you feel full all the time and feel sick. It can also cause other problems like indigestion (a painful, burning feeling in your chest) and difficulty finishing even small meals.
Medicines such as steroids and certain types of anti-sickness medicine can help.
Jaundice
The cancer can block the bile duct. This is the tube that takes a fluid called bile from the liver to the duodenum (the first part of the small intestine). You can see the bile duct on this diagram.
A blocked bile duct causes jaundice, which can make you feel and be sick, as well as turning your eyes and skin yellow.
If the bile duct is blocked, you may need a stent put in, to open the bile duct. This will relieve symptoms of jaundice.
Treatments for the cancer
Some treatments for the cancer, such as chemotherapy or radiotherapy, can make you feel sick. You should be given anti-sickness medicine to help with this.
You may also feel sick after having surgery to remove the cancer. This is because it can take time for your digestive system to start working properly again. The sickness can be treated with drugs and is usually only temporary. Eating smaller meals more often can also help.
Problems digesting food
Pancreatic cancer can cause problems with digesting food, which can make you feel sick. Problems digesting food can be treated with pancreatic enzyme replacement therapy (PERT), which should relieve sickness. Read more about digestion and pancreatic cancer.
Some medicines
Some medicines, such as antibiotics and opioid painkillers (such as morphine) can make you feel sick. Follow the advice your medical team gives you about how to take your medicines, as this will help to prevent sickness. This includes instructions about taking tablets with or after food. Your doctor or nurse may also give you anti-sickness medicine. If your painkillers are making you feel sick, speak to your nurse or doctor.
Opioid painkillers can also cause constipation (when you find it harder to poo), which can cause sickness, as well as being very uncomfortable. You should be given medicines called laxatives to take with opioids. If these don’t help the constipation, speak to your nurse or doctor.
Anxiety
Feeling anxious or distressed can make you feel sick. For example, people sometimes feel sick because they feel anxious before chemotherapy treatment.
There are things that can help with anxiety. Your doctor or nurse may give you a medicine to treat anxiety, such as lorazepam. Or you might find relaxation techniques can help. Read about different ways to help you deal with the emotional impact of pancreatic cancer.
