Feeling and being sick at the end of life

Possible causes of sickness in the last few months of life include:

• cancer blocking the duodenum
• the stomach emptying slowly
• the liver not working properly
• constipation (problems emptying your bowels)
• some medicines
• anxiety.

Feeling and being sick is unpleasant and distressing. It may also mean that you aren’t properly absorbing medication that you take as tablets. If you are being sick a lot, there is a risk that you could become dehydrated (where your body loses more water than it takes in).

How is sickness managed?

Speak to your doctor or nurse if you are being sick. If you have been vomiting for a day or more, contact your GP, district nurse, or your GP out of hours service. They will work out what is causing your sickness, and give you treatment. For example, they may give you anti-sickness drugs. Read more about sickness, including anti-sickness medication that’s available, and other things that can help.

Blocked duodenum at the end of life

Pancreatic cancer can block the duodenum (the first part of the small intestines), which will mean that food can’t flow out of the stomach.

If this happens, food can build up in your stomach, making you feel full and be sick. You may find you are sick more in the evenings or at night, and you may vomit large amounts. You may feel better for a while afterwards but then start to feel sick again. A blocked duodenum may also cause pain, cramping and bloating in the tummy area, loss of appetite and weight loss.

Diagram showing the cancer blocking the duodenum

A duodenal stent to treat a blocked duodenum

Some people in the last few months of life may be able to have a duodenal stent inserted to treat a blocked duodenum. This is a tube that will open the part of the duodenum that is blocked. You should find that your symptoms start to improve afterwards.

If you have already had a stent put in, it can get blocked, making you feel sick. If this happens, the stent may need to be replaced.

To avoid the stent getting blocked, eat small, frequent meals and choose soft foods like porridge, minced meat and mashed potato. Read more about diet and a duodenal stent.

A duodenal stent won’t be suitable for everyone. You will need to be fit enough to have a sedative (to make you sleepy) or an anaesthetic (so that you are asleep) to have the procedure.

If you can’t have a duodenal stent

If a stent isn’t suitable or if you are not fit enough to have a stent put in, your doctor will give you medication to manage the sickness as well as any other symptoms, such as pain relief.

Some people may be able to have their stomach drained to stop them being sick. This may be done with a nasogastric tube, which is a thin tube that passes up your nose and down into your stomach. Or occasionally a tube called a venting gastrostomy tube can be inserted through the skin into the stomach. This won’t be suitable for everyone, and may not be used that often.

Published March 2018

Review date March 2020