Eating problems

Some people who are ill find that their taste changes, although this is usually temporary. They may no longer enjoy certain foods or find that all foods taste the same, or they notice a metallic taste in their mouths. Occasionally, they can’t taste anything at all.

If your taste changes, here are some tips for making your food more palatable:

• concentrate on eating the foods that you like the taste of and ignore those that do not appeal to you. However, do try them again after a few weeks, as your taste may have gone back to normal
• use seasonings and herbs like rosemary, basil and mint, and spices to flavour your cooking. However, if your mouth is sore you may find that some spices and seasonings make it worse
• Try marinating meat in fruit juices or wine, or dress it in strong sauces like sweet and sour or curry. Cold meats may taste better garnished with pickle or chutney
• sharp-tasting foods like fresh fruit, fruit juices and bitter boiled sweets are refreshing and leave a pleasant taste in the mouth
• some people might go off the taste of tea or coffee. You could try a refreshing lemon or green tea instead or perhaps an ice-cold fizzy drink like lemonade
• some people find that cold foods taste more palatable than hot foods
• serve fish, chicken and egg dishes with sauces

This is the time to rely on quick convenience foods such as frozen meals, tinned foods, boil-in-the-bag meals and takeaways. Remember, though, to defrost frozen foods thoroughly and to cook all foods properly to avoid any risk of food poisoning. Read cooking instructions carefully and stick to them.

If you know in advance the times you are likely to feel tired, for example after treatment, then you could try to plan ahead to help you through these times. If you have a freezer, you could prepare food while you are feeling active and freeze it for when you are more tired. You could stock up on convenience foods.

This is also a good opportunity to give friends and family the chance to help you by doing some shopping or cooking.

If you really can’t face eating, try a nourishing drink. You can make a smoothie by blending bananas, peaches, strawberries or other soft fruit (fresh or frozen) with fortified milk, fruit juice, ice cream or yoghurt in a liquidiser or blender.

If you feel you need more help at home with your cooking or eating, tell your GP, or if you have either a dietitian or specialist nurse inform one of them.

Soft diets can become boring if people tend to rely on soup and ice cream. But with a little imagination and effort, a soft diet can be both appetising and nutritious.

The golden rule is to eat your favourite foods, but make changes which will soften them. For example, cover foods in interesting sauces and gravies; finely chop meat and vegetables and casserole or stew them; and cut the crusts off bread for softer sandwiches. If you have a blender you could blend or liquidise cooked foods.

There are several commercial products that you may find helpful for convenience and variety. You can get these products from your chemist. Your doctor may give you a prescription for some of them.

Weight loss and poor appetite are common in cancer and chronic illnesses. Both can affect energy levels and quality of life and can cause anxiety in people who have an illness and their carers. Loss of appetite may cause withdrawal and isolation if you do not feel like joining others for a meal.

Some people have a loss of appetite and a loss of taste due to their treatment. If you notice these problems, it may be helpful to discuss them with a dietitian at the hospital or if you are at home, with your doctor or nurse who may then refer you to a community dietician. They should be able to help you with any eating difficulties and suggest how to make food more palatable.

• Eat little amounts as often as possible if you cannot face big meals. Try to have a small portion of food every two hours during the day
• Tempt your taste buds by making your food look as attractive as possible. Put small portions on your plate and garnish the food with lemon, tomato or parsley
• A glass of sherry or brandy half an hour before a meal is a good way of stimulating your appetite. Some people find a glass of wine with their meals helps their digestion
• Keep snacks handy to nibble whenever you can. Bags of nuts, crisps, dried fruit or a bowl of grated cheese are quite light and tasty. If these are hard for you to swallow, a yoghurt or fromage frais may slip down more easily
• Sweet or savoury nourishing drinks can be used to replace small meals and can be sipped slowly over the course of a day
• Eat your meals slowly, chew the food well and relax for a little while after each meal
• Sometimes the smell of food cooking can be appetising, but occasionally it can put you off eating. If cooking smells spoil your appetite, keep away from the kitchen and ask your family or friends to cook, or eat cold foods attractively presented
• Everyone’s appetite changes and you may have good and bad days. Make the most of the good days by eating well and treating yourself to your favourite foods
• Have your meals in a room where you feel relaxed and without distractions
• It may be possible to stimulate your appetite using medicines. Your doctor may prescribe these for you

Some medicines such as steroids may give you a big appetite and may make you want to eat much more than usual. It is important to try and eat healthy foods such as fruit and vegetables instead of sweets and crisps so that you don’t put on too much weight.

• Make sure you have plenty of fibre (roughage) in your diet. Good sources of fibre include wholewheat breakfast cereals like Weetabix, Shredded Wheat, or muesli; wholemeal bread and flour; brown rice; wholemeal pasta; fresh fruit and vegetables with skins on
• Favourite natural remedies for constipation are syrup of figs, prunes and prune juice
• Make sure you drink plenty of fluids. Hot or cold drinks will be helpful. Aim to drink at least two litres a day
• Gentle exercise will help to keep your bowels moving
• If the constipation is due to medicines that you are taking (such as painkillers or anti-sickness drugs) you will need to take laxatives. Your doctor can prescribe these for you

• Tell your doctor if you have diarrhoea. They can investigate the cause, and prescribe some anti-diarrhoea medicines
• Make sure you drink plenty of fluids to replace the water lost with the diarrhoea, but avoid alcohol, coffee and orange juice
• Acidophilus or other bacteria found in live yoghurt or live-yoghurt drinks can help to ease diarrhoea caused by antibiotics. Antibiotics can kill off the healthy bacteria normally found in the bowel, but the bacteria found in live yoghurt may replace them. Avoid live yoghurt if your immunity is low
• Eat small, frequent meals made from light foods – dairy produce, white fish, poultry, eggs (well-cooked), white bread, pasta or rice. Avoid highly spiced or fatty foods and eat your meals slowly

Try the following advice for dealing with excess wind:

• Eat and drink slowly. Take small mouthfuls and chew your food well
• Avoid food that you think gives you wind; for example, beans, pickles and fizzy drinks
• Peppermint can help - either drunk as two teaspoonfuls of peppermint water dissolved in a small cup of hot water (with sugar if necessary), peppermint tea or peppermint capsules
• You could try taking charcoal tablets, available from your chemist
• Gentle exercise, especially walking, can bring some relief
• Try to ensure your bowels are opening regularly - wind can be a sign of constipation
• If the pain becomes severe or continues, tell your doctor

Try the following advice if you feel sick:   

• if the smell of cooking makes you feel sick, eat cold meals or food from the freezer that only needs heating up. However, remember to defrost it thoroughly before cooking, and to make sure it is properly cooked
• if possible, let someone else do the cooking
• avoid greasy, fatty or fried foods
• try eating some dry food, such as toast or crackers, first thing in the morning before you get up
• when you feel sick, start by eating light foods like thin soups or egg custards and gradually introduce small portions of your favourite foods, slowly building up to a more substantial diet
• food or drink containing ginger can help to reduce feelings of sickness. You can use crystallised ginger, ginger tea, or ginger biscuits
• sipping a fizzy drink is a popular remedy for feeling sick. Try mineral water, ginger ale, lemonade or soda water and sip it slowly through a straw
• try having drinks between meals rather than with your food
• ask your doctor to prescribe some anti-sickness tablets (anti-emetics) for you. Take these regularly, as recommended by your doctor, to prevent sickness
• eating small meals frequently can be better than trying to eat large meals less often
• try to make sure you have regular bowel movements - constipation can make you feel sick

Some people may have particular eating problems that are not covered by this section. For example:

• People with diabetes
• People who have a colostomy or ileostomy.
• People who have had all or part of their stomach removed.
• People who have had treatment to their mouth or jaw.

These people may need to follow a special diet individually designed for them. You can get advice about these diets from your doctor, specialist nurse or dietitian.