Practical Management of Eating Difficulties

Anorexia

Anorexia (loss of appetite) is often associated with other eating difficulties, such as nausea, taste changes, and constipation, and addressing these problems may improve the patient's appetite. Pain may also contribute to anorexia, and regular analgesia for pain may in turn help improve appetite, as may dietary alterations (Table 2). For patients who have severe anorexia, an appetite stimulant should be considered, such as dexamethasone, medroxyproes-terone acetate, or megestrol acetate.

Taste Changes

Cancer patients may suffer from lack of taste or 'taste blindness,' they may find that foods taste metallic or excessively salty or sweet, or they may find that foods taste abnormal. Depending on the taste change experienced, it is often worth excluding certain foods from the diet or using certain flavorings to try to stimulate the taste buds (Table 3).

Table 2 Dietary management of anorexia

Give small, frequent meals and snacks in preference to three meals daily.

Serve food on a small plate.

Ensure food looks appetizing.

Encourage any food the person prefers, even if it is all of one type (e.g., puddings).

Distract from eating (e.g., by conversation, watching television, or listening to music).

Give an alcoholic drink to be sipped before meals or with food.

Table 3 Suggestions for overcoming taste changes

Taste change

Suggestions

Excessively

Reduce sugar content of food and drink.

sweet

Add a pinch of salt to drinks and puddings.

Excessively

Avoid packet soups, gravy, and sauces.

salty

Avoid salted snacks (e.g., crisps and nuts) or

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