Nausea and Vomiting After Surgery

Postoperative nausea and vomiting (PONV) is a major problem during recovery from surgery. It's also quite common. After surgery:

• 30% of people have vomiting
• 50% have nausea
• 80% of high-risk people have both

PONV can lead to complications. These include dehydration, discomfort, pain, and problems with the incision.

This article looks at the possible complications, reasons for nausea and vomiting, and how to prevent it.

Complications of Nausea and Vomiting

Feeling nauseous after surgery is uncomfortable. It can drastically slow your return to normal eating and drinking.

Vomiting is more serious. It can cause dehydration and pain. Plus it puts a lot of stress on some incisions.

That can lead to major complications. The sides of the incision can pull apart. Organs may even protrude through the opening. These problems are called dehiscence and evisceration.

When PONV starts, quick treatment can prevent serious issues.

Why Is Nausea Common After Surgery?

PONV happens for several reasons. It's a known risk of anesthesia. Other causes include:

• Dehydration
• Taking medications on an empty stomach
• Returning too quickly to a normal diet
• Lack of preventative medication

Research suggests you're more like to have PONV if you're:

• Female
• Over 50
• A non-smoker
• Prone to motion sickness

The type of anesthesia also plays a role. If you're sedated for an outpatient or dental procedure, you'll get less anesthesia and for less time than the average person having major surgery. 

Some people have nausea and vomiting every time they go under anesthesia. That makes preventing the problem more important.

This may mean getting medications before and even during surgery. That way, they're in full effect when you really need them. 

If you have chronic nausea, you're at a far higher risk of POVN. It's common for anesthesia to make your typical urge to vomit even worse. 

Prevention

With proper planning and communication, you and your medical care team can prevent nausea and vomiting after surgery.

Talk to Your Care Team

If you have chronic nausea or you've had PONV before, you're at risk of having it again.

Talk to your surgeon and anesthesiologist about it. They may be able to choose medications that are less likely to cause nausea and vomiting.

Your care team can also provide preventative medications such as:

• Zofran (ondansetron)
• Phenergan (promethazine)
• Benadryl (diphenhydramine)

These medications can also be used if you're nauseous after surgery. Speak up as soon as you notice nausea.

Prevent Dehydration

Staying hydrated before and after surgery can help prevent PONV.

You need to stay away from food and non-clear liquids for safety reasons. But anesthesiologists sometimes okay clear fluids closer to the time of surgery.

Dehydration can be a problem after procedures, as well. Drinks containing electrolytes can help hydrate you more quickly than other beverages.

If you're recovering at home, have a sports drink or Pedialyte. If you're in the hospital, ask the nurse for something with electrolytes. 

Control Your Pain

Don't skip your pain medication because you're nauseous. You may be concerned that the drugs will make you sick.

But research suggests pain makes you more likely to vomit. Pain control can make it less likely.

Don’t Rush Your Diet

Slowly return to normal foods to minimize nausea. Usually, after surgery, you don't get to eat until you're passing gas.

After that, stick with small amounts of clear fluids for a few hours. If they don't bother you, try to drink some juice or milk.

Assuming you're still doing well, then introduce some soft foods. Applesauce or pudding are common choices.

Go back to a normal diet only if you've been able to tolerate everything so far. Keep it slow and cautious, though.

Temperature May Be Key

Some people are sensitive to the temperature of fluids. If cold drinks tend to bother your stomach, ask for room-temperature or warmer drinks. Or, if hot drinks are a problem, ask for cooler options. 

Getting overheated makes some people nauseous. If you're feeling overly warm, do what you can to cool off.

Use Ginger

Ginger, in general, has been shown to help with nausea. Candy and other foods that contain real ginger can be helpful. Be sure they contain real ginger and not just flavoring.

Some people make tea with fresh ginger and drink it hot or over ice for relief. 

Flat ginger ale may be soothing to the stomach and help with nausea. Avoid carbonated drinks, though. Contrary to popular belief, they can make nausea worse. 

Again, check the label to see if it contains actual ginger or artificial flavor.

Avoid Strong Smells

Avoid heavily scented people and places if you're prone to nausea after anesthesia. For hospital stays, tell your care team you're avoiding fragrances.

Ask people who may visit you during recovery to skip body sprays, perfume, and other fragranced products. Ask for foods with mild smells, too.

Summary

PONV causes discomfort and is hard on incisions. It has many causes. Medications before or during surgery can prevent PONV.

To combat nausea:

• Stay hydrated
• Manage your pain
• Return slowly to a normal diet
• Try warm drinks instead of cold
• Manage your body temperature
• Eat/drink ginger
• Avoid strong odors

Let someone know as soon as you feel nauseous.

A Word From Verywell

Prevention is incredibly important when it comes to postoperative nausea and vomiting. It's far easier to prevent than to treat. 

Communication is key, both before and after surgery. Keep your care team informed so they can help you avoid PONV and the problems it can create.