Symptom: Poor Appetite and Nausea

Reviewed by: HU Medical Review Board | Last reviewed: November 2019

Heart failure (HF) has classic symptoms such as shortness of breath and swelling but it also has a number of less common symptoms including a loss of appetite and nausea.1-2

The feeling of being full, even when you haven’t eaten or have eaten very little, can be an indication that you may be experiencing heart failure. This is called early satiety. Fluid retention and other symptoms of heart failure can interfere with your ability to consume enough calories and nutrients to support your body.2 This can result in weight loss and the loss of muscle, symptoms that are consistent with disease progression.2

Why am I nauseous?

Heart failure may cause a change in your appetite.3 If you are feeling full, bloated or nauseated you probably don’t feel like eating. This can happen when there is decreased blood flow to the digestive system resulting in interference with the digestive process.1 This occurs because as the heart has to work harder to pump blood throughout the body, the volume of circulating blood decreases because the chambers of the heart don’t fill and empty properly. Blood gets diverted from the digestive system to more vital organs like the brain.3

A poor appetite can also result from the accumulation of fluid in the liver and digestive system.3 Fluid accumulation, edema, is a common symptom of heart failure. We most commonly think of swelling in the legs and ankles, but it can happen anywhere in the body.3 The swelling can cause you to feel sick to your stomach. Nausea can lead to weight loss because it interferes with appetite and the body’s ability to absorb nutrients from the food.4

Swelling in the abdomen, sometimes called ascites, can also contribute to abdominal pain or tenderness.3,5 The accumulation of fluid that is responsible for the abdominal swelling can decrease your appetite and result in nausea as well as discomfort from the weight gain.

What can I do about it?

Some people try eating smaller amounts more often. This helps reduce the sensation of feeling full or bloated.3 If your appetite is poor, try selecting foods that you really feel like eating, that provide the most nutrition, or are easy to digest. This can make eating more pleasant or easier to tolerate.2Doctors don’t recommend forcing a person with heart failure to eat because it can be uncomfortable. In the later stages, considered advanced heart failure, forcing food will not change the outcome or help people live longer.2

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