Symptoms: Poor Appetite and Nausea

Many symptoms of heart failure (HF) are easy to recognize. For example, shortness of breath, swelling, and getting tired easily are all common symptoms. But there are some symptoms that you might not immediately connect with HF. Nausea and a loss of appetite are 2 examples. These symptoms occur most commonly with right-sided HF.^1-3

Improved treatments now allow people with HF to live much longer than they might have before. But these treatments do not actually cure the disease. So, people may end up having more symptoms over a longer period.³

Why do poor appetite and nausea happen with heart failure?

Many people with HF may feel full even if they have not eaten. This is because their heart has weakened. It is struggling to pump blood around the body. Blood is moving more slowly to and from the heart, causing it to back up in the veins. This forces bodily fluids into tissues, causing swelling (edema) in some parts of the body.^1-3

Swelling is common in the ankles and the stomach area. Swelling can make you feel full or bloated. Extra fluid in the stomach also may cause pain or tenderness in the abdominal area. This pain can decrease your appetite or make you feel sick.^1-3

The slow movement of blood around the body also slows down the digestion process. The food you eat may stay in your digestive tract for longer, adding to the feeling of nausea and the loss of appetite.²

Other health conditions that may appear alongside HF (complications) may worsen nausea and poor appetite. These complications include decreased kidney function, liver problems, and increased inflammation.³

Nausea and poor appetite also can stem from medicines used to manage HF and its complications. Some medicines may slow down digestion, while others may affect your sense of taste or smell.^3-5

How do poor appetite and nausea affect people with heart failure?

As many as half of all people with HF have a loss of appetite. And more than 1 in 4 people with HF will have gastrointestinal (GI) symptoms such as nausea or bloating.³

GI problems linked to HF may lead to other complications, including:^1,2,6

• Pain
• Depression
• Extreme tiredness (fatigue)
• Weight gain
• Malnutrition

These complications are all connected. Weight gain from fluid retention can lead to depression, pain, and fatigue. Likewise, poor digestion and loss of appetite can cause fatigue and sadness.^2,6

If you are eating less due to loss of appetite and/or nausea, and your digestive tract is not working as well due to poor blood flow, you run the risk of malnutrition. Your body will absorb fewer nutrients, which can cause fatigue and lead to vitamin and mineral deficiencies. Malnutrition can also cause weight loss and muscle wasting.^1,2,6

How are poor appetite and nausea with HF treated?

Tell your doctor about any loss of appetite or nausea. They may prescribe 1 or more medicines to help ease the symptoms. These may include antiemetics to treat nausea and medicine to boost your appetite. Do not take any over-the-counter drugs without telling your doctor first. They may interfere with your prescribed medicines. And do not stop or change any of your medicines without consulting your doctor first.^3,6

Doctors do not advise trying to force a person with HF to eat. This can cause discomfort or further nausea. Instead, eating small portions more often may help. Choosing plain foods that are easy to digest also may help. If you are at risk for malnutrition, your doctor may recommend nutritional supplements.⁶