During bortezomib treatment, nausea, diarrhea, and fatigue are relatively common and can mostly be controlled through dietary adjustment, lifestyle management, and timely communication.

I. Nausea

1. Dietary Adjustment

Eat small, frequent meals and avoid overeating at one time.

Choose light, easily digestible foods such as porridge, noodles, and steamed eggs.

Avoid greasy, spicy, and strongly odorous foods.

Try lukewarm or cool foods to reduce odor stimulation.

2. Medication and Lifestyle Management

Use antiemetics as prescribed; do not wait until vomiting occurs.

Avoid lying down immediately after eating; sit for a while or take a slow walk.

Keep the room ventilated and stay away from irritants such as kitchen fumes.

3. When to Seek Medical Attention

Seek timely medical attention for persistent vomiting, inability to eat, or obvious dehydration.

Significant weight loss requires assessment of nutritional support.

II. Diarrhea

1. Dietary Management

Eat small, frequent meals and choose low-residue, easily digestible foods.

Rice, noodles, bananas, and applesauce may be selected.

Avoid raw, cold, spicy, greasy, and high-fiber foods.

Temporarily stop milk and dairy products and observe whether symptoms worsen.

2. Fluid Replacement and Monitoring

Pay attention to fluid and electrolyte replacement; oral rehydration salts may be used.

Record the frequency and character of bowel movements and watch for bloody stools or fever.

With frequent diarrhea, pay attention to perianal hygiene to reduce irritation.

3. Medication and Medical Attention

Use antidiarrheal drugs as prescribed; do not increase the dose on your own.

Seek timely medical attention if diarrhea persists without relief or is accompanied by dehydration or fever.

Severe diarrhea may require withholding or adjusting antitumor treatment.

III. Fatigue

1. Activity Arrangement

Ensure adequate rest and reasonably arrange activity and sleep.

Light activity such as walking during the day is acceptable; avoid prolonged bed rest.

Schedule important tasks during periods of better energy.

2. Nutritional Support

Ensure sufficient calories and high-quality protein, such as fish, eggs, lean meat, and soy products.

When appetite is poor, choose energy-dense foods and eat small, frequent meals.

Consult a dietitian if necessary to assess nutritional supplementation.

3. Identifying Underlying Causes

Fatigue may be related to anemia, electrolyte disturbances, or infection.

Recheck the complete blood count and electrolytes as prescribed.

Seek timely medical attention if fatigue suddenly worsens or is accompanied by fever or palpitations.