Mucositis – Prevention and Treatments for Mucositis

A Side Effect of Chemotherapy

Chemotherapy-induced mucositis is the inflammation of your mucous membranes, which are tissues that line your digestive system – all the way from your mouth, esophagus, stomach, intestines, rectum to your anus. Mucositis is caused when chemotherapy attacks and kills the rapidly-dividing cells in your mucous membranes. This condition feels like sunburn (or heartburn) on your mucous tissues, and often leads to sores in your mouth or on your tongue. It is a common side effect of chemotherapy for breast cancer.

Call Your Doctor If You Have These Mucositis Symptoms:

• Mouth sores that are so painful that you avoid eating or speaking
• Mouth sores that just won't heal
• Persistent burning feeling in your mouth, throat, stomach, or digestive tract
• Fever of 100.5° F or chills with shaking

Some Self-Care Tips For Mucositis:

• Drink 8 eight-ounce glasses of water daily. Purified or deionized water can reduce irritation, if you are feeling very raw.
• Drink sports drinks with electrolytes (Gatorade, Poweraid) to stay hydrated.
• Cut down on or avoid caffeine and alcohol (these dry your tissues).
• Eat soft comfort foods: ice cream, popsicles, milkshakes, smoothies, pudding, yogurt, gelatin, mashed potatoes, bananas, and applesauce (not spiced).
• Avoid food and drink that irritate tissues: citrus fruits and juices, tomatoes, spicy or salty foods. Forget about hot peppers, curry, salsa, and raw ginger and onions, until you feel better.
• Avoid all forms of tobacco and nicotine, because these irritate raw tissues (such as mouth sores) and delay healing.
• Avoid foods and liquids that contain a lot of sugar.
• Use lip balm (not mentholated) for dry lips, and avoid breathing through your mouth.
• If you wear dentures, use them only for meals, to let your gums rest, and to reduce irritation.
• Use a soft toothbrush and floss gently, to avoid irritating your gums.

Treatment and Prevention of Mucositis:
Medicines are available to give you relief from mucositis. Your doctor will tell you which one may help you the most, and how you should use it. Most of these are applied gently with a swab, gargled, swished inside your mouth, and sometimes swished and swallowed.

• Prevention of Mucositis – ice chips held in your mouth during chemo, Caphosol solution, and MuGard Mouth Rinse
• Pain relief - benzocaine, dyclonine, lidocaine, oral opioid medications
• Prevention or treatment of infection - amphotericin, clotrimazole, itraconazole, nystatin
• Cover sores and promote healing - antacids, sucralfate
• Coat sores and relieve pain - double mix, triple mix
• Mouth cleaning - chlorhexidine, saline solution

Home Treatments for Mucositis:
Use these mouth rinses as a swish and spit routine, to alleviate symptoms.

• To neutralize acid and dissolve thick saliva:
  1⁄2 teaspoon salt and 2 tablespoons baking soda in 4 cups of water.
• To clean crusted mouth sores:
  Equal parts hydrogen peroxide and water or saltwater (1 teaspoon of salt in 4 cups of water).
  Note: Don't use this solution for more than 2 days at a time, because it will prevent mucositis from healing.
• To prevent dry mouth and maintain oral hygiene, use four times daily:
  1⁄2 teaspoon salt and 1⁄2 teaspoon baking soda in 1 cup of warm water.

_{Sources:
National Cancer Institute. Oral Complications of Chemotherapy. Management of Oral Complications During and After Chemotherapy and/or Radiation Therapy. Last Modified: 06/05/2007.}