Mucositis chemotherapy or chemotherapy induced mucositis is a common side effect caused by certain chemotherapy drugs. Mucositis is an inflammation of the mucous lining of the upper gastrointestinal tract from mouth to stomach that includes mouth, lips, throat and the surrounding soft tissues.

This could develop into painful ulcers and infection that cause difficulty in eating, swallowing, talking, chewing and changes in the taste. These symptoms last for a few days. Mucositis is caused when chemotherapy drugs attack the rapidly dividing cells in the mucous membranes along with the cancer cells.

Mucositis cannot be treated as such. We can only relieve the symptoms by using various oral and topical medications. The aim is to reduce the severity and duration of mucositis, provide relief and prevent any further infection at least till the patient recovers from the effects of chemotherapy.

Immediately consult your doctor in case of persistent mucositis and if you develop the following symptoms-

• Fever of 100.5 degrees F or more

• Chills
• Persistent burning in the mouth, throat, stomach or digestive tract
• Consistent pain while eating and talking

Treatment and Prevention of Chemotherapy Mucositis-

You can get relief from mucositis with the help of certain medications that are swallowed, gargled, swished inside the mouth or applied with a cotton swab.

• Prevention of Mucositis - ice chips held in the mouth during chemotherapy, Caphosol solution, and non alcoholic mouthwashes

• Pain relief - benzocaine, dyclonine, lidocaine, etc
• Prevention or treatment of infection - amphotericin, clotrimazole, itraconazole and nystatin
• Healing the sores - antacids
• Mouth cleaning - chlorhexidine, saline solution

These ingredients can be used as a mouthwash with a regular swish and spit routine to reduce the symptoms of mucositis-

• 1/2 teaspoon salt and 2 tablespoons baking soda in 4 cups of water can be used to neutralize the acid and dissolve the thick saliva.

• Equal parts of hydrogen peroxide and water or 1 teaspoon of salt in 4 cups of water can be used to clean the crusts that appear on the mouth sores. These solutions can be used for 1 or 2 days consecutively not more than that.
• To maintain oral hygiene, use 1/2 teaspoon salt and 1/2 teaspoon baking soda in 1 cup of warm water.

Managing Mucositis

• Use saliva substitute available in the market if required.

• Apply lip moisturizer often. Suck on hard, sugar free candies.
• Keep mouth & teeth clean by maintaining basic oral hygiene.
• Use soft-bristle toothbrush, cotton swabs, mouth swabs, etc to the clean teeth after each meal and at bedtime.
• Clean dentures after eating. Remove them in case of any discomfort.
• Floss gently
• Rinse mouth with water frequently or twice a day with the above mouthwashes

Avoid the following-

• Mouthwash containing alcohol.

• Lemon glycerin swabs as glycerin can dehydrate the mouth cavity.
• Hot, spicy and rough textured foods.
• Very hot or cold foods.
• Citric juices or foods containing citric acid, tomatoes, oranges, lemon, etc.
• Alcohol, caffeine and tobacco products.
• Liquid medication like cough syrups containing alcohol

Your doctor could recommend special medications like anti fungal, anti bacterial, toothpastes, mouthwashes and antiviral medications to relieve chemotherapy induced mucositis.

It is always good to be on a soft and bland diet till you recover from mucositis. Avoid the following foods- hot peppers, curry, fried foods, strong spices, raw ginger and onions.

Mucositis due to chemotherapy is a common but a dreaded side effect as it can be extremely painful and hamper your quality of life. However, it is essential to speak about it to your doctor and keep certain medications handy in case it occurs.