Mucositis is inflammation of the mucosa, the mucous membrane that covers your mouth and your entire gastrointestinal tract. This is a common side effect of cancer treatments involving radiation or chemotherapy. Mucositis is temporary and resolves on its own, but it can be painful and carries some risks. Managing it requires self-care and medical care.
What is Oral Mucositis
Mucositis is a painful inflammation of the mucosa, the protective membrane lining the gastrointestinal tract from the mouth to the intestines. Mucous membranes line many cavities and canals in your body, but mucositis particularly affects your digestive system, especially your oral mucosa. This is a common side effect of some cancer treatments, including chemotherapy, radiation therapy, or stem cell transplant (bone marrow transplant).
Mucositis usually affects your mouth and the inside lining of your cheeks (buccal mucosa). These mucous membranes are particularly sensitive. Oral mucositis causes inflammation inside your mouth – red, shiny, swollen, raw, and painful. This often causes mouth sores or white spots of pus in your mouth. Oral mucositis can be mild or severe. Healthcare providers use a grading system to assess pain levels, with grades 1 and 2 indicating relatively mild discomfort, while grades 3 and 4 represent severe pain. In severe cases, eating may be difficult, and individuals undergoing cancer treatment may need to adjust their therapy accordingly.
Affection of Mucositis on the Body
Therapy designed to treat cancer will attack any cells that divide rapidly. Unfortunately, this includes any mucosa of the area – these treatments cannot discriminate between the two. The mucous membrane covers your entire GI tract, including your mouth, throat, esophagus, stomach, and small and large intestines. Normally, rapid cell turnover is part of making your mucosa a protective barrier. This allows the mucous membrane to be regularly refreshed, cleared of abrasive particles and pathogens, and to recover quickly from injuries.
Mucositis not only damages the existing cells in your mucosa but also their ability to replicate and heal themselves. This means that parts of your body that normally require a protective barrier are now exposed to irritants from your everyday activities. In your digestive system, he is eating. These parts are also more sensitive to infection. Some people also get gastrointestinal mucositis. If the inflammation is close to your stomach it may manifest as stomach pain and nausea, or if the inflammation is in your colon it may manifest as diarrhea or painful bowel movements.
Who gets mucositis?
Mucositis develops in 50% of people who receive chemotherapy and 80% to 100% of people who receive local or whole-body radiation therapy or a stem cell transplant (bone marrow transplant).
You may have a higher risk of developing or experiencing more severe mucositis if you:
- Smoke or chew tobacco
- Drinking too much alcohol
- Are dehydrated
- There is a protein deficiency
- Have a low BMI
- Get dental implants or dentures
- Have gum disease
- Have kidney disease
- If you Have diabetes
- Have HIV
Symptoms of Oral Mucositis
Inflammation causes redness, soreness, heat, and swelling. Mucositis can cause various specific symptoms in different parts of your body.
Here are some causes of oral mucositis:
- Red, shiny, swollen mouth and gums
- dry mouth
- Extra thick saliva
- Mouth ulcers
- Soft white spots of pus
- Difficulty swallowing, talking, or eating
- Bleeding in Mouth
- White mucus coating
What causes mucositis
When healthcare providers refer to mucositis as a condition, they typically mean mucositis of the gastrointestinal (GI) tract, which includes the mouth, resulting from cancer treatment. These treatments damage rapidly dividing cells, including those that make mucosa. High-dose radiation or chemotherapy to the entire body, or low-dose treatment to a local area, can affect your mouth or stomach organs. Inflammation of the mucosa may also occur with other conditions such as infection. But when it does happen, it is usually known by a more specific name. For example, stomatitis refers to inflammation of the mouth, while gingivostomatitis specifically indicates inflammation of the mouth resulting from infection.
Complications of mucositis
Undernutrition
Eating may be difficult due to pain in your mouth, throat, esophagus, or digestive organs. This can have serious consequences for people with cancer, who already suffer from food aversions and weight loss, and for whom adequate nutrition is especially important. As many as 70% may require hospitalization for tube feeding.
Chronic diarrhea
People with persistent diarrhea or blood in the stool may need to be hospitalized and monitored to prevent dehydration or anemia from blood loss.
Infection
When the mucous membrane is broken down, your body loses one of its most important protective barriers against infection. People who have cancer already have low white blood cell counts, which reduces their immunity. Mucositis can also cause open wounds, which can invite infection into your bloodstream.
Reduction in cancer treatment
Severe mucositis may cause some people with cancer to postpone or reduce their treatment, posing additional risks to their health. More than 30% of people discontinue treatment as a result of this condition.
Diagnosis of Mucositis
Mucositis is an expected side effect of cancer treatment and is easy to diagnose based on your symptoms, medical history, and a look at the inflamed tissues. In cases of gastrointestinal mucositis, imaging tests may be necessary to examine the tissues internally. Additionally, your healthcare provider may conduct tests to screen for specific bacterial or fungal infections, which can be accomplished through a simple blood test.
Treatment of Mucositis
Mucositis will go away on its own after your cancer treatment course is over. If you have chemotherapy, mucositis usually appears one to two weeks after treatment starts and resolves after one to six weeks. If you have radiation therapy, mucositis appears two to three weeks after treatment begins and resolves within two to four weeks after your therapy ends. The severity of mucositis and the effectiveness of preventive care to avoid further irritation can impact the healing duration. While it’s curing, you’ll need:
Pain Management
Pain in mucositis is a serious problem, especially in the mouth. Topical agents may not stay in your mouth long enough, or may not be able to reach all affected areas. You may need a combination of different methods to manage your pain, including topical gels and mouthwashes, over-the-counter pain medications, and even prescription opioids. Don’t try to make it difficult – it’s important that you can eat and drink enough to continue treatment. Talk to your healthcare provider about pain management in cancer care.
Mouth Care
When dealing with oral mucositis, it’s essential to provide special care to your mouth. This not only helps alleviate discomfort but also safeguards it from further irritation and infection. Even simple things like chewing, speaking, and swallowing can contribute to breaking down your weakened mucosa. This involves selecting gentle foods and products to provide lubrication and coat your mouth and throat. Your weakened mucosa is particularly vulnerable to infection, so hygiene is also extra important.
What should I eat or drink while recovering from mucositis
Do eat
- High protein foods
- Nutritional shakes
- Soft foods
- Sugar-free popsicles
Don’t eat
- Spicy foods
- Acidic foods
- Greasy or fried foods
- High-sugar foods
Do drink
- Chamomile tea
- Lots of water
Don’t drink
- Carbonated beverages
- Alcohol
Prevention of Mucositis
There isn’t much in our toolbox yet to prevent mucositis from causing cancer, but healthcare providers are working on it. Several medications are being tested that may help reduce the length and severity of the condition for some people. Options include:
Cryotherapy
Sucking ice cubes before and during chemotherapy treatment may help prevent oral mucositis.
Palifermin
This medication is a synthetic version of keratinocyte growth factor (KGF), a substance your body produces to help protect and repair the cells of your mouth and GI tract. It has been demonstrated to decrease the duration and severity of mucositis in individuals with blood cancer undergoing bone marrow or stem cell transplants.
Amifostine
This medication may reduce the severity of oral mucositis in people receiving radiation therapy to the head and neck when taken previously. Nausea may arise as a side effect.
Conclusion
Mucositis is pain and inflammation of the lining of the mouth and intestine, usually caused by cancer treatment. This makes eating and talking difficult and can lead to infection. You’re more likely to get it if you smoke, drink too much alcohol, or have certain health problems. To help, doctors can provide pain medication, suggest a gentle diet, and monitor for infection. This usually resolves on its own after treatment is stopped, but it can become serious. Scientists are looking for ways to prevent this, such as using special medications or sucking on ice cubes during treatment.