Mucositis refers to the painful inflammation and
ulceration of the mucous membranes lining the digestive tract. It is usually
the adverse effect of chemotherapy and radiotherapy treatment for cancer.
Mucositis can occur anywhere along the digestive tract from the mouth to the anus.
Symptoms of mucositis usually begin five to ten days
after chemotherapy, or fourteen days after radiotherapy. The common symptoms include:
- Red burn-like sores throughout the mouth
- Ulcers covering by a yellowish white fibrin clot called a pseudomembrane
- Peripheral erythema
- Burning pain accompanied by reddening
- Speaking and/or eating problems
- Trouble of opening mouth
- Dysgeusia (an alteration in taste perception)
Mucositis is usually the side effect of cancer treatment such as chemotherapy and radiotherapy.
There are mainly three scales to diagnose mucositis:
- The World Health Organization (WHO) Oral Toxicity score,
- The National Cancer Institute Criteria (NCI-CTC) for Oral Mucositis,
- The Mucositis Assessment Scale (OMAS) developed in 1999.
The WHO combines the appearance and the function of the erythema and
ulceration into a single score which grades the severity of the condition from 0 (no mucositis)
to 4 (cannot swallow so that the patient needs supplementary nutrition).
NCI has separate scores for the appearance and the function of the erythema and
ulceration. By the way, the function means the pain and ability to eat solids,
liquids or nothing by mouth.
Based on the assessment of the appearance and extent of redness and ulceration in various areas of the mouth, the OMAS provides an objective assessment of mucositis.
In order to treat and prevent from developing mucositis, I have the
- Oral hygiene
It is the mainstay of treatment. Patients should clean their mouth every four hours and at bedtime.
- Water-soluble jellies
They are used to lubricate the mouth.
- Salt mouthwash
They are useful in soothing the pain and keeping food articles clear, thus avoiding infections.
- Drinking plenty of water
- Medicinal mouthwashes
Examples of these medicinal mouthwashes include Chlorhexidine gluconate and viscous Lidocaine, and they can alleviate the pain triggered by mucositis.
- Avoiding alcohol, hot foods and citrus fruits
Otherwise, they will aggravate mucositis lesions.
- Barrier protection agents
These agents, such as concentrated oral gel products, can help relieve the pain triggered by mucositis.
It is a mouth rinse which is useful to prevent and treat oral mucositis caused by radiation and high-dose chemotherapy.