Mucositis refers to a condition which results in inflammation of the oral mucosa. In most instances, this inflammation extends to the GI tract extending to the rectum and is a result of cancer treatments including radiation and chemotherapy and bone marrow transplants. The inflammation often leaves the mucosal tissue open to ulceration and infection. The key diagnostic factors include erythema or ulceration as well as oral pain.
While mucositis is temporary and heals on its own, it can also be painful and carries certain risks. It requires self-care and medical care to manage.
Oral mucositis also known as stomatitis is the most common adverse condition as a result of chemotherapy. The inflammation and swelling can lead to pain as well as nutritional problems as a result of the inability to ingest properly. It has a significant effect on the patient’s quality of life and can be dose-limiting (i.e., requiring a reduction in subsequent chemotherapy doses).
Common Symptoms Of Mucositis
The symptoms of mucositis can range from Red, shiny, or swollen mouth and gums, to bleeding, sores and ulcers in the mouth which can also occur on the gums or tongue. Other symptoms include pain in the mouth or throat, trouble swallowing or talking, and mild burning. In extreme cases, the oral cavity is covered with soft, white patches or pus in the mouth or on the tongue followed by increased mucus or thicker saliva in the mouth leading to extremely uncomfortable conditions.
Who Can Get Mucositis?
Mucositis commonly affects people with suppressed immunity. Such patients include those undergoing radiotherapy or chemotherapy for head and neck cancers as well as total body irradiation. Patients undergoing bone marrow or stem cell transplants.
Chronic irritation from ill-fitting prostheses or faulty restorations can also predispose patients to the development of oral mucositis due to local irritation and trauma. Meanwhile, diseases such as kidney disease, diabetes, or HIV/AIDS can also make the patient prone to mucositis.
Consequences Of Mucositis
Mucositis often tends to generate a myriad of consequences including a portal of entry for organisms, interruption of therapies, enhanced use of antibiotics and narcotics, increases length of hospitalization as well as elevating the overall cost of treatment.
Patients suffering from both neutropenia and oral mucositis also have a relative risk of septicemia (a systemic, toxic illness caused by the invasion of the bloodstream by virulent bacteria coming from a local infection) more than 4 times that of patients with neutropenia only.
Frequent nausea and vomiting that often occur with treatment can further trigger mucositis. Chemotherapy and radiation therapy can affect the ability of cells to reproduce, slowing the healing of the oral mucosa, and often extending the duration of present mucositis. Patients with damaged oral mucosa and reduced immunity are also prone to mouth infections.
Management of Mucositis
Mucositis management includes palliative as well as curative treatments, Topical anaesthetics including lidocaine, benzocaine, dyclonine hydrochloride (HCl) and Ulcerease (0.6% phenol). Magic mouthwash, a mix of lidocaine, diphenhydramine and Maalox. Anti-inflammatory drugs, such as prednisone. GI cocktail which comprises a mix of Maalox, Nystatin and Hurricane Liquid. Acetaminophen for pain relief. Prescription narcotic pain medications are often combined with stool softeners to prevent constipation.
Cryotherapy is another great option which involves sucking on ice chips during chemotherapy administration. It has shown some effect in preventing mucositis caused by 5-FU (fluorouracil) chemo treatments.
If you do have severe mucositis, make sure to keep your healthcare provider informed of your condition and ask for the help you need. Mucositis is temporary, but it’s not worth suffering through when you can get help.