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Hindi television and Bollywood actress Hina Khan recently spoke about her struggle with mucositis on Instagram. Mucositis is a common side effect experienced by cancer patients during chemotherapy or radiation therapy and can significantly affect the quality of life of many patients. It can cause inflammation of the mucous membranes of the mouth, throat and digestive tract, making it difficult to perform daily activities such as eating a meal or swallowing a few sips of water.
Recently, Hina had talked about the side effects of chemotherapy on her social media handle and how mucositis had made it difficult for her to eat and drink. The beautiful Bollywood actress said that she is following her doctor’s advice for its treatment, but she has also sought some more advice from the doctor.
Chemotherapy is a powerful treatment option for treating cancer, but as well as targeting cancer cells, it also attacks healthy tissue, especially the tissues in your mouth. This can lead to feelings of irritability, frustration, anxiety, guilt, sadness, anger and overthinking.
Mucositis symptoms you shouldn’t ignore
In an interview with HT Lifestyle, Dr Atul Narayankar, Consultant Medical Oncologist, Wockhardt Hospitals, Mira Road, Mumbai, revealed, “Symptoms of mucositis usually appear within 2 to 4 weeks of starting chemotherapy or radiation treatment. The intensity and severity of the symptoms can vary depending on the condition of the individual. One may experience a variety of symptoms such as dry and sore mouth, mouth ulcers, mouth infections, bad breath, diarrhea, blood in stools, constipation, diarrhea, abdominal cramps, pain on swallowing, excess saliva production, episodes of nausea and vomiting. It may also make you more sensitive to specific food or beverages, especially those that are hot, spicy or acidic. These symptoms of mucositis should not be ignored and one must immediately inform their doctor about these symptoms for effective treatment.”
Sharing his expertise, Dr. Balasubramanya KV, HOD and Senior Consultant – Periodontics at Sakra World Hospital, Bengaluru, said, “Mucositis presents with different signs and symptoms depending on the affected area. Oral mucositis usually manifests as a red, shiny and swollen mouth and gums, often with painful ulcers and soft white patches of pus. Patients may experience thick saliva, dry mouth and have difficulty swallowing, talking or eating. In more severe cases, there may be bleeding in the mouth and the presence of a white mucous layer. Gastrointestinal mucositis, on the other hand, affects the digestive system and can cause redness and swelling of the mucosa, leading to abdominal pain, nausea, vomiting and diarrhoea.
Treatment options for mucositis
According to Dr. Atul Narayankar, mucositis can be successfully treated with certain medications or treatments prescribed by your doctor. He explained, “He may recommend some painkillers, over-the-counter pills, tablets, mouthwashes or gels. These mouthwashes can help clean and numb your mouth and provide much-needed relief. If your mucositis is affecting your stomach, your doctor may recommend some medications to relax your digestive system while reducing the intensity of pain, stomach cramps, diarrhea or constipation. Low-level laser therapy (LLLT) is a medical innovation that brings hope to patients suffering from mucositis.”
Mucositis treatment methods mainly focus on pain management, dental hygiene and pharmacological interventions to promote healing and provide comfort. Dr. Balasubramanya KV explains –
1. Pain relief: One of the most important aspects of treating mucositis is effectively controlling pain. To numb the affected areas, topical anesthetics such as dyclonine hydrochloride, lidocaine, and benzocaine are often used. Healthcare providers may recommend Magic Mouthwash, which contains a mixture of Maalox, diphenhydramine, and lidocaine, for mouth discomfort. For minor pain, over-the-counter medications such as ibuprofen or acetaminophen (Tylenol®) may be helpful; however, prescription-strength narcotics may be necessary for more severe pain. To prevent constipation, these stronger medications are usually taken in addition to stool softeners.
2. Oral hygiene: Keeping your mouth healthy is important. Patients should use a soft-bristled toothbrush and non-whitening toothpaste to gently brush their teeth three to four times a day. The lesions can be cleaned and soothed by frequent mouth rinsing, five to six times a day, using salt water or a solution of salt and baking soda. It is advisable to avoid spicy, acidic or sweet foods that can aggravate the mucosa, in favor of a soft, gentle diet. In addition, maintaining hydration by consuming more fluids and using lip balm or artificial saliva helps keep the mouth moist.
3. Medical intervention: To treat problems such as malnutrition or dehydration, patients may require medical intervention in extreme circumstances. If eating becomes too uncomfortable, enteral nutrition—tube feeding—may be needed. Antibiotics may be recommended to prevent or manage infections that result from open sores or tears in the mucous membranes associated with mucositis. Intravenous (IV) fluids can help treat dehydration caused by recurring diarrhea.
Treatment measures for mucositis
Mucositis can be a challenging experience for people undergoing cancer treatments such as chemotherapy. Dr. Atul Narayankar advises, “One needs to prioritize their oral and digestive health by making wise choices. Avoid brushing or flossing your teeth vigorously, which can worsen your symptoms. Use a gentle toothbrush with soft bristles to prevent the risk of oral infections as well as reduce pain. Avoid eating foods or drinks that can irritate your stomach and mouth such as oily, spicy, hot and acidic foods for the betterment of your health. Avoid drinking alcohol, especially when experiencing mucositis, as it increases ulcers and inflammation in your mouth.”
Tips to prevent mucositis:
“Eat soft and tasteless foods that are easy to chew and swallow, drink plenty of water, and rinse your mouth with warm water,” suggests Dr Atul Narayankar.
Dr. Balasubramanian KV adds the following to the list of tips for prevention of mucositis –
1. Cryotherapy: Using ice cubes during chemotherapy may help reduce the risk and severity of oral mucositis by reducing damage to tissues.
2. Medicines: Palifermin, which is a synthetic keratinocyte growth factor, helps protect and repair mucous membranes, reducing the severity of mucositis in cancer patients. Amifostine, this drug can reduce the risk of oral mucositis, especially in patients undergoing radiation therapy for head and neck cancer.
3. Topical preservatives: Gels such as GelClear® and Zilactin® provide a protective barrier for the mucosa, helping to prevent irritation caused by cancer treatment.
4. Good oral hygiene: Practicing regular and gentle oral care, such as brushing with soft bristles and using an alcohol-free mouthwash, can help reduce the risk of infection and irritation for people with mucositis.
5. Low-level laser therapy (LLLT) It is used to reduce pain and enhance the healing process.
Disclaimer: This article is for informational purposes only and is not a substitute for professional medical advice. Always seek the advice of your doctor for any questions about any medical condition.
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