A health condition that causes inflammation of the mucosa is called mucositis. It affects the mucous membranes that line the mouth and the whole gastrointestinal tract. While most of the time it is an adverse reaction to cancer treatments (including radiation therapy and chemotherapy), it disappears on its own without treatment. In rare cases, it may carry certain risks and cause moderate to severe pain.
Furthermore, the protective mucous membranes line the gastrointestinal (GI) tract, from the mouth through the intestines. In most cases, mucositis affects the digestive system (especially the oral mucosa).
How Does Mucositis Affect My Body?
Mostly, people develop this condition due to cancer treatments that attack any cells that divide quickly (including the mucosa). Normally, the fast cell turnover is a part of the protective barrier of the mucosa, which allows it to refresh itself regularly, clearing out abrasive particles and pathogens. It is important to understand that mucositis not only damages existing cells in the mucosa but also affects its ability to heal and replicate itself. While it mostly affects the inner lining of the cheeks (also called buccal mucosa), it may also impact other parts of the body.
The severity of this condition ranges from mild to severe, and doctors often use a grading system for pain levels. In more severe cases, doctors may recommend stopping cancer treatments.
Symptoms
People with mucositis often experience different symptoms because they depend on several factors. For example, the severity of the condition, which part of the body is affected, existing health problems, gender, and age. Check some examples below:
Oral Mucositis Symptoms
- Mouth ulcers
- Extra-thick saliva
- Dry mouth
- Bleeding
- White mucous coating
- Red, shiny, swollen mouth and gums
- Problems with eating, talking, or swallowing
- Soft white patches of pus
Gastrointestinal Mucositis Symptoms
- Erythematous mucosa (redness)
- Diarrhea
- Abdominal (belly) pain
- Blood or mucus in the stool
- Painful bowel movements
- Nausea
- Vomiting
If any of the previous symptoms occur, immediately contact your healthcare professional. Otherwise, it may lead to unpleasant outcomes.
Causes and Risk Factors
In most cases, when doctors talk about mucositis, they mean GI inflammation that often occurs during cancer treatment. These treatments affect the fast-dividing cells (including those that make up the mucosa). Furthermore, even low-dose treatments in the local area may affect the mucosa and cause symptoms.
Additionally, the mucosa can become inflamed in conjunction with other health conditions (such as infections). For instance, it may happen along with stomatitis (inflammation of the mouth), gingivostomatitis (inflammation of the mouth caused by other infections), and others.
This condition can affect anyone, but Mucositis occurs in about 50% of people who get chemotherapy, and in about 80% to 100% of people who receive radiation therapy or stem cell transplants. Healthcare professionals have also identified some factors that may increase your risk of mucositis. These include:
- Smoking or chewing tobacco
- Gum diseases
- Dental implants or dentures
- Diabetes
- HIV infection
- Low body mass
- Protein deficiency
- Dehydration
- Misuse of alcoholic drinks
What Are The Potential Complications of Mucositis?
Those who develop this disorder may also experience some complications, especially if they do not get the treatment right away. Check some of them below:
- Undernutrition – Approximately 70% of people with mucositis require hospitalization for tube feeding because they cannot eat. It occurs due to pain in the throat, mouth, esophagus, or other digestive organs. In general, undernutrition may cause additional health problems, including weight loss, headaches, and others.
- Chronic diarrhea – People who have long-term diarrhea may also be hospitalized to get treatment that helps prevent dehydration and anemia (low red blood cell count).
- Infections – This complication often occurs because one of the most important protections breaks down. Moreover, people who suffer from cancer may also have low white blood cell counts.
- Fibrosis
- Xerostomia
- Taste loss
- Temporarily stopping cancer treatments – In more severe cases, doctors may stop the cancer treatment to reduce risks to their health. About 30% of people who develop mucositis need to stop cancer treatment.
The previous list does not contain a full list of complications, but you can consult with your physician about ways to reduce the risk of developing them.
How to Prevent Mucositis?
Physicians may recommend some options that may reduce the risk or even prevent this disorder. Examples include:
- Cryotherapy – Usually, sucking ice chips during chemotherapy may help against oral mucositis.
- Palifermin – This is a synthetic form of Keratinocyte growth factor (KGF) that the body produces naturally to protect and repair cells in the mouth and gastrointestinal tract. According to some research, Palifermin helps people with mucositis relieve the symptoms.
- Topical agents – Physicians may also prescribe some topical gels to reduce oral mucositis.
- Amifostine – This medicine often helps relieve the symptoms in people who receive radiation therapy to the head and/or neck.
Diagnosis
In most cases, mucositis is an expected adverse reaction to cancer treatments. Doctors often diagnose it based on symptoms, medical history, and a physical examination. However, they may also perform some tests to confirm the condition and rule out other disorders that cause similar symptoms. Check some examples below:
- Blood tests
- Imaging tests – The following tests are done to make detailed images of different tissues and organs in the body. Doctors often perform CT (computerized tomography) scans, ultrasound, X-rays, or MRI (magnetic resonance imaging) scans.
Treatment
While most people get rid of mucositis after finishing cancer treatment, doctors may recommend some options to relieve the symptoms. Usually, people develop mucositis within 2 weeks after beginning the cancer treatment and heal between 1 and 6 weeks after the treatment is done. Check some options to relieve the symptoms below:
Pain Treatment
This is a very serious symptom of mucositis, especially if it occurs in the mouth. First, physicians will recommend topical gels, but they usually do not last long. People with mucositis usually require a combination of treatments to ease pain. For example, over-the-counter (OTC) pain relievers, topical gels, and mouthwashes. Physicians often recommend the following options. For example:
- Anti-inflammatory drugs (such as Prednisone)
- A mix of Lidocaine and Diphenhydramine
- Prescription pain medications
- Acetaminophen
- Topical anesthetics that contain one of the following active ingredients. These include Lidocaine, Dyclonine hydrochloride (HCI), Benzocaine, or Ulcerease.
Mouth Care
For people who develop oral mucositis, doctors often recommend special care for the mouth. It helps protect it from irritation and infections. Check some options below:
- Mouth rinses – You should rinse your mouth between 5-7 times per day with salt water and baking soda solution. It is one of the gentlest and most effective options to clean mouth sores. It is also possible to use an alcohol-free antiseptic mouthwash.
- Dietary changes – People with mucositis should avoid spicy, crunchy, and acidic foods. You should also avoid sugar and alcohol. Instead, you can use protein shakes that may help with undernutrition and dehydration.
- Hydration – Most people with mucositis need extra fluids to compensate for dry mouth and loss of lubrication in the gastrointestinal tract.
Frequently Asked Questions
What products and drinks should I consume while healing from mucositis?
Check some foods and drinks that you should choose below:
- Nutritional and high-protein shakes
- Soft foods
- Sugar-free popsicles
- Chamomile tea
- Plenty of water
Foods that you should avoid:
- Spicy and acidic foods
- Greasy or fried foods
- High-sugar foods
- Alcohol
- Carbonated drinks
When should I see my healthcare provider?
Immediately visit a doctor if any of the following symptoms occur. For example:
- Long-term (chronic) diarrhea
- Fever
- Bleeding
- Losing weight
- Difficulty eating and drinking
What is mucositis caused by?
While most people develop mucositis due to high-dose cancer treatments (such as chemotherapy and radiation therapy), it may also occur due to poor oral hygiene, dehydration, infections, misuse of tobacco and alcoholic products, and others. If you have additional questions, ask your healthcare provider.
