Managing Mouth Ulcers after Chemotherapy and tips:

Managing mouth Ulcers after Chemotherapy is very important. Chemotherapy drugs damage the oral mucosa, which results in oral ulcers or mouth sores. Ulcers are very painful and affect the patient’s oral intake. Sometimes so severe that even the patient becomes unable to take a sip of water. Ulcers begin 5-7 days after starting chemotherapy and last for 12-15 days. Also, it gets worse when the patient goes into the neutropenic phase.

Care of a Patient having Mouth Ulcers:

The following are some tips for managing mouth Ulcers after Chemotherapy.

• Avoid spicy and very hot food.
• Use mouthwash regularly prefer any mouthwash containing antifungal in it.
• Avoid drinking milk, which can coat the ulcer and delay healing. Avoid cold drinks containing more acids.
• Try to take a liquid diet and juices to maintain good nutrition.
• Can take prescribed painkillers for pain relief if needed.
• Use plum (phat kadi in Hindi) water to rinse your mouth twice or thrice daily. Make 0.5 litres of plum water by putting at least 1/3 teaspoon of plum in ordinary drinking water.
• Avoid mouthwash containing alcohol.
• Try to eat food that is easy to swallow, such as blended food, ice cream, etc.
• Use lip moisturizers to protect lips from cracking due to dryness.
• Applying honey in the mouth 3-4 times a day. Do not use honey with warm water it can cause diarrhea.

Prevention of Mucositis :

Mucositis is prevented with a therapy called cryotherapy or cold therapy, in which patients’ oral mucosa is kept cold during chemotherapy treatment. It can be done by offering ice chips or ice cream to the patient. This causes blood vessels in the mouth to be narrowed, causing decreased blood flow to the oral mucosa, resulting in a decreased formation of oral sores.

How do mouth sores affect patient health?

Mouth ulcers have a greater impact on patients’ intake. Patients become unable to eat properly with ulcers. It directly affects patients’ weight loss. Secondly, there is a greater risk of dehydration. So, it is recommended that total parental nutrition should be started if the patient is having level 3 and 4 grade mucositis.

What are the stages or grades of ulcers/mucositis?

Mucositis is graded on the basis of the severity of oral mucosa involved and signs and symptoms patients depict, such as unable to drink liquids or drooling of saliva following are the grades of mouth ulcers. They are from grades 1,2,3, and 4.

What are the gradings of mucositis?

Grade 1 mucositis:

In this grade, only erythema and soreness are found. The Patient can take all kinds of food in this grade.

Grade II:

In grade II, redness with some ulcers starts to develop, but the patient in this grade can eat solid food.

Grade III:

In this condition, ulcers worsen, redness increases, and the patient will not be able to eat solid food. But can eat liquid and soft food. However patient needs intravenous hydration to meet full body requirements.

Grade IV:

In this grade, the redness and ulcers extend to the throat as well. The patient in this stage will not even be able to take liquids also not be able to swallow his/her saliva. Intravenous nutritional support is required in this stage.

However, Mucositis is a common complication of chemotherapy. By applying the above-mentioned tips and guidelines, patients’ oral mucosa can be protected and alleviate patient suffering, and keep patients comfortable. The above tips can be more effective and beneficial if done in the initial time of developing ulcers or before developing ulcers by practicing tips like cryotherapy(chewing ice cubes or ice cream).