Mucositis affects the lining of your mouth or gut (bowel) and is often caused by chemotherapy or radiotherapy.
Mucositis is often very painful and needs strong painkillers to help control the pain. It often interferes with eating and drinking and has a very negative effect on your quality of life. However, it can be prevented, can be treated and usually gets better soon after the treatment with chemotherapy or radiotherapy has stopped.
What is mucositis?
Mucositis occurs when your mouth or gut (bowel) becomes very sore and inflamed, often as a side-effect of chemotherapy or radiotherapy when used to treat cancer.
How common is mucositis?
Mucositis affecting the mouth is common and occurs in about 1-2 people out of every 5 people receiving chemotherapy. The risk increases to 8 out of every 10 people receiving high-dose chemotherapy.
Nearly all people receiving head and neck radiotherapy will develop some degree of mucositis affecting the mouth. If you are treated with radiotherapy for your pelvis there is a high risk of developing mucositis affecting your gut (bowel).
What are the symptoms of mucositis?
The symptoms of mucositis usually begin around 1 to 2 weeks after starting cancer treatment. The symptoms will depend on whether it is your mouth or your gut (bowel) that is affected.
The symptoms of mucositis affecting the mouth include:
- Sore mouth. This can vary from just soreness and redness to severe pain and mouth ulceration.
- Difficulty with eating and drinking.
- Dry mouth and lips.
Diarrhoea, bleeding from your back passage (rectal bleeding), or pain when pooing may occur when mucositis affects your gut.
What are the treatments for mucositis?
Mucositis should get better within a few weeks of finishing cancer treatment. However there are things you can do and treatments that can help to make it a lot better.
The most important way to treat mucositis affecting your mouth is by regular mouth care. Keeping your mouth clean and making changes to your diet can help if you have mucositis affecting your mouth. The simple measures you can do to treat mucositis affecting your mouth include:
- Brush your teeth at least twice a day.
- Use a soft toothbrush.
- Use dental floss regularly.
- Rinse your mouth with warm salt water several times a day.
- Suck on crushed ice or ice lollies.
- Eat soft, moist foods.
- Drink plenty of water.
- Only use a mouthwash that has been prescribed or recommended by your doctor or nurse. Mouthwashes can help to clean your mouth and reduce the discomfort, but some mouthwashes may irritate your mouth and make the symptoms worse.
- Avoid eating crunchy, rough or sharp foods (like crisps).
- Avoid eating hot, spicy or salty foods.
- Avoid eating acidic foods, such as oranges or lemons.
- Avoid drinking hot drinks, fizzy drinks or alcohol.
- Don't smoke.
Your doctor or cancer care team will also be able to offer advice and provide treatments for mucositis, including:
- Sprays or gels to help keep your mouth moist.
For mucositis affecting your gut (bowel), medicines to stop diarrhoea or reduce soreness inside your back passage (anus) can help.
How can you prevent mucositis?
All the advice outlined in the treatment section above can also be used to help reduce your risk of having mucositis. You don't have to wait until you do have a problem. Start this mouth care as soon as you know you are going to be treated with radiotherapy or chemotherapy.
Mucositis affecting your mouth is also more likely if you have dental problems such as caries or gum disease. So it's also very important to see a dentist and a dental hygienist to get any treatment and advice to treat or prevent any dental problems.
Using ice treatment (cryotherapy), such as putting ice chips in your mouth during chemotherapy, may also help to prevent as well as treat mucositis affecting your mouth.
If you are being treated for a cancer in your pelvis, probiotic agents containing lactobacillus can be used to help prevent chemotherapy- and radiation‐induced diarrhoea. Mucositis affecting your gut (bowel) can also be prevented by using certain medicines; your cancer specialist (oncologist) will give you advice about this. This will depend on exactly what treatment you are given.
Further reading and references
Lalla RV, Bowen J, Barasch A, et al; MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2014 May 15120(10):1453-61. doi: 10.1002/cncr.28592. Epub 2014 Feb 25.
Campos MI, Campos CN, Aarestrup FM, et al; Oral mucositis in cancer treatment: Natural history, prevention and treatment. Mol Clin Oncol. 2014 May2(3):337-340. doi: 10.3892/mco.2014.253. Epub 2014 Feb 7.
Chaveli-Lopez B, Bagan-Sebastian JV; Treatment of oral mucositis due to chemotherapy. J Clin Exp Dent. 2016 Apr 18(2):e201-9. doi: 10.4317/jced.52917. eCollection 2016 Apr.
Riley P, Glenny AM, Worthington HV, et al; Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy. Cochrane Database Syst Rev. 2015 Dec 23(12):CD011552. doi: 10.1002/14651858.CD011552.pub2.
Al-Ansari S, Zecha JA, Barasch A, et al; Oral Mucositis Induced By Anticancer Therapies. Curr Oral Health Rep. 20152(4):202-211. doi: 10.1007/s40496-015-0069-4. Epub 2015 Oct 19.