Mucositis is the term used to refer to the mouth sores or esophagitis which can range in severity from sore mouth to open sores that make the individual unable to eat. The mucous membranes of the body are the soft tissue that lines the digestive system from the mouth to the anus. Commonly, this develops as the side effect of cancer treatment such as chemotherapy or radiotherapy. It is divided into two forms; oral mucositis and gastrointestinal mucositis.
Oral mucositis
The symptoms associated with the oral mucositis can occur between five to ten days after exposure to chemotherapy or 14 days after radiotherapy. The tissues that line the inside of the mouth begin to feel sore developing white patches or ulcers which can be very painful making it difficult to eat food. The affected individual can also present dry mouth and the sense of taste can also become affected. The milder form of this condition should ease within three to four weeks after the cancer treatment has completed.
Gastrointestinal mucositis
This can develop with the cancer treatment involving chemotherapy or radiotherapy for abdominal or cancer of the pelvic area. The symptoms can occur after 14 days of exposure to chemotherapy or radiotherapy and include ulcers in the anus, rectal bleeding, diarrhea, nausea, bloating, passing mucus from the anus, difficulty swallowing and abdominal pain. Although the symptom can disappear when the treatment stops, diarrhea can continue to persist for several months.
Causes
It is estimated that the majority of individuals receiving chemotherapy as cancer treatment can develop mucositis which in some cases can be severe. With chemotherapy, mucositis develops as the result of low white blood cell count and with exposure to radiation, it can occur due to the inflammatory effect of radiation on the mucosa. Individuals with the damaged oral mucosa and with weakened immunity can also develop mouth infections.
Diagnosis
The diagnosis is based on the symptoms evident such as red burn-like sores or ulcers after the exposure to the chemotherapy or radiotherapy. According to WHO, the oral mucositis is graded to determine the severity that is based on; grade one that presents soreness but no ulcers, grade two presents ulcers in the mouth although the individual can consume food, grade three is when the individual cannot eat solid food but can swallow liquids and grade four is based on the individual’s inability to swallow or eat solids or liquids. The diagnosis of gastrointestinal mucositis is based on the symptoms and in rare cases, further testing is required.
Treatment
Individuals with the oral mucositis should follow a good oral hygiene routine such as brushing teeth after every meal, flossing teeth at least once a day and rinsing the mouth about five times a day using a bland rinse. Sucking ice chips can provide relief from the symptoms of oral mucositis and painkillers in the form of mouth rise can also be beneficial. The low level laser therapy can also help reduce the severity of the oral mucositis and the infected ulcers may be treated with antifungal medicines. In the case of rectal bleeding and ulcers, medications inserted in the anus can help relieve the pain and the inflammation.
References
http://www.nhs.uk/Conditions/Mucositis/Pages/Treatment.aspx
http://oralcancerfoundation.org/complications/mucositis/
https://www.oncolink.org/support/side-effects/mucositis/mucositis-the-basics
