Medicines for Mucositis

What it is

Mucositis is inflammation and, often, ulceration (sores) of the moist lining (mucous membranes) of the mouth or the digestive tract. It most commonly refers to a side effect of some cancer treatments — particularly certain chemotherapy and radiotherapy (especially radiotherapy to the head and neck area) — which can damage the rapidly dividing cells that line the mouth and gut, causing inflammation and soreness. Oral mucositis (affecting the mouth) is the most common and well-recognised form. The symptoms of oral mucositis can include: a sore, red, and inflamed mouth; painful ulcers or sores in the mouth and on the tongue; difficulty and pain with eating, drinking, and swallowing; a dry mouth; and increased sensitivity. Mucositis can also affect the lining further down the digestive tract, causing symptoms such as tummy discomfort or diarrhoea. Mucositis can be painful and can significantly affect a person’s ability to eat and drink, their comfort, and their quality of life during treatment, and it can also increase the risk of infection (as the broken lining is more vulnerable). It usually develops during a course of the relevant treatment and improves and heals after the treatment finishes, over a period of weeks, as the lining recovers. Because mucositis is a known and common side effect of certain cancer treatments, it is anticipated and managed as part of cancer care: measures are used to help prevent or reduce it, to relieve the pain and symptoms, to support eating and drinking and nutrition, and to prevent and treat infection, while the lining heals. Good mouth care is an important part of this. The care team supports the person through it. The key messages are that mucositis is painful inflammation of the lining of the mouth or gut, commonly a side effect of some cancer treatments, that it can affect eating, comfort, and infection risk, and that good mouth care and supportive measures help manage it while it heals after treatment.

How it is treated

Mucositis, most often a side effect of certain cancer treatments, is managed as part of cancer care — with measures to help prevent or reduce it, relieve pain and symptoms, support nutrition, and prevent and treat infection, while the lining heals; good mouth care is central. Because mucositis is a known side effect of some chemotherapy and radiotherapy, it is anticipated and managed proactively by the care team. Prevention and reduction measures may be used before and during treatment where appropriate — including good oral care and, in some situations, specific measures to reduce the risk or severity (guided by the care team). Good mouth care is a central and important part of management: keeping the mouth clean and moist, gentle brushing with a soft toothbrush, regular mouth rinsing (for example with recommended mouthwashes or salt water, as advised — avoiding alcohol-containing or irritant mouthwashes), keeping the lips and mouth moist, and attending to dental health (ideally with a dental check before treatment where planned) all help. Relieving the pain and symptoms is important: pain relief (from simple measures up to stronger pain relief, and specific mouth treatments such as coating or numbing preparations, as advised) helps with the soreness, particularly to allow eating and drinking. Supporting eating, drinking, and nutrition is a key aspect, as mucositis can make these difficult and painful — measures include soft, moist, bland foods, avoiding foods that irritate (such as spicy, acidic, rough, or very hot foods), plenty of fluids, and, where needed, dietary support, nutritional supplements, or other feeding support to maintain nutrition and hydration. Preventing and treating infection is important, as the broken lining is more prone to infection (including in the mouth), and the person’s immune system may also be affected by treatment — so watching for and treating infections (such as oral thrush or other infections), and good hygiene, are part of care. The care team monitors and supports the person through mucositis, and adjusts cancer treatment if necessary in severe cases. Mucositis usually heals over a period of weeks after the causative treatment finishes, as the lining recovers, and the symptoms improve. It is important to tell the care team about mouth or throat soreness, difficulty eating or drinking, or signs of infection, so support and treatment can be provided promptly. The reassuring messages are that mucositis, though painful, is an anticipated and managed side effect of certain cancer treatments, that good mouth care, pain relief, nutritional support, and infection prevention help manage it, that the care team supports the person through it, and that it usually heals after the treatment finishes — so reporting symptoms and following mouth-care advice are important.