Causes, Symptoms And Treatment Of Oral Mucositis

Causes, Symptoms And Treatment Of Oral Mucositis

Oral mucositis is painful inflammation of the mucous membrane lining of the mouth. Mucous membrane is the outer soft tissue layer lining the digestive tract, from the mouth to anus. Oral mucositis results as a complication of chemotherapy and radiotherapy treatment given in cancer patients. Mouth will feel sore and painful, with difficulty in eating, drinking, and talking. Mouth ulcers develop. Sometimes it can lead to infection.

Usually, the mucositis heals by itself, unless infection supervenes. Chemotherapy-induced mucositis takes around 2-4 weeks to heal, and that induced by radiotherapy takes around 6-8 weeks to heal. Proper oral hygiene prevents infection. Painkillers (analgesics) can be taken for the pain. Other treatments include palifermin, laser therapy, and antibiotics.


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Causes of Oral Mucositis

Oral mucositis is commonly a side effect of chemotherapy and radiotherapy. Biological therapies and stem cell transplant can also cause it. It is more common in those with certain well-identified risk factors.

Radiotherapy and Chemotherapy

Both chemotherapy and radiotherapy are used very commonly in treating cancers. These treatments not only kill the cancer cells but sometimes injure the healthy cells, particularly those of the mucous membrane. The frequency of the occurrence of the mucositis can vary from 5 to 40% depending on the chemotherapy agent, and dose and duration of radiotherapy.

Radiotherapy

Biological Therapy

Biological therapies are another form of treatment used in cancer management. They, too, can cause oral mucositis.

Bone Marrow Transplantation

Sometimes the mucositis can develop during or after bone marrow transplantation. This is because during such therapy, medicines are given that depress the immune system, making the body vulnerable to illness and infection.

Risk Factors

Oral mucositis is more common in young people. Poor oral hygiene, smoking, drinking alcohol, dehydration, and consumption of spicy foods put you at greater risk for developing mucositis.


Symptoms of Oral Mucositis

The symptoms typically begin 5-10 days after the start of chemotherapy, or two weeks after the start of radiotherapy. Symptoms resolve by themselves after some time if infection does not occur.

Redness and Ulceration

Due to the cell damage and death, the oral mucosa can become red, thin, and may even slough off, leading to ulcer formation. Ulcers can be as small as 0.5 cm or as big as 4 cm or more. They can get covered with yellowish white clot due to bleeding. If the ulcers get infected, the infection can spread to blood and other organs, which can sometimes be life-threatening.

Ulceration

Pain

There can be severe pain in the mouth. Its severity is positively correlated with the amount of tissue damage. It may be described as burning sensation. Because of it, the patient might have difficulty in talking, drinking, and eating.

Pain in mouth

Altered Taste Sensation

Taste sensation may be altered. The complaints may be that the food tastes bland, too bitter, too sweet, or metallic.


Treatment of Oral Mucositis

Treatment is mainly supportive and preventive. Maintenance of good oral hygiene is a very important part of the treatment. Healing occurs within a few weeks.

Oral Hygiene

You should maintain proper oral hygiene by brushing every morning and at bedtime, and after each meal. Flossing should be done once or twice daily. Rinse the mouth with mouthwashes. Sucking of ice cubes is thought to be of some help.

Oral Hygiene

Painkillers (analgesics)

Since pain is a common symptom of mucositis, painkillers are necessary. Ibuprofen or paracetamol can be tried initially. If the pain is not controlled, then lidocaine, codeine or morphine needs to be taken.

Palifermin

Palifermin aids the growth of fresh cells in the mucous membrane lining. This reduces the severity of symptoms and facilitates the faster healing of ulcers.

Palifermin

Other Therapies

Low-energy laser therapy aimed at the affected tissues can reduce the symptoms. If infection has occurred, antibiotics need to be taken. Other agents that may have a role to play include amifostine, glutamine, vitamin E, allopurinol, and sucralfate.

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