Mucositis - Not just about pain

‘It is like a sharp blade cutting through your throat and gut when you swallow anything as simple as water!’ – This is how patients usually described the symptoms of mucositis. Such intense pain triggered by the medical condition is just part of the nightmare as the consequence could be severe in long term. Mucositis, an inflammatory and the abilities of chewing and swallowing. Together with the intolerable pain, sufferers often have very poor appetite, leading to malnutrition unless appropriate dietary remedies.

Mucositis usually goes hand in hand with chemo-and radio-therapies as one of the most prevalent complications for cancer treatment, particularly at high dosage of chemo-drugs or when irradiation at head-and–neck position is used. Both treatments induce damage on mucosa lining which triggers ulcers and inflammatory response. Mounting research data revealed that over 90% of patients after receiving head-and-neck radiotherapies had experienced various degrees of mucositis with some even required withholding the treatment.

To prevent excessive weight loss while stay strong during mucositis episode, strategies for adequate nutrition is of utmost importance. The eating pattern, food choice and preparation come into time are generally recommended approach to accommodate their poor appetite and pain as eating. Boosting up food nutrient profile without extensively enlarged the portion are found to be more tolerable. For instance, fortifying porridge with egg, protein powder or nutrition supplement during cooking or adding fish, tofu or pumpkin pureed to congee can enrich calories and protein content at every bite. Having creamy soup rather than Chinese-style broth and going with milkshake and nutrition supplement can yield more nutritive values. As chewing and swallowing can be difficult at times, softened foods with moist and smooth texture, instead of dried and tough deep-fried foods, such as avocado, tofu and food pureed, may ease the eating process. At bad days, consuming blended food with uniform texture via straw can help get down the digestive tract without too much irritation to the ulcers. Other than food texture, milder flavors are generally more desirable than sally, spicy and sour foods such as citrus juice, chili and curry sauce. Specific nutrients such as arginine, nucleotides and omega-3 oil have recently received more attention of their potency in the cancer treatment complication prevention.

Recovery from mucositis requires both adequate nutrition and proper oral care, so, don’t forget to use oral rinsing agent such as saline or soda water!

References

  1. BC Cancer Agency, Oncology Nutrition. Nutritional Guidelines for symptom Management mucositis.http://www.bccancer.bc.ca/nutrition-site/Documnets/Mucositis.pdfLast updated:2005
  2. Stableforth WD, Thomas S, Lewis SJ (2009) A systematic review of the role of immunonutrition in patients undergoing surgery for head and neck cancer. lnt J Oral Maxillofac Surg 38:103-110

330 Tips provided by:  Dr. Forrest Yau  (Health/ Fitness Specialist, Centre for Nutritional Studies, School of Public Health and Primary Care, Faculty of Medicine, CUHK)