Healing Nutrition

Mouth sores are areas that might look like little cuts or ulcers in the mouth, also known as mucositis or stomatitis. This side effect is because specific cancer treatments involving one or a combination of chemotherapy treatment agents and radiation treatments can damage cells causing redness, swelling, tenderness, and sores on the lining of your mouth, tongue, and lips (1, 2).
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The pain associated with severe oral mucositis can make it very difficult to eat food, resulting in weight loss and consequently affecting the person's nutritional status.

 

A soft diet and liquid nutrition supplements are more easily tolerated. Therefore you must look for foods with a soft and smooth consistency that you can chew and swallow without difficulties (3, 4). 

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Nutrition Strategies for Mouth Sores

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• Eating small, frequent meals of bland, moist foods.​

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• Puree or liquefy foods in a blender to make them easier to swallow. ​

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• Use a straw for drinking beverages to bypass mouth sores. ​

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• Choose lukewarm or cold foods and cold beverages that are soothing. ​​

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• Before eating, keep very cold water in your mouth or even crushed ice if you can stand it to numb the pain and eat better.​

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• To help prevent infections, rinse your mouth regularly - Mix 1 liter of water, 1 teaspoon of salt, and 1 teaspoon of baking soda. Gargle the mixture but don't swallow it.

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Talk to your doctor or registered dietitian if you start developing mouth sores. Your doctor may prescribe Magic Mouthwash ("swish and swallow" mouthwash) to help you heal and eat better.

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What to Eat with Mucositis in Cancer

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The discomfort caused by mucositis exacerbates when eating, causing you to eat less. This reduction in the portion sizes of foods results in weight and muscle loss - during this period, it is advisable to add foods rich in protein, fat, and carbohydrates to your diet to maintain weight and speed healing.
 

• Soups, casseroles, and stews with soft and tender chopped meats or beans

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• Mashed potatoes and sweet potatoes softened with milk, cream, butter, or gravies

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• Ground, chopped, or blenderized meats, chicken, turkey, or fish

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• Soft proteins such as eggs, tofu, beans, and lentils

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• Add olive or avocado oil, broth, butter, milk, gravy, sauces, and dressings to moisten foods.

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• Dairy like milk, yogurt, and cheeses, especially cottage and ricotta cheese 

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• Cooked cereals, such as cream of wheat or thinned oatmeal

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• Cold cereals softened in milk

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• Fruit juices like apple juice and fruit nectars

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• Ripe fruits such as bananas, strawberries, and avocados

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• Fruit cups like pears and peaches

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• Fruits rich in water can be soothing, like watermelon, peaches, and grapes; try them cold too

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• Pasta with white sauce and finely chopped chicken

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• Custards, rice pudding, frozen yogurt, and popsicles

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• Pancakes and other bread softened in butter and honey or agave syrup

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• Dip dry bread in soups and sweet bread in plain or chocolate milk to moisten

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• Well-cooked vegetables like squash, carrots, and spinach - can be mashed with a fork or eaten in creams, purees, or concentrated soups, just like lentil and bean soups.

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What to Drink with Mucositis in Cancer

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Drinking can be less painful and more manageable than chewing foods if you have mouth sores. Water should be the first beverage of choice, but when it comes to getting more calories in your diet, there are other choices to boost your nutrient intake. Choose drinks with nutrients and prepare shakes at home high in calories and protein to replace meals. 

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• Milk and plant-based milks

• Cold cocoa drink

• Fortified milk

• Coconut water

• Fruit juices

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Shakes 

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Consider preparing nutritious shakes with milk or plant-based milk alternatives using a blender at home. Add nutrient-dense foods such as protein powder, fruits, nuts, and natural nut butter like peanut butter, cashew butter, and almond butter. You also can add yogurt, coconut oil, oats, flaxseeds, greens, hemp seeds, avocado, fruits, or fruit juices. 

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• Milkshakes

• Smoothies 

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Oral nutritional Supplements

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Oral nutritional supplements (ONS) can be part of the nutrition care plan. This nutrition intervention can help add calories, protein, vitamins, and minerals to a daily diet when you can't get your nutrition needs with food alone. 

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• Kate Farms

• Orgain Organic

• Premier Protein

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What Causes Mucositis in Cancer

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Mucositis is one of the most common side effect in radiation therapy for head and neck cancers. Mucositis usually becomes clinically evident during the second or third week of radiation therapy [5]. 

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Chemotherapy, such as busulfan, cyclophosphamide, doxorubicin, 5-FU, bleomycin, paclitaxel, vincristine, and vinblastine, may cause mucositis [7, 8].

 

Risk factors such as age, nutritional status, type of malignancy, and oral care during treatment will play important roles in developing mucositis [7, 8].

Mucositis may also limit the patient's inability to tolerate either chemotherapy or radiation therapy, resulting in dose-limiting toxicity affecting cancer treatment and outcome.

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Foods and Drinks to Avoid with Mucositis in Cancer

 

​Eating foods that are hard to chew or swallow should be avoided. Certain foods may cause pain, including foods that are highly seasoned and acidic or foods that are very hot or very cold. 
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Avoid all these foods that will irritate the surface of the wound even more, and also try to have good oral hygiene and drink plenty of water.

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• Tobacco

• Alcohol

• Mouthwash containing alcohol

• Salty foods and foods that contain strong spices such as chili and curry powders, peppers, and horseradish​

• Citrus fruits and juices, including orange, lemon, lime, grapefruit, and pineapple

• Tomatoes and tomato sauce

• Hard, dry, or coarse foods like toast, crackers, raw vegetables, potato chips, and pretzels

• Very hot or cold foods and liquids

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