Suggestions for people with cancer who are experiencing stomatitis include the following:
- Eat soft foods that are easy to chew and swallow, including bananas and other soft fruits; applesauce; peach, pear, and apricot nectars; watermelon; cottage cheese; mashed potatoes; macaroni and cheese; custards; puddings; gelatin; milkshakes; scrambled eggs; oatmeal or other cooked cereals; pureed or mashed vegetables such as peas and carrots; and pureed meats.
- Avoid foods that irritate the mouth, including citrus fruits and juices such as orange, grapefruit, or tangerine; spicy or salty foods; and rough, coarse, or dry foods, including raw vegetables, granola, toast, and crackers.
- Cook foods until soft and tender.
- Cut foods into small pieces.
- Use a straw to drink liquids. Eat foods cold or at room temperature; hot and warm foods can irritate a tender mouth.
- Practice good mouth care, which is very important because of the absence of the antimicrobial effects of saliva.
- Increase the fluid content of foods by adding gravy, broth, or sauces.
- Supplement meals with high-calorie, high-protein drinks.
- Numb the mouth with ice chips or flavored ice pops.
(Refer to the PDQ summary on Oral Complications of Chemotherapy and Head/Neck Radiation for more information on mucositis.)
Nausea can affect the amount and types of food eaten during treatment. Eating before treatment is important, as well as finding foods that do not trigger nausea. Frequent triggers for nausea include spicy foods, greasy foods, or foods that have strong odors. Once again, frequent eating, and slowly sipping on fluids throughout the day may help.
Additional eating suggestions include the following:
- Eat dry foods such as crackers, breadsticks, or toast, throughout the day.
- Sit up or recline with a raised head for 1 hour after eating.
- Eat bland, soft, easy-to-digest foods rather than heavy meals.
- Avoid eating in a room that has cooking odors or is overly warm; keep the living space comfortable but well ventilated.
- Rinse out the mouth before and after eating.
- Suck on hard candies such as peppermints or lemon drops if the mouth has a bad taste.
(Refer to the PDQ summary on Nausea and Vomiting for further information.)
Radiation, chemotherapy, gastrointestinal surgery, or emotional distress can result in diarrhea. Avoiding hyponatremia, hypokalemia, and dehydration during episodes of diarrhea requires the intake of additional oral fluids and electrolytes. Broth, soups, sports drinks, bananas, and canned fruits may be helpful for the replenishment of electrolytes. Diarrhea may worsen with greasy foods, hot or cold liquids, or caffeine. In the presence of radiation enteritis, fibrous foods-especially dried beans and cruciferous vegetables-may contribute to frequent stools. Meal planning should be individualized to meet nutritional needs and tolerances. Oral glutamine may also help prevent intestinal toxicity from fluorouracil.[Level of evidence: I]