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Nutrition Therapy

    continued...

    Suggestions for lessening or alleviating dry mouth include the following:[36]

    • Perform oral hygiene at least 4 times per day (after each meal and before bedtime). (Refer to the Routine Oral Hygiene Care section of the PDQ summary on Oral Complications of Chemotherapy and Head/Neck Radiation for more information.)
    • Brush and rinse dentures after each meal.
    • Keep water handy at all times to moisten the mouth.
    • Avoid rinses containing alcohol.
    • Consume very sweet or tart foods and beverages, which may stimulate saliva.
    • Drink fruit nectar instead of juice.
    • Use a straw to drink liquids.

    (Refer to the PDQ summary on Oral Complications of Chemotherapy and Head/Neck Radiation for more information on xerostomia.)

    Mucositis/stomatitis

    Stomatitis, or a sore mouth, can occur when cells inside the mouth, which grow and divide rapidly, are damaged by treatment such as bone marrow transplantation, chemotherapy, and radiation therapy. These treatments may also affect rapidly dividing cells in the bone marrow, which may make patients more susceptible to infection and bleeding in their mouth. By carefully choosing foods and by taking good care of their mouths, patients can usually make eating easier.[42,43,44] Individuals who have mucositis, mouth sores, or tender gums should eat foods that are soft, easy to chew and swallow, and nonirritating.[32] Some conditions may require processing foods in a blender. Irritants may include acidic, spicy, salty, and coarse-textured foods. A pilot study found that oral glutamine swishes might be helpful in reducing the duration and severity of mucositis.[45][Level of evidence: I] Glutamine may also reduce the duration and severity of stomatitis during cytotoxic chemotherapy.[45,46][Level of evidence: I]

    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.
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