Published: 18 Jun 2025

ICD9: 528.00      ICD10: K12.30      ICD11: CA09.0

Mucositis is the painful inflammation and ulceration of the mucous membranes lining the digestive tract.
It often occurs as a side effect of cancer treatments, particularly chemotherapy and radiation therapy.

Here's a more detailed breakdown:

What is it?

Inflammation: Mucositis is essentially an inflammatory response in the mucous membranes.
Mucous Membranes: These are the moist inner linings of the body that produce mucus. They line the digestive tract (mouth to anus), as well as the nose, sinuses, lungs, and some parts of the reproductive tract. In the context of mucositis, we're usually referring to the *oral* (mouth) and *gastrointestinal* (GI) tract.
Ulceration: As the inflammation progresses, it can lead to the breakdown of the mucosal surface, resulting in painful sores or ulcers.

Causes:

The most common cause is cancer treatment, specifically:

Chemotherapy: Certain chemotherapy drugs are toxic to rapidly dividing cells. Mucous membrane cells divide rapidly, making them vulnerable.
Radiation Therapy: Radiation can directly damage the cells lining the digestive tract, especially when radiation is targeted to the head, neck, or abdomen.
Stem Cell Transplant: High-dose chemotherapy and radiation used before stem cell transplantation often cause severe mucositis.
Sometimes, other factors such as infection, poor oral hygiene, and certain medications can contribute.

Where does it occur?

Oral Mucositis: Inflammation and sores in the mouth (gums, tongue, inner cheeks, palate, throat). This is very common.
Esophagitis: Inflammation of the esophagus (the tube connecting the throat to the stomach). Can cause pain when swallowing.
Gastritis: Inflammation of the stomach lining.
Enteritis/Colitis: Inflammation of the small intestine (enteritis) or large intestine (colitis). Can cause diarrhea, abdominal pain, and bleeding.
Proctitis: Inflammation of the rectum and anus.

Symptoms:

The symptoms depend on the location and severity of the mucositis, but common symptoms include:

Pain: Pain in the mouth, throat, abdomen, or rectum.
Redness: Redness and swelling of the mucous membranes.
Ulcers/Sores: Open sores or ulcers in the affected area.
Difficulty Swallowing (Dysphagia): Painful or difficult swallowing.
Difficulty Eating: Pain makes it hard to eat and maintain nutrition.
Taste Changes: Altered taste perception.
Dry Mouth (Xerostomia): Reduced saliva production.
Diarrhea: Frequent, loose stools.
Nausea and Vomiting: Feeling sick to the stomach and throwing up.
Abdominal Cramps: Painful cramps in the abdomen.
Bleeding: Bleeding from the mouth, esophagus, stomach, or rectum.
Infection: Damaged mucous membranes are susceptible to infection.

Why is it a problem?

Mucositis can have a significant impact on a person's quality of life:

Pain: Can be debilitating, interfering with daily activities.
Malnutrition: Difficulty eating leads to weight loss and nutrient deficiencies.
Dehydration: Diarrhea and vomiting can lead to dehydration.
Infection: Ulcers provide entry points for bacteria and other pathogens, increasing the risk of local and systemic infections (sepsis).
Treatment Delays: Severe mucositis may require a reduction in chemotherapy dosage or a delay in treatment, potentially affecting cancer outcomes.
Increased Hospitalization: Severe cases may require hospitalization for pain management, nutritional support, and infection control.

Treatment and Prevention:

Treatment focuses on pain management, preventing infection, and maintaining nutrition. Prevention strategies aim to reduce the severity and duration of mucositis. Specific approaches include:

Good Oral Hygiene: Regular brushing, flossing (if tolerated), and rinsing with salt water or baking soda solutions. Avoid alcohol-based mouthwashes.
Medications:
Pain relievers: Mouthwashes containing anesthetics (like lidocaine) or systemic pain medications.
Palifermin (Kepivance): A keratinocyte growth factor that can help protect and repair the lining of the mouth.
Antifungal medications: To prevent or treat fungal infections.
Antibiotics: To treat bacterial infections.
Cryotherapy (Ice Chips): Sucking on ice chips during chemotherapy infusions can help reduce blood flow to the oral mucosa, potentially decreasing drug exposure.
Soft Diet: Avoid spicy, acidic, and rough foods that can irritate the mucous membranes. Choose soft, bland foods.
Nutritional Support: If eating is difficult, nutritional supplements or intravenous (IV) nutrition may be necessary.
Laser Therapy: Low-level laser therapy is sometimes used to reduce pain and inflammation.

Important Considerations:

Mucositis is a complex condition, and management often requires a multidisciplinary approach involving oncologists, nurses, dentists, nutritionists, and pain specialists.
The best approach depends on the individual patient, the type of cancer treatment, and the severity of the mucositis.
It's crucial for patients receiving cancer treatment to report any symptoms of mucositis to their healthcare team promptly.

In summary, mucositis is a common and often debilitating side effect of cancer treatment that causes inflammation and ulceration of the mucous membranes. Effective management requires a comprehensive approach to pain control, infection prevention, nutritional support, and careful oral hygiene.