Mucositis — Inflammation of Digestive Lining

Mucositis represents an inflammatory response that develops when cytotoxic cancer treatments damage the rapidly dividing epithelial cells that form the protective mucosal lining. This process primarily affects the oral cavity (oral mucositis) but can extend throughout the entire gastrointestinal tract, causing inflammation from the oesophagus to the rectum.

The condition progresses through distinct phases: biological initiation, upregulation and message generation, ulceration with loss of mucosal integrity, and eventual healing. During the ulcerative phase, painful sores develop that leave vulnerable underlying tissues exposed to microbial colonisation and potential infection.

Severe mucositis can significantly impact your daily quality of life and your cancer treatment schedule. Pain can make drinking fluids and eating food challenging, creating risks of dehydration, malnutrition, and weight loss. Furthermore, open sores in the mouth provide a pathway for bacteria to enter the bloodstream, which is particularly hazardous when your white blood cell counts are low. Severe symptoms may necessitate treatment delays, dosage reductions, or hospitalisation for pain control and nutritional support.

Mucositis has no specific blood biomarker; it is diagnosed through clinical examination and graded on established scales, such as the World Health Organization oral toxicity scale. Doctors and nurses inspect the mouth and throat for redness, ulceration, and evaluate the patient's ability to swallow fluids and solid food.

Oral mucositis is especially prevalent in people receiving high-dose chemotherapy prior to stem cell transplants and those undergoing radiotherapy for head and neck cancers. It also affects patients receiving standard chemotherapy regimens for colorectal, breast, lung, and haematological malignancies.

Management focuses on symptom prevention, pain relief, and infection control. Strategies include intensive oral hygiene, therapeutic mouth rinses, ice chips (cryotherapy) during drug infusions, and pain medications ranging from topical gels to opioids. Nutritional support, such as feeding tubes or intravenous hydration, may be necessary in severe instances.