Help for Mouth Sores

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Q:Can you recommend anything to help my brother with mouth sores that developed as a result of chemotherapy?

Debbie, Gilford, New Hampshire 

Mouth and tongue sores are an inflammatory response to the chemotherapy treatment. There are many ways you can try to alleviate the discomfort and pain associated with mouth sores during chemotherapy. These mouth sores may or may not last for the entire duration of chemotherapy.

Rinses and healthy oral hygiene may help reduce the onset and length of time the mouth sores are present. Studies have shown that a glutamine mouth swish and swallow may help decrease the length of time and severity of mouth sores.

Glutamine is a type of amino acid (a building block of protein) that can help to feed the cells lining the intestinal tract and has been shown to be "conditionally essential" during certain times of stress, such as chemotherapy.

Research has demonstrated that glutamine supplementation for cancer patients is both safe and may also be effective.

Pure L-Glutamine powder can be found in many supplement/vitamin stores and some pharmacies. Try to find a pure powder with no fillers in the ingredients. It is important to have your brother check with his doctor before starting a new type of mouth rinse, such as glutamine.

A basic mouth rinse made of one tablespoon of baking soda to one quart of water will also help to remove food and germs and keep the mouth clean. It is important to rinse the mouth to reduce bacteria.

There are certain types of foods that will not irritate the mouth or tongue and may help alleviate your brother's pain. Eating foods that are high in protein and calories will help the healing process.

Eating soft and bland food, such as scrambled eggs, creamed soups, and cooked cereals will provide protein and nutrients and will be easier to eat. Also, pureeing or liquefying foods and drinking them through a straw, to avoid the sores, may also make food easier to eat. Hot foods may irritate mouth sores, so try to serve foods lukewarm or cold.

Cold foods can sometimes alleviate the pain of mouth sores. Foods like Italian ice (particularly watermelon flavor), ice cream, sorbet, sherbet and pudding may also be soothing.

Some foods to avoid are citrus fruits and fruit juice as well as tomato sauce or juice. These are very acidic and may irritate mouth sores.

Spices or seasonings, such as pepper, chili powder, cloves, nutmeg, salsa, and horseradish, may also be irritating and painful to eat.

Avoid some raw vegetables, granola, toast, crackers and other rough, course, or dry foods.

Tobacco and alcohol may exacerbate mouth sores, so it is also good to avoid these.

Your brother should experiment with different foods to find out which are the most soothing for him. He should start his trials with water, Italian ices (not lemon), sherbet and warm broth. After those, he can progress to yogurts, puddings and fruit purees. After those, he can try soft, solid foods like mashed potatoes, macaroni and cheese and oatmeal.

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