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by Robyn

News about the online centre and other cancer related topics
30 June 2017 at 17:04

Sore mouth and swallowing problems

Caroiline our Nutritional advisor and Sue ( susieq) held a session in their Food for thought series on how to manage eating when cancer and it's treatments have caused a sore mouth, tthroat, and swallowing difficulties. They discussed the nutritional solutions, that could run along medical support and options to help ease oral discomfort. 

You can read the transcript below. if you would like to read other transcripts from this informative series of discussions you can join the Food for thought group - find out more on our group page.  If you have any questions or comments you are welcome to message Sue, Caroline or me.

 

Food for thought transcipt Sore mouth and swallowing problems

susieq: Hello and welcome to today's Food for Thought

carolineh: Hello Sue. The topic today is difficulty eating, swallowing due to sore throat or loss of saliva,. loss of taste and a sore mouth due to treatment.

susieq: Thanks Caroline, there are a number of reasons for a dry mouth in cancer care as we know. These include chemotherapy and radiotherapy, antidepressants, diuretics, dehydaration, some painkillers, and/or a mouth infection....So quite a range of issues that can lead to this distressing symptom...

carolineh: Yes and of course the medical team will be on board with this but there are a few things that could be tried to help alleviate the symptoms.

susieq: It is useful to know what we can try at home...

carolineh: I can give evidence of what people have tried which seems to have helped but of course with all things some work better for some than others. One of the most distressing things is when the taste buds change and people develop a metallic taste in the mouth which takes the joy out of eating.

susieq: A really annoying an distressing symptom when you're already possibly dealing with a low appetite. What sorts of things do you suggest?

carolineh: Many people find that eating warm or cool food helps better than hot foods (temperature) but also eating well flavoured spicy foods seems to help. Using plastic knives and forks for eating seems a step to far but it does help.

susieq: I agree, we used to use plastic cutlery for some people at the hospice if patients were experiencing an unpleasant metallic taste.

carolineh: I also know of people who use foods that are semi frozen like slush puppy sort of foods if that makes sense. Eating little and often also seems to help as this keeps the taste buds busy and eating this way is more nourishing than eating the 3 normal meals a day.

susieq: I remember that pineapple chunks helped, and ice lollies/crushed ice...and the eating little and often makes sense.

carolineh: Yes that sort of food seems to really help. Again it is trial and error to find what may help the individual.

susieq: Whilst not entirely nutrition related, artificial saliva, from the doctor's/hospital, can help, both with speech and eating...

carolineh: Yes - I know many people who use the artificial saliva which of course helps with swallowing and chewing the food. We also have those who are receiving radio for head and neck cancers which can really make eating so very difficult due to no saliva or difficulty swallowing due to soreness or inflammation.

susieq: I was thinking that in some cases the mouth may be very sore...apart from all the things the chemo suite/hospital can prescribe, is there anything natural that could relieve the discomfort?

carolineh: Yes, several things. Some people find that using honey rubbed around the mouth really sooths and helps. An aloe vera juice used as a mouth wash then swallowed helps and also you can buy a mouth wash called Cucumall which helps to heal a sore mouth and boost the local immunity. Zinc lozenges from a chemist also help with local immunity and soreness if they are sucked.

susieq: That's useful to know...I'm guessing avoiding dry foods, and drinking plenty of fluids might help too...

carolineh: Taking food through a straw that is put to the back of the mouth helps and eating foods like mashed avocado which has a silky texture slips down with very little effort or drinks with avocado in has a similar effect.

susieq: oh that's a good idea!

carolineh: One study showed that if people rubbed honey into there gums and mouth 20mins before radiotherapy that it reduced the soreness quite significantly so this too may be worth trying.

susieq: it makes sense, and is a natural product....anything for mouth ulcers?

carolineh: Yes Manuka is probably the best to use but any smooth honey would help. When interest in food does go because of the side effects people have it is important to get family or friends on board to prepare simple snacks that are moist and nourishing to encourage eating.

I have even suggested to people to set the alarm every 2-3 hours to remind them they must try and have some nourishment. I really know that this can be very challenging and takes real commitment but very important. Meanwhile, for mouth ulcers I would recommend the zinc lozenges or the aloe vera gargle.

susieq: I have in the past, suggested people set an alarm to remind them to drink plenty of fluids during the day too....so am with you there. Texture of food can sometimes be a problem....

carolineh: Obviously very smooth moist food is the type to try. Very soft mashed potato for example but beat an egg into it for extra nutrition. Soften the potato with butter and or milk. Some people can cope with porridge made with milk or a smoothie which includes some protein powder for nourishment. Avoid foods that are clawy if that's the right word. They may appear moist but stick in the mouth rather than being east to swallow.

susieq: I know what you mean. This would help people who have difficulty chewing too...?

carolineh: Of course. This is where the straw trick comes in. It is important tho that the liquid food is as nourishing as possible. I know that dieticians and recommend build up drinks which you can also buy from the chemist but also drinks like hot chocolate (obviously cooled ) or complan made with milk and cooled before drinking.

susieq: Yes, there is a place for supplements here..

carolineh: As in drink supplements, not pills or capsules. We must not forget soups which if made with good bone stock will be very good to have. Well blended naturally, using a variety of vegetables. Butter nut squash gives a good texture so does well blended peas added to a soup. They are still very tasty cooled rather than hot.

susieq: That makes good sense. This may be going off the beaten track a bit here, but some people get quite a cracked mouth, lips, and mouth corners....is this a case of back to the straw approach, again?

carolineh: Yes - with the cracked sore lips Vaseline rubbed in helps or an aloe vera based pure non perfumed cream. Again I am sure that the medics would recommend some specific creams here. And yes the straw would certainly help.

It is so important tho' that if eating really does become too difficult that the medics are told so that other steps can be taken.

susieq: Very much so....people often feel they should battle on, but it needs addressing early. Mention it to your medical team. Sometimes, there may be a simple solution, as something like oral thrush (Candida albicans fungus) can develop when on steroids or chemotherapy - and can be very uncomfortable, but easily rectified.

carolineh: We have banded about a lot of ideas which will hopefully help some. Anyone who has gone through this will know how difficult the subject is to deal with and there is no easy answer.

susieq: One final little tip I recall from my nursing days to get rid of a bad taste in the mouth, is to make a mouthwash with half a teaspoon of salt and half a teaspoon of baking soda....and swill round mouth (and spit out)....I saw it on Cancer.Net website today, and it reminded me...

carolineh: That sounds like a plan Sue although I have not heard of this myself.

susieq: I thought it was a bit old fashioned these days, but interesting to see it still being put forward.

carolineh: It does sound it and the aloe vera may be more pleasant but if people have tried most things that have not helped sometimes the old fashioned methods work best. I think that the use of Honey is also good as this is naturally cooling and soothing.

susieq: (and nicer tasting). As we draw to a close for today, Caroline, as always, I'd like to thank you...and invite people to message you with any queries on this, or any other nutrition topic...

carolineh: Yes of course . Also it is important to remember that food is such an emotional topic and it is important that people do get support if mood becomes low or people become depressed as a result of the whole issue around food soreness inability to eat etc.

susieq: Good advice, Caroline....

carolineh: Thank you for your time today. I hope that this session will help some and please do contact me individually if more advice is needed as I am really happy to help.

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Further reading:-

Taste Changes Cancer.Net

Dealing with changes. (Dietary help for those who experience changes in taste and smell/dry sore mouth) Caroline's blog.

How chemotherapy can affect your mouth Macmillan Cancer Support



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