mouth sores, also called mucositis or Stomatitis, is a very common side effect of chemotherapy that causes a lot of discomfort in people. Fortunately, there are treatments that can help relieve pain.
This article will review why canker sores occur, how to treat them, and what to do if they are severe.
What is mucositis (mouth ulcers)?
Mucositis is inflammation of the mucous membranes, which are the cells in the gastrointestinal tract. Starting in your mouth (oral mucositis), damage to these cells continues into your esophagus (esophageal mucositis) and through your digestive system (intestinal mucositis).
Inflammation can be caused by chemotherapy or radiation therapy. It feels like a sunburn in your body. Other symptoms of mucositis include:
- redness of the mouth
- mouth ulcers
- swelling of the tongue or other parts of the mouth
Mucositis usually begins shortly after chemotherapy is started, but the severity may depend on the chemotherapy drugs given. It is important for people with mouth ulcers to speak with their oncology team to help determine the best treatment plan.
Pain from mouth ulcers can keep people from getting enough nutrition, which is one of the most important things people need when recovering from cancer treatment.
What is a triple mix?
Triple Blend is a combination of three liquid medicines to treat and relieve oral and esophageal mucositis. The exact medication can vary and is usually only available by prescription. The usual concoctions contain pain relievers, reduce inflammation, and sometimes treat bacterial or fungal infections.
Your healthcare provider must prescribe this medication, and your pharmacist will need time to create it. The triple mix must be mixed when ordering – which means it must be made in a pharmacy and not mixed yet.
Triple mixes typically contain:
- Maalox (apply and soothe sores)
- lidocaine (a local anesthetic that numbs sores)
- Benadryl (diphenhydramine, an antihistamine)
Other ingredients may include:
- Nystatin (an antifungal drug used to treat thrush)
- Steroids (to reduce inflammation)
There are several variations of this mixture, and your oncologist has an opinion on which mixture seems to work best. Be sure to ask them, preferably before you start chemotherapy and develop mouth sores.
You may have heard a solution whose name is not a triple mix. These include:
- triple solution
- magic mouthwash
- GI (Gastrointestinal) Cocktail
How to use triple mix
Exact instructions on how to take the triple mix will come from your oncologist. It can be used as a mouthwash, gargling in the mouth to coat sores and the tongue. In this case, the solution is not swallowed, but spit out.
The triple mixture can also be rinsed and swallowed to cover the back of the throat and esophagus. This may help when sores are in these areas. If swallowed, wait at least 30 minutes after using the triple mixture before eating or drinking anything.
Complications of mouth ulcers
The problems caused by mucositis are not just pain. Mouth ulcers can affect your ability to eat, and eating a healthy diet is important to maintain your strength during cancer treatment. Other symptoms, such as loss of appetite, nausea, or changes in taste, may make the problem worse.
Thrush is a complication that can be seen in mucositis.This infection is caused by a fungus candida albicans, It usually results in a white coating on the tongue and inside of the cheeks. Thrush can cause burning pain that worsens the pain of mouth sores. It is usually treated with a topical cream such as nystatin or oral Diflucan (fluconazole).
Manage mouth ulcers with chemotherapy
Triple Blend helps treat pain and discomfort from mouth ulcers. Other ways to help improve pain include:
- Rinse with salt or baking soda mixed in water
- Avoid alcohol or peroxide-based mouthwashes
- Avoid spicy or acidic foods and drinks
- eat cold and wet food
for severe mucositis
Using the triple mix and dietary modifications is sufficient to control symptoms, but some people need treatments beyond these. Other options, such as cryotherapy, can be very effective for even the most severe canker sores.
If your mouth ulcers do not improve with your current treatment, call your oncology team right away. They can advise and recommend other treatments if needed.
Mouth sores can be a painful side effect of cancer treatment. Medications such as the triple combination can help relieve mouth or esophageal ulcers so you can continue to eat and drink adequately. Prescription treatments may also sometimes be required, especially if a fungal or bacterial infection is present.
If you have mucositis from chemotherapy, talk with your healthcare provider about strategies for pain relief. Do not hesitate to contact your oncology team for help managing mouth ulcers or any other side effects of cancer treatment. Your quality of life during cancer treatment is very important.
Frequently Asked Questions
How long does the triple mix last?
Typically, the triple mix needs to be used every four to six hours, but your oncologist will provide precise instructions. Since each prescription for the triple mix may be slightly different, it’s hard to say how long it will last.
Can I swallow the triple mix?
Yes, the triple mix can be swallowed, which is prescribed if there are sores in the back of the mouth, throat or esophagus. Your oncologist will give you specific instructions on how to take it.
Does the triple mix need to be refrigerated?
The triple mix usually doesn’t need to be refrigerated, but keeping it in the refrigerator may soothe your mouth even more. Ask your pharmacist for specific instructions.