Nutritional Management of Chewing and Swallowing Difficulties

Nutritional management of treatment side effects:

There is more to nutrition during cancer and cancer therapy than getting enough calories and protein. The foods you choose also help you cope with side effects, such as loss of appetite, nausea, vomiting, diarrhea, chewing and swallowing difficulties, and taste changes.

As each person''s individual medical profile and diagnosis is different, so is his/her reaction to treatment. Side effects may be severe, mild, or absent. Be sure to discuss with your cancer care team any/all possible side effects of treatment before the treatment begins.

Nutritional management of chewing and swallowing difficulties:

Cancer treatments target fast growing cancer cells in your body. Healthy cells that are fast growing can also be damaged. Examples of fast growing cells include cells in the mouth, digestive tract, and hair. These may be affected by cancer treatment. Eating well from the beginning of cancer therapy has been found to prevent mouth problems. 

Stomatitis, or mucositis, is the presence of sores in the mouth caused by some anti-cancer drugs. In addition to being painful, mouth sores can become infected by the many germs that live in the mouth. They can make it difficult to swallow and chew as well. If you develop sores in your mouth, tell your physician or nurse. You may need medication if the sores become painful or prevent you from eating. 

The following suggestions may help if you have mouth problems:

• Eat the following soft, soothing foods (at cold or room temperature), and puree cooked foods in the blender to make them smoother and easier to eat
  
  
  • ice cream
  • milkshakes
  • baby food
  • soft fruits (bananas and applesauce)
  • mashed potatoes
  • cooked cereals
  • soft-boiled or scrambled eggs
  • yogurt
  • cottage cheese
  • macaroni and cheese
  • custards
  • gelatin
  • puddings

• Make sure to eat foods with extra sauces, gravies, or butter to help make food easier to get down.

• Try to avoid irritating, acidic foods and juices, spicy or salty foods, and rough or coarse foods such as:
  
  
  • tomato juice and citrus juice (orange, grapefruit, and lemon)
  • raw vegetables
  • granola
  • popcorn
  • toast
    
    
• For mouth dryness:
  
  
  • Drink plenty of liquids. 
    
    
  • Ask your physician if you can suck on ice chips, Popsicles®, or sugarless hard candy. You can also chew sugarless gum. (Sorbitol, a sugar substitute that is in many sugar-free foods, can cause diarrhea in many people. If diarrhea is a problem for you, check the labels of sugar-free foods before you buy them, and limit your use of them.) 
    
    
  • Moisten dry foods with butter, margarine, gravy, sauces, or broth. 
    
    
  • Dunk crisp, dry foods in mild liquids. 
    
    
  • Eat soft and pureed foods. 
    
    
  • Use lip balm or petroleum jelly if your lips become dry. 
    
    
  • Carry a water bottle with you to sip from often. 

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