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Mucositis and stomatitis
KELLY YOUNG
n Agents
n Opioids
n Topical anesthetics
n NSAIDs
n Sucralfate
n Amlexanox
n Corticosteroids
n Evidence
Available evidence for treating pain caused by mucositis (inflammation of the
digestive tract’s lining) and stomatitis (mucositis involving the mouth) can be
categorized into two general categories, depending on whether or not the
stomatitis is related to cancer therapy (either chemo- or radiation therapy).
This chapter is thus divided into two sections. The initial portion of the discussion
addresses cancer treatment-associated stomatitis (CTAM). The chapter
concludes with an overview of the evidence, lesser in quality and quantity,
addressing non-CTAM stomatitis (e.g. from aphthous ulcers or viral agents).
For the purposes of this chapter, the term mucositis will be used with the
understanding that the major focus of discussed evidence is on oral disease
(i.e. stomatitis). As is the case with many disease states, the line between
treating pain and treating the disease’s pathophysiology can be indistinct.
This chapter deals mostly with topical approaches and systemic analgesics,
with the understanding that disease-specific systemic therapy (e.g. acyclovir
[aciclovir] for herpetic gingivostomatitis) may be warranted in some cases.
CANCER TREATMENT-ASSOCIATED MUCOSITIS
For CTAM, which can be a substantial (treatment-limiting) complication in
oncology, prophylactic therapy is often used; these approaches are not