Mr. Seyer will receive radiation therapy and chemotherapy as an outpatient. In question #8, you identified potential nutritional complications with both

Question

Choose one of these nutritional complications and describe the nutrition intervention that would be appropriate.

Answer 1

Mucositis
• Sip warm tea slowly.
• Eat chilled foods and fluids.
• Eat soft foods that are moist and easy to swallow.
• Eat small, frequent meals of bland, non-spicy foods. Avoid raw vegetables and fruits, and other hard or crusty foods such as chips or pretzels.
• Avoid acidic fruits and juices, such as tomato, orange, grapefruit, lime, or lemon.
• Avoid carbonated drinks.
• High-calorie, high-protein milkshakes or nutritional supplements may be beneficial (Ensure, Boost, Resource, etc.).
Dysgeusia
• Avoid metal utensils.
• Use plastic utensils.
• If meat is not tolerated, try peanut butter, cottage cheese, cheese, poultry, and soy meat substitutes.
Xerostomia
• Rinse mouth with water and baking soda (½-1 tsp in 8 oz water) every 2 hrs while awake.
• Avoid mouthwashes that contain alcohol.
• Brush with a very soft "baby" toothbrush.
• Avoid tobacco, alcohol, coffee, and tea as these may exert a drying effect.
• Increase fluid intake to assist chewing and swallowing.
• Carry a water bottle and sip regularly throughout the day.
• Limit foods that stick to teeth to cut back the risk of caries.
• Use Chapstick® and moisturizing gels on lips.
Dysphagia: Thickening agents may be necessary (readily available foods from the grocery store can be used as thickeners).
Odynophagia
• Avoid hot foods (temperature); allow them to cool to room temperature.
• Avoid rough foods like nuts, crackers, dry cereal, and raw fruits and vegetables.
• Avoid spicy foods or "acidic" foods likes tomatoes, oranges, grapefruits, lemons, or limes.
• Ice chips or a cool drink may soothe the pain.
• Soft or pureed food, like applesauce, puddings, custards, mashed potatoes, cooked cereals, high-protein milkshakes, ice cream, ice milk, or sherbet, may cause less pain.
• Drink liquids through a straw.
• Avoid alcohol and tobacco.
• Take small bites and chew food thoroughly.

Diarrhea
• Drink small amounts of liquids frequently throughout the day (avoid excessive fruit juice)
• Increase intake of foods high in soluble fiber (this may conflict with anorexia and meeting adequate amounts of oral intake)