Benefits of a Mouth Lozenge with Slippery Elm
The oral mucosa is an extremely sensitive part of our bodies, especially when the immune system is compromised during long treatments like chemotherapy. There is evidence that this tissue might change completely in as short as every 3 days. Since most of the current chemotherapies act on the cells that are dividing, the risk of mucositis has been found to be as high as 40% to even 70 % in patients undergoing cancer treatments. The common medical practices to prevent this side effect have been limited to the use of ice to decrease perfusion during the actual chemotherapy infusion. However, this practice is limited by patient’s tolerance to the extreme cold temperatures such as in patients being treated with oxaliplatin that will give them a cold induced neuropathic sensation.
Once the mucositis develops our conventional medical arsenal has been very limited to aid with symptomatic relief. Concoctions like the so called magic mouth wash (a mixture of viscous lidocaine and other medications such as aluminum hydroxide), have marginal medical evidence of benefit.
That is the reason why most health care professionals have turned their attention to more natural alternatives that present better evidence. However, the risk of using these therapies in an indiscriminate way might end up being more problematic. Mostly since one of the best natural substances that come to mind treating this bothersome side effect is goldenseal as a byproduct of berberine. Even though it is a great antibacterial in the mucosa, it is also extremely active in the liver producing an inhibition of important enzymes involved also in the metabolism of many other medication including chemotherapy. This could potentially create the risk of even more toxicity.
With that in mind it is pivotal that when deciding what to use for the treatment of mucositis one must not only take into consideration the topical effect but if there could also be systemic effect and to try to avoid it, since it would not make any sense to treat a side effect with a compound that can generate a new side effect.
The main issues when considering therapy of oral ulcers is the combination of demulcents, defined as substances that relief irritation of the mucous membranes in the mouth by forming a protective film, and other constituents that could provide antibiotic effect with the intention of decreasing super infection of the unprotected tissues and decrease bacterial overgrowth.
One of the best demulcents is Slippery Elm because it contains mucilage, a substance that becomes a slick gel when mixed with water. It coats and soothes the mouth, throat, stomach, and intestines. It also contains antioxidants that help relieve inflammation in a topical fashion with minimal absorption. Other compounds on this category include propolis derived from the bee hives, found to be very high on flavonoids and reported extensively in the literature to have topical antifungal and bacterial effect. However, in regard to antibiotic effect it is very likely that one of the most extensively studied substances has been xylitol that upon review of the literature has been widely found to be active against many of the typical oral bacteria and even against candida species. Combining all the previously mentioned ingredients, yields a wider body of evidence in the treatment of this bothersome side effect over the standard use of traditional medical interventions. Moreover, the lack of herb-drug interactions and minimal absorption would allow patients to have the possibility of frequent dosing contributing to better symptomatic control when is mostly needed at the time of dietary intake.
Specializing in Hematology/Oncology, Dr. Mike Cusnir has been in practice for more than 15 years. As a graduate of the Fellowship in Hematology/Oncology from the University of Maryland, Greenebaum Cancer Center (Baltimore, Maryland), oncologist Dr. Cusnir brings top notch experience in the scientific filed. Dr. Cusnir is certified by the American Board of Internal Medicine, the American Board of Medical Oncology and the American Board of Hematology.
Dr. Mike Cusnir is also making integrative medicine a part of his practice by graduating from the Fellowship in Integrative Medicine at the Arizona Center for Integrative Medicine in October of 2012. This fellowship, created by Andrew Weil, MD in 2000, has achieved international recognition as the leading integrative medical education program in the world. He has authored and published multiple peer review articles on the field and he has also presented his research in the most prestigious American and European medical meetings. He has completed the first clinical study of the benefits of miracle fruit for cancer patients whose chemotherapy drugs leave an unpleasant taste in their mouth. His research has gained the attention of major media outlets being featured, among many other, on CNN and The New York Times. You can connect with Dr. Mike Cusnir on Twitter.
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