Your digestive system

Some chemotherapy drugs can affect the lining of the digestive system and may cause the following problems:

Sore mouth

Possible side effect	Sore mouth
When symptoms may occur	7–14 days after chemotherapy
Symptoms include	Dry mouth and tongue Sore mouth or tongue Bleeding from gums, mouth or tongue
What you should do	Drink plenty of fluids Use a mouth wash regularly Clean your teeth regularly Keep your lips moist Contact your GP or hospital immediately if you are unable to eat or drink because of mouth ulcers

During chemotherapy the lining of your mouth may become sore and prone to infection. This usually happens around 7 to 10 days after chemotherapy. It’s important that you keep your mouth clean and healthy, and the following suggestions may help:

Drink plenty of fluids, to keep your mouth moist and fresh.
Use a mouthwash regularly. Ask your doctor, nurse or oral hygienist which one is best.
Clean your teeth regularly using fluoride toothpaste and a soft toothbrush. If someone needs to clean your teeth for you, they may find a child’s toothbrush easier to use.
Clean your dentures after meals as well as at night.
Keep your lips moist using a lip salve available from a chemist.

Tell your doctor or nurse if your mouth becomes sore. It may be possible to prescribe some tablets to prevent this in future. If you need further advice, ask to see an oral hygienist. Depending on the cause of your sore mouth it may be possible to provide you with medication to relieve the discomfort.

During chemotherapy, you may be more prone to infection and bleeding. Always consult your doctor before having any dental work done. Your blood count may need to be checked before the dentist can decide whether to proceed with dental treatment or not.

Taste and smell changes

Possible side effect	Taste changes Changes in smell
When symptoms may occur	During your course of chemotherapy
Symptoms include	Changes in the way food or drink taste Increased awareness of smells that may now become unpleasant, for example cooking and perfumes
What you should do	Suck a strong flavoured sweet if you have an unpleasant taste during an injection Avoid areas where unpleasant smells are present

Some people experience a change in their sense of taste or smell. You may find that food may taste more salty, bitter or metallic. This is only temporary. Normal taste and smell usually returns two or three months after the end of treatment.

If an unpleasant taste occurs during an injection, it can be disguised by a strong-flavoured sweet.

Occasionally, some people may experience food cravings.

See Eating well when you have cancer for more information.

Nausea and vomiting

Possible side effect	Nausea and vomiting
When symptoms may occur	7-14 days after chemotherapy
Symptoms include	Feeling sick (nausea) Being sick (vomiting)
What you should do	You should take anti-sickness tablets or suppositories regularly as prescribed Contact your hospital if you continue to have nausea or vomiting – you can be given different anti-sickness drugs that may be more effective

Nausea and vomiting aren’t side effects of every chemotherapy drug although many people believe they are. Some drugs or treatment plans cause a greater reaction than others. Also, everyone is individual – a similar drug combination may cause nausea in one person but not in another.

If you do feel nauseous or even vomit following your treatment, there are many anti-sickness (anti-emetic) drugs to help overcome this problem. These come as tablets, injections or suppositories.

You will be given anti-sickness injections before the chemotherapy and tablets to take home with you. You should take these regularly as prescribed, even if you are not feeling sick, as some anti-sickness drugs are better at preventing than stopping sickness. Some people find taking ginger helpful.

Should you still have nausea or vomiting, please tell your doctor or nurse and you can be given different anti-sickness drugs that may be more effective. If you experience vomiting at home then anti-sickness tablets may not be effective and you should ask your doctor for suppositories with your next course.

You may also find relaxation or other therapy helpful.

See Coping with nausea and vomiting for more information.

Changes in appetite

Possible side effect	Changes in appetite
When symptoms may occur	7-14 days after chemotherapy
Symptoms include	You may not feel like drinking or eating
What you should do	Drink plenty of fluids Have small frequent meals or snacks Ask to see a dietitian if you are worried about your diet

If you experience any taste changes or lose your appetite, you may not feel like drinking or eating. However, you should try to drink plenty of fluids (about ten glasses or cups each day) and eat well.

Try sipping clear, cold fluids, such as water and soft drinks, slowly through a straw. Fizzy drinks like soda water and ginger ale are quite refreshing, as are lemon or herbal teas. Avoid coffee, which has a strong taste and may also make you more thirsty.

You may need to change your meal times and have small, frequent meals or snacks of whatever you fancy. Eat slowly and chew your food well. After a meal, relax in a sitting or slightly reclined position instead of lying down. Eat light meals on the day of your treatment.

See Eating well when you have cancer for more information. If you’re worried at all about your diet, please ask to see a dietitian.

Diarrhoea or constipation

Possible side effect	Diarrhoea or constipation
When symptoms may occur	7-14 days after chemotherapy
Symptoms include	Frequent or loose bowel movements Not be able to control bowel action Irregular or hard bowel movement
What you should do	Drink plenty of fluids Contact your GP or hospital immediately if you have diarrhoea (four or more bowel movements more than usual or diarrhoea at night)

Diarrhoea or constipation may occur with a few drugs. They can often be managed by tablets, medicines or a change of diet. Please tell your doctor or nurse if you have any problems.