Grade I - sore but can eat/ erythamatous mucosa
Grade II - modified diet/ patchy ulceration
Grade III - unable to maintain adequete hydration/ confluent ulceration
Grade IV - cannot eat or drink/ tumor necrosis and bleeding
Mx:
- Symptomatic topical lignocaine mixed with mylanta (use when in pain or 30 min before meal)
- diligent mouth care for anaerobes (Na bicarbonate)
- nystatin fungal drop - candidiasis
- nutritional status (inflammation of mucosa) - consider nasogastric feeding or total parenteral nutrition.
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