The Effect of Oral Care With Black Mulberry Extract on Oral Mucositis, Dry Mouth, and Weight Gain in Patients With Cancer
Citation
Karabey, T., Karagözoğlu, Ş. Aygün N. ve Sümer, Z. (2022). The Effect of Oral Care With Black Mulberry Extract on Oral Mucositis, Dry Mouth, and Weight Gain in Patients With Cancer. Clinical Journal of Oncology Nursing, 26(6): 636-642. DOI:10.1188/22.CJON.636-642Abstract
Because oral mucosa epithelial cells divide more rapidly than other cells,
chemotherapeutic agents suppress the growth and maturation of cells and
disrupt the primary mucosal barrier in the mouth and throat (Shumsky et
al., 2019). As a result, oral mucositis can develop. Oral mucositis can lead to
deterioration in the mucosal barrier; weakening of the oral mucosal epithelial
cells; erythema; edema; bleeding; ulcerations; hoarseness; and difficulty
speaking, chewing, and swallowing (Shimamura et al., 2018). Oral mucositis
typically occurs within one week after chemotherapy administration and
heals after 21 days (Bahar et al., 2019). Weight loss, dehydration, ulceration of
the mucosa, and fluid–electrolyte imbalance may develop in patients who are
undernourished (Eduardo et al., 2018). The presence of mucositis can cause
patients to experience severe pain in the oral cavity and/or throat, which
impairs their ability to chew, swallow, and speak, leading to inadequate fluid–
nutrient intake, malnutrition, and communication problems (Lee et al., 2020;
Silva et al., 2021). These symptoms and side effects can increase the length of
patient hospital stays and treatment costs, as well as cause patients’ quality
of life to deteriorate (Fernández-Rodríguez et al., 2019; Pereira et al., 2018).
Various pharmacologic and nonpharmacologic oral care methods and
therapies are used in the treatment of oral mucositis (Lim & Choi, 2019;
Thakur et al., 2020). In a study conducted in Turkey, the most common
substances used to prevent mouth sores in patients with cancer receiving
chemotherapy included chlorhexidine gluconate mouthwashes (68.2%);
sodium bicarbonate (54.2%); saltwater (51.7%); sage, chamomile, and fennel
tea (46.7%); water with lemon (27.5%); black mulberry molasses (26.7%);
honey (24.2%); and turmeric (17.5%) (Berk et al., 2020). Black mulberry has
anti-inflammatory, antioxidative, and analgesic effects (Li et al., 2018; Liu et
al., 2021). Black mulberry contains papiriflavonal A, kuraridin, saforaflavanon
D, and saforaiso flavanon A, all of which can provide antifungal and strong
antimicrobial activity and are particularly effective in the healing of mouth
and dental wounds (Sireesha & Sri, 2021). Doğan et al. (2017) also reported
that black mulberry molasses prevents oral mucositis by 38%, delays the
formation of mucositis, and reduces the severity of mucositis in patients
undergoing radiation therapy to the head and neck. In a study of patients
with chronic obstructive pulmonary disease unrelated to cancer, Korkut et
al. (2021) found that oral care with black mulberry syrup accelerated the