Table 5.

Management strategies for acute radiation esophagitis

Supportive measure	Recommendation	Reference
Dietary modification	• Consider dietician referral • Avoid potentially irritant foods (tobacco, alcohol, coffee, and spicy foods) • Soft, bland diet • Small, frequent meals	56
Nutritional support	• Liquid meal replacements/supplements • Intravenous hydration • Electrolyte correction • For prolonged symptoms, enteral feeding or total parenteral nutrition may be required, although former is preferred • Antiemetics may be beneficial	1,55,57
Analgesics	• Topical analgesics (viscous lidocaine, liquid morphine sulfate, “Pink Lady”, benzydamine mouthwash) • Opioid analgesics often required • Combination solutions containing a topical analgesic, antacid, and nystatin may be particularly effective	1,55,56
Antifungal treatment	• Nystatin solutiona • Oral antifungals may be required for refractory cases	53,56

Notes:

^aProphylaxis may be considered.

^bRecommended at first symptoms of esophagitis.