The type and amount of food the patient consumes are also monitored. Several blood tests enable the dietitian to monitor glucose, protein stores and electrolyte levels, as well as liver and kidney function. Consuming sufficient calories, protein and fluids can be difficult, particularly during the first few weeks post-transplant. Side effects of TBI, chemotherapy, some antibiotics, drugs used to control GVHD, and some pain medications can make food unappetizing or painful to swallow. Often, patients are fed intravenously during this period to ensure they receive sufficient calories, protein, vitamins, minerals and fluids.
Many patients experience mouth and throat sores two to four weeks after transplant.
The sores are usually caused by TBI or chemotherapy. However, infection, GVHD and drugs such as methotrexate can also be the source of the problem. Mouth sores usually heal once the patient's white blood cell count returns to normal. However, some patients who develop chronic GVHD continue to have mouth sores or oral sensitivity a year or more post-transplant. Mouth and throat sores can make eating and swallowing difficult.