In recent days, I have seen a colleague posting that it makes no sense to change the spicy eating habits to make patients lose their appetite due to the loss of appetite caused by radiotherapy, and that a heavy taste will increase the appetite of patients and stimulate the secretion of digestive juices, which will help the amount of food eaten. It is possible that a heavy diet has a role in stimulating appetite, but it is not only the patient’s appetite that should be addressed during chemotherapy, but more importantly, the patient’s gastrointestinal tract should be protected because chemotherapy can cause damage to the mucosa of the gastrointestinal tract! Reasons to avoid spicy and stimulating diet during chemotherapy 1, first of all, chemotherapy can lead to vomiting in some patients, and when food flows back into the esophagus, stomach acid and spicy and stimulating ingredients together can damage the esophagus and even the throat, leading to increased discomfort. 2, chemotherapy can cause damage to the mucosa of the digestive tract. In terms of intestine, intestinal mucosal epithelial cells include: intestinal epithelial cells, cup cells, Pan cells, undifferentiated cells and endocrine cells; in addition, there are specialized epithelial cells such as follicle-associated epithelial cells and membrane epithelial cells. The intestinal epithelial cells originate from stem cells in the intestinal crypts and have a short lifespan of about 2 – 5 days, and can be completely renewed and shed once. Chemotherapy kills the very cells that, like tumor cells, proliferate more rapidly. Therefore, the mucosa of gastrointestinal tract is easily damaged by chemotherapy. After the mucosa of gastrointestinal tract is damaged, inflammation of gastrointestinal mucosa occurs, which leads to a series of gastrointestinal reactions such as nausea, vomiting, diarrhea and abdominal distension. It can be said that the gastrointestinal tract is very fragile during chemotherapy. If you eat spicy stimulants at this time, it can only aggravate the damage to the mucosa of the gastrointestinal tract. This does not include those patients who received gastrointestinal surgery soon, such patients should avoid spicy stimulating food. 3, the intestinal tract is responsible for the digestion and absorption of nutrients throughout the body, and is also the body’s immune barrier. Chemotherapy can affect the intestinal flora, and the intestinal flora plays a role in the occurrence and development of inflammation of the digestive tract mucosa. When the gastrointestinal flora is out of balance, the gastrointestinal tract should be protected and spicy and stimulating foods should be avoided. 4, Some chemotherapy drugs can cause diarrhea, even severe diarrhea, such as irinotecan and docetaxel. It has been confirmed that chemotherapy drugs can lead to destruction of the mucosal layer of the gastrointestinal tract and detachment of the intestinal epithelium, disproportionate increase and atypical proliferation of cupped cells and crypt cells, destruction of the resorption function of microvillous cells, resulting in an increase in intestinal luminal fluid, which eventually leads to an imbalance in the function of absorption and secretion in the small intestine, resulting in the appearance of diarrhea. When diarrhea encounters spicy and stimulating diet, it can only aggravate the gastrointestinal symptoms of patients. 5, of course, during chemotherapy, because of the application of antiemetic drugs, many patients show constipation, when patients need to receive laxative treatment. Spicy stimulation will also aggravate the discomfort of this part of the patient, is also not recommended for these patients to eat spicy stimulating diet. If the conclusion of medical issues need to be supported by evidence-based medicine, then the mucosal damage of the gastrointestinal tract during chemotherapy is evidence-based, and perhaps the contraindication is a bit serious, but during chemotherapy, in view of the existence of mucosal damage of the gastrointestinal tract, spicy stimulation should be avoided as much as possible. Medicine is an evidence-based science, and doctors or people involved in medicine will consider many aspects of the problem, but a hundred secrets are inevitable, and because of the limited language and understanding differences, and because evidence-based medicine is an evolving science, differences are inevitable.