Thrush

summary about thrush

Thrush (moniliasis or oral candidiasis) is a mycosis caused by the fungus Candida albicans , which particularly affects the oral region.
Candida is part of our flora in the gastrointestinal and genital tracts, so it is normally present in our bodies. This fungus normally does not cause disease in a healthy individual, but it has the propensity to multiply more than normal and cause disease when there is an imbalance in the environment in which it lives, for example, a deficiency in our immune system.

People at risk
The most affected individuals are babies, elderly people, people with immunosuppressive diseases (AIDS, leukemia), people who use certain medications (chemotherapeutics, antibiotics and corticoids), diabetics and people hospitalized in the ICU.

Symptoms
The main symptom of thrush is the appearance of a white layer on one or more mucous membranes in the mouth, which can extend along the line, cheek, etc. Inflammation is also a very common symptom in people with prostheses such as dentures. In babies, the white layer can be confused with traces of milk. It is very common for the fungus to also be found under the nails and in skin folds.

The diagnosis is basically made through clinical examination and patient history.

Treatment often involves taking an antifungal medication topically, that is, applied directly to the oral mucosa (for example, as a gel). In the United States in particular, oral antifungal medications such as nystatin tablets are often recommended for thrush, in which case the duration of treatment is usually 10 to 14 days.1 .
However, if the thrush spreads to other parts of the body (esophagus, nails and skin folds), it will be necessary to adhere to an oral antifungal treatment. In cases of long-term treatment with antibiotics, a diet rich in probiotics can help prevent thrush. As well as proper cleaning of dentures and mouth rinsing after using inhaled corticosteroids used in asthma and rhinitis treatments.

Definition

Definition and synonyms
Thrush is an infectious disease caused by the fungus Candida albicans , which usually locally affects a mucosa, such as the mouth, but can spread and cause multiple organ failure. More specifically, thrush of the mouth and throat is called oropharyngeal candidiasis.

Yeast Candida
is part of our flora in the gastrointestinal and genital tracts, so it is normally present in our bodies. This fungus (yeast) has the propensity to multiply more than normal and cause illness when there is an imbalance in the environment in which it lives.

People Involved
This disease occurs mainly in the mouth in the following individuals:
– babies (this is a very common and benign condition in babies)
– people with impaired immune systems
– elderly people, people with dentures

Causes

The fungus Candida albicans is responsible for thrush. It is usually controlled by other bacteria and microorganisms in the body. At first, our immune system is able to defend itself against this fungus, however, babies, elderly and immunosuppressed people (that’s why thrush often appears in AIDS patients), who do not have a robust immune system are susceptible to developing the disease. .

Treatments, including medication 
In addition, some treatments can affect the buccal mucosa, weakening it. This facilitates the development of Candida albicans and thrush.
The treatments that can weaken the buccal mucosa are:
– chemotherapy
– radiotherapy
– contraception with contraceptive pills
– antibiotic therapy
– corticosteroid therapy
Some simple measures can prevent the disease in case of treatment with antibiotics or corticosteroids (read more below in Prevention , for example, taking probiotics during antibiotic therapy).

Groups of risk

The fungus Candida albicans responsible for thrush is generally harmless, because in a healthy body, the immune system prevents its spread, and therefore the appearance of the disease. On the other hand, in people whose immune systems are weakened, the fungus can cause the disease. People who are part of the risk group are:
– babies and newborns (they do not have a fully developed immune system)
– people with prostheses (which injure the oral mucosa)
– immunosuppressed people ( AIDS )
– people with a weakened immune system due to drug treatment ( antibiotics , chemotherapy, radiotherapy to the neck or head and corticosteroids)
– recently transplanted people (who have had an organ transplant)
– people who are in intensive care units (ICU)
– diabetics (especially if their diabetes is not controlled)2. )
People in the latter group can take simple steps to prevent the disease from developing.

Symptoms

Thrush is characterized by a white coating that is found on the oral mucosa of sick people. This lining can be confused with a post-feeding milk deposit in babies. But if this coating does not come off, then we are talking about the presence of thrush. Remember that thrush can also occur in children and adults.

Symptoms of thrush can be:
– inflammation of the mucous membrane, which is red and dry. This is often characteristic of the first stage of thrush.
– the buccal wall is covered with a whitish layer: on the wall of the cheeks, tongue and throat. At the level of the palate, you can see white spots or dots, under these spots the color is red. The tongue is often white, partially or completely. Thrush appears as a growth that may look like cottage cheese.
– sore throat .
– difficulty in swallowing when the thrush has already spread to the esophagus, the pain can be very violent when swallowing food or even the saliva itself.
– in children, thrush can spread to the fingernails and skin folds.
– dry mouth.
– bad breath .
– loss of taste or an abnormal sensation in the mouth.
– cracks on the lips.

Pain and thrush
A sore throat, sometimes very violent, can also be associated with thrush. The pain is often aggravated by swallowing, including the saliva itself. Some patients also have great difficulty sleeping because of the pain. In the treatments section you can discover painkillers to be used during a thrush crisis.

Cluster of symptoms
Thrush often develops suddenly.

Diagnosis

The diagnosis of thrush is made clinically. The white layer that covers the buccal mucosa is very characteristic of the disease. This layer resembles dried milk but does not come off and must be treated first with an antifungal medication.

The diagnosis cannot be confirmed by culture of the fungus obtained by scraping the lesions, as Candida can normally be found in the gastrointestinal tract.

Furthermore, if the fungus spreads into the esophagus, the patient will have difficulty swallowing. At this stage, you will need to take an antifungal medication by mouth.

If thrush has spread down the esophagus, further testing may be needed. The healthcare professional may do the following tests:
– Take a throat culture (swib the back of the throat with a sterile cotton ball and study the microorganisms under a microscope).
– Endoscopy of the esophagus, stomach and small intestine (examination of the lining of these parts of the body using a lightweight camera mounted on the end of a tube passing through them).
– X-rays of the esophagus.

Complications

Thrush is a benign disease that can be easily treated with local antifungals.

However, if it is not treated quickly, it can extend into the esophagus, causing discomfort when swallowing. In this case, the local antifungal is not enough, it will be necessary to take one orally.

Spread to other areas of the body
It should be noted that thrush rarely spreads to other organs or reaches the bloodstream (in this case, the so-called candidemia). Thrush can actually spread to other parts of the body, including the lungs, liver, and skin. This happens more often in people with cancer, HIV, or other conditions that weaken the immune system. In people with reduced immunity, thrush symptoms can be more difficult to control.

Treatments

Basic Antifungal Treatments, Topical Application
Thrush is treated first by applying a local antifungal, either a cream or gel, including miconazole-based products. Miconazole gel is indicated for babies from 4 months of age and small children.
Young children
In young children, the gel should be sucked on the finger or applied to the lesions with the finger. The liquid must be instilled into the mouth with a small syringe.
Other local treatments Local
application of an isotonic bicarbonate solution (that is, with the same molecular concentration as in blood plasma) is sometimes recommended against thrush, especially in France3.

Possible additional treatments
Usually this treatment is sufficient, however, if thrush is not treated quickly and spreads (in the esophagus), systemic treatment will be necessary. In this case, the doctor will prescribe an oral antifungal – the active ingredient terbinafine. Fluconazole is another possible oral treatment, including cases of thrush that has spread to the esophagus.

Nystatin
The treatment can also be done through medicines based on nystatin and clotrimazole . In the United States, an oral antifungal agent such as nystatin, for example, a tablet, lozenge, or liquid, is often recommended by health professionals for thrush, and the duration of treatment is usually 10 to 14 days.4.

Pain management
In case of pain (eg sore throat, pain when swallowing), the doctor may prescribe various medicines. These include paracetamol, ibuprofen and in case of severe pain (especially in adults), cortisone or tramadol. Locally it is also possible to use anesthetics such as, for example, a spray, an ointment, a gel or gargle.

natural remedies

– Gargle based on salt water . Be careful, in case of severe thrush pain, salt water can cause irritation.

– Milk with honey (to relieve sore throats, sometimes caused by thrush)

Tips

– Babies are the main target of the Candida albicans fungus , responsible for thrush. As this disease is located mainly in the buccal mucosa region, a simple antifungal treatment is enough. However, it is important to be careful with the application of the medicine, because if you put too much gel in the baby’s mouth, you can asphyxiate him.

– Divide the amount of gel to be applied in several times and do not put it in the mouth, so that the baby does not suffocate.

– Leave the medicine in your mouth for a few moments and then swallow it. This tip applies to all patients.

– Even during infection, it is important to maintain good oral hygiene (brush your teeth at least twice a day and use dental floss). Replace toothbrushes several times to avoid contamination.

– It is advisable to eat probiotic yogurt, keep the yogurt for 1 minute in the mouth before swallowing to increase the effect against Candida albicans . If possible, choose a yogurt with Lactobacillus acidophilus .

– Drink cold or frozen drinks to ease the pain.

– To ease the pain, you can place an ice cube in your mouth or face.

– Sleep with your head up, possibly on your stomach to avoid swallowing too much saliva, a process that can be very painful in some cases of thrush, especially if it has already spread to the esophagus.

Good advice for babies: 
Try to remove the small whitish patches, because if they come off easily, it’s just a deposit of curdled milk and not thrush.

Prevention

– People who wear dentures should clean them frequently and carefully to avoid the proliferation of fungi.

– For babies, two days after starting thrush treatment, sterilize all teats and pacifiers by placing them in boiling water for a few minutes to prevent reinfection. If your child is breastfed, also wash the nipples in warm soapy water for a few days and treat any cracks with a cream.

– Probiotics are strongly advised in case of large-scale antibiotic treatment. The antibiotic, not very specific, will destroy the “good bacteria” in our body (present, for example, in the intestines and participants in the digestion process) and will cause diarrhea.

– Corticosteroids are found in the case of treatment against asthma or rhinitis: in the form of a spray or powder to be inhaled. These steroids weaken the buccal mucosa and Candida albicans can cause thrush. Therefore, it is advised to rinse the mouth after each use of these corticoids. Powder tends to settle deep in the lungs to treat asthma, however, a powder residue may remain in the mouth, and it is this corticosteroid-containing residual powder that must be removed to prevent the condition.

– In the case of vaginal mycoses, it is important to start treatment as soon as the infection is discovered.

– Adopt excellent dental hygiene, brush your teeth at least twice a day and floss at least once a day.

– Regularly visit your dentist at least once a year. This advice is particularly important if you are diabetic or have dentures.

– Quit smoking, smoking is a risk factor for thrushes.

– Limit the amount of sugar and yeast-containing foods you consume. Foods such as bread, beer and wine promote the growth of Candida yeast .

Jeanne Kenney
 | Website

I’m a stylist trainer, a content creator, and an entrepreneur passion. Virgo sign and Pisces ascendant, I move easily between my dreams, the crazy world I want, and my feet on the ground to carry out my projects.

Leave a Reply

Your email address will not be published. Required fields are marked *