1 Thrush Summary

Do you have a strange white-colored rash inside your mouth or vagina? You may have thrush. Thrush is a skin condition and it is caused by infection of a fungus or yeast called Candida albicans.

If it occurs in the mouth, it is called oral thrush. If it occurs in the vaginal area, it is called vaginal thrush. This section discusses both conditions.

Thrush can also appear in places such as nipples, and this occurs when a baby with oral thrush breastfeeds and passes the fungus to the mother’s nipples. Oral thrush can also spread and reach as far as the esophagus.

Candida albicans is a type of disease-causing yeast that can infect the skin or mucous membranes and cause thrush, both in the mouth and the vagina. Certain factors can allow Candida albicans to grow and cause infection.

Thrush is a common type of skin infection. It can occur to people of all ages, but it tends to affect those with poor immune system status such as babies, pregnant mothers, and elderly.

Oral thrush causes symptoms such as:

  • Creamy white lesions on the tongue, inner cheeks, the roof of the mouth (palate), gums, and tonsils. The lesions are somewhat raised and may look like cottage cheese.
  • Slight bleeding when white lesions are removed.
  • Redness and soreness in the mouth, which may cause problems in eating and swallowing.
  • Cracking and redness of the skin at the corners of the mouth.
  • ‘Cottony’ sensation in the mouth.
  • Loss of taste
  • Babies may exhibit fussiness, irritability, and trouble feeding, aside from having white lesions inside the mouth.

Vaginal thrush may cause the following symptoms:

  • Itching and irritation in the vagina
  • Burning sensation while having sex
  • Redness, pain, soreness and swelling of the vulva
  • Rash in the vagina
  • Watery vaginal discharge, or
  • Thick, white vaginal discharge that looks like cottage cheese.

Candida albicans is normally found in the body, where its numbers are kept under control by the body’s immune system and good bacteria, so the infection does not occur. If the immune system becomes weak, the numbers of Candida albicans increases greatly and infect skin and mucous membranes, causing infection and thrush.

Thrush is a minor health problem to persons who are healthy and have no other health problems. However, thrush can be a serious health threat to individuals who already have serious illnesses (like HIV or cancer) or have problems in the immune system. Severe thrush infects vital organs such as heart valves, digestive tract, lungs or liver, and cause life-threatening complications.

To diagnose thrush, the doctor will check for the presence of Candida albicans infection by examining samples acquired from the mouth or vagina. Aside from that, the doctor may perform a physical examination and procedures to visualize your pelvic organs or deep into your throat to check for lesions.

Treating thrush depends on whether the infection is simple or if the patient has other medical problems. Medicines that specifically Candida albicans is used to treat the infection. Thrush may recur so treatment may be done for some time until the lesions do not come back.

2 Causes

The ultimate cause of all kinds of thrush is Candida albicans, a fungus or yeast microorganism. Candida albicans is normally found in the body but in small numbers.

The body’s indigenous bacteria and immune system keep numbers of Candida albicans and other infectious pathogens under control, so no infection occur. Thrush occurs if Candida albicans increase in numbers and becomes capable of causing infection.

Thrush may occur for the following reasons:

Untreated diabetes - Diabetes mellitus causes your blood sugar levels to rise uncontrollably. Candida albicans is a yeast that also digests glucose, so very high blood sugar levels can allow it to thrive and multiply to cause infections. People with diabetes tend to have oral thrush, as the saliva tends to contain large amounts of sugar.

Pregnancy - Women are at risk of vaginal thrush when they are pregnant. Pregnancy cause elevated blood sugar levels and reduced immune system activity, which can promote the growth of Candida albicans.

Note that a pregnant mother can pass Candida albicans to her baby during childbirth, which may cause the baby to have oral thrush. The doctor should treat thrush that occurs during pregnancy as oral medications can be harmful to the baby.

Use of antibiotics - Some people prescribed with antibiotics experience thrush. Certain antibiotics kill many bacteria in the body, including beneficial ones, allowing Candida albicans to thrive and cause thrush. Individuals taking antibiotics should call their doctors at the first sign or symptom of thrush.

Use of birth control pills or hormone therapy - Popular birth control pills may give you thrush. Hormone therapy medicines and birth control pills change the hormonal makeup of your body, which has an unintended effect of causing high blood sugar levels.

Impaired immune system - Poor immune system status means that bad bacteria such as Candida albicans can thrive and cause infections. This is a reason why oral or vaginal thrush is a risk to individuals with impaired immune system.

Cancer and drugs used to treat cancer can reduce the activity of the immune system, increasing the risk of thrush. HIV itself obliterates white blood cells, so individuals with AIDS are at risk of having thrush as well.

Engaging in oral sex with someone with thrush - Thrush is not exactly described as a sexually transmitted disease as women that don’t have sex can still have them. However, thrush can be passed to others through oral sex. An individual may acquire oral thrush after having oral sex with a woman with vaginal thrush.

If left untreated or if the infection becomes severe, Candida albicans can infect internal organs such as the esophagus, heart, liver, lungs, uterus, and the airways. Thrush is not a serious problem if it occurs in healthy adults or children, but it can cause serious complications to those with HIV or cancer.

3 Diagnosis and Treatment

Doctors can check lesions in the mouth and easily determine if it is oral thrush or not. To be sure, the doctor may order a throat swab and have it examined under the microscope to see if lesions are caused by fungi or bacteria.

If there are lesions deep down the throat, or if it is suspected that there are lesions in the esophagus or stomach, the doctor may perform an endoscopy. Endoscopy inserts a thin tube with a camera into your throat until it enters the digestive tract, and it enables the doctor to see if there are thrush lesions in your esophagus, stomach, or upper intestines.

In the case of vaginal thrush, the doctor may perform a pelvic exam. In this procedure, the doctor will insert a speculum into your vagina to check the birth canal and cervix for the presence of thrush lesions. The doctor may also send a sample of vaginal fluids to the laboratory and analyzed for the presence of Candida albicans or other microorganisms.

Oral or vaginal thrush require a physical examination and thorough review of medical history. You have to tell your doctor about past vaginal infections, having sexually transmitted diseases, or a number of sexual partners you had recently.

Vaginal and oral thrush is treatable conditions, especially to those that do not have other health issues. For oral thrush, the doctor may prescribe antifungal drugs.

These drugs may be available in the form of lozenges, tablets, or liquids that you gargle first and then swallow. For babies, the doctor may prescribe a mild form of antifungal drug and an antifungal cream to the mother if breastfeeding to prevent cross infection.

For vaginal thrush, the doctor may prescribe antifungal creams, ointments, oral tablets, or pessaries. You must follow doctor’s orders in using these medicines. These medicines are usually taken for 7 days, so make sure to complete course of treatment.

Not doing so makes the infection harder to treat. For vaginal thrush in the case of pregnancy, the patient is usually treated with pessaries or creams applied inside the vagina. Most oral medications are harmful to the developing fetus when given to pregnant patients.

Note that medications used in treating vaginal thrushes like vaginal creams and pessaries may weaken latex used in condoms or diaphragms. You may have to avoid sex during and for at least 5 days after treatment, or consult your doctor about other forms of birth control methods to use.

Individuals with other conditions may experience severe or recurrent thrush and may need more treatment. For serious or recurrent vaginal thrush, the doctor may order a 7- to 14-day treatment with antibiotics administered as vaginal cream or pessary, or multiple oral antibiotics if the patient is not pregnant. The doctor may have to consider treatments lasting as long as six months if vaginal thrush is particularly recurrent. 

Oral thrush may be harder to treat in patients with AIDS or cancer. In such cases, the doctor may order strong antifungals to stop infection. If such drugs are not effective, the doctor may institute treatment with Amphotericin B. However, Amphotericin B is known to cause many side effects, and therefore only used if other drugs fail.

There are simple ways to prevent thrush. Practicing good oral hygiene and cleaning dentures, baby bottles and flossing may help prevent oral thrush. Women must avoid wearing tight underwear or pants, pantyhose, or have very hot baths, which all promote the growth of yeasts that may cause vaginal thrush.

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