It Is Not a Sore Throat, It Is (Oral Candida) Thrush!

Last updated: December 2018

Ugh, Thrush happens every now and then. Luckily, I have not had it happen in a while, however, I happen to be quite susceptible to thrush in the past. I am a very diligent rinser after inhaled corticosteroids, yet that pesky thrush seems to pop up.

What is thrush or "Oral Candida"?

Oral thrush by definition is the fungus Candida albicans (essentially a yeast) that acclimates on the lining of your mouth. Thrush can happen is anyone, however it is more common in babies, the elderly, those with suppressed immune systems and those that are on certain medications There is even new research to say the incident of thrush are also on the rise in the general public.

I have had thrush cases which felt like a sore throat coming on and then cases in which I didn't even know I had. I had the unfortunate circumstance of having it discovered on a bronchoscopy. That was slightly embarrassing. I pride myself on being a diligent rinser after inhaled steroids, however, at the back of my throat was the stubborn esophageal thrush that the doctor had spotted and taken photos of. I know have this experience documented in my chart. My doctors love to question compliance and, one of the first questions is generally about being a good rinser after inhaled steroid use. Steroid use2 is linked to reduced salivary flow, reduced salivary flow can lead to thrush as salivary is highly microbial and keep organisms away.

What makes thrush so pesky?

Candida’s are " truly opportunistic pathogen”, what this means is that and that it will only instigate infection when there is already an underlying predisposed condition in the host.1  An immune response is then instigated when candida become colonized, it releases a Th2 and Th17 pathway response, that initiates a process for protecting the mucosal lining.3 This is largely accomplished by dendrite cells related to both the Th2 and Th17 pathways.4 You may be familiar with these pathways in relation to your asthma.

How do you know if you have thrush?

Always have your suspicions of thrush confirmed by a physician. They will be able to properly diagnosis you. As I mentioned earlier, I sometimes feel like it is just a cold or a sore throat coming on when in fact it is Thrush. Symptoms are related to the underlying cause of your crush and may present as the following symptoms.4

  • Creamy white lesions on your tongue, inner cheeks, and sometimes on the roof of your mouth, gums, and tonsils
  • Slightly raised lesions with a cottage cheese-like appearance
  • Redness or soreness that may be severe enough to cause difficulty eating or swallowing
  • Slight bleeding if the lesions are rubbed or scraped
  • Cracking and redness at the corners of your mouth (especially in denture wearers)
  • A cottony feeling in your mouth
  • Loss of taste

Prevention is key

The first steps to not getting thrush are having good prevention methods, such as always practicing good oral hygiene. Take care in tooth brushing and the inclusion of an antimicrobial mouthwash may be helpful. The use of an antifungal is often the treatment of choice. In my experience, I have gotten to know the long process of using an antifungal very well. Mine has been in the form of oral drops which needs to be swished in the mouth and swallowed. It is important that you take the full course of the antifungal dose to ensure that you have fully treated the infection. Thrush is pesky and can be back in a flash.

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