Oral Thrush

Oral thrush is infection with fungus Candida albicans in oral mucous lining. It appears as creamy white lesions, usually on tongue or inner cheeks. It can be painful and may bleed slightly. It can affect roof of mouth, gums, tonsils or pharynx that is back of throat.

Signs and symptoms – The signs and symptoms of thrush may develop suddenly with loss of taste and persist for a long time. Lesions look creamy white or cottage cheese like mostly appear on tongue, inner cheeks and sometimes on the roof of mouth, gums, tonsils and pharynx. Pain and slight bleeding may occur. Corners of mouth may be red and cracked. The thrush may spread into esophagus (food pipe) causing difficulty in swallowing. It can also spread into trachea (wind pipe) and lungs.

An infant fed on breast may become fussy and irritable if he gets thrush in mouth. Infection passes between the infant’s mouth and mother’s breast. Skin of areola (darker, circular area around nipple) becomes shiny or flaky and nipples become red and itchy and sensitive. There occur stabbing pains deep within the breast during or between feedings.

Causes - Oral thrush and other Candida infections occur due to weak immune system due to some disease as AIDS, cancer, diabetes mellitus, vaginal yeast infection, anemia or immuno-suppressive drugs - oral or inhaled corticosteroids, chemo and radio-therapy or antibiotics disturbing the natural bacterial flora in the body, some habits as smoking, tobacco chewing or wearing denture and dry mouth.

Complication - Oral thrush infection may recur in a healthy person even after being treated but can be more serious for people with the conditions mentioned in causes. Then the thrush is likely to spread to other parts of body, mouth or esophagus, digestive tract, to the intestines making nutrition difficult, also to lungs and liver.

Diagnosis – Oral thrush can be diagnosed simply by looking at the lesions, but diagnosis can be confirmed by microscopic examination of a sample. Diagnosis may be confirmed by throat swab culture for esophageal thrush and endoscopic examination of esophagus, stomach and the upper part of small intestine (duodenum).

Treatments - The treatment is aimed to stop the rapid spread of the fungus and cure it.

Homoeopathic Medicines – As indicated early that the compensated immunity is the cause of infection, homoeopathy does not treat the problem locally, as every local manifestation of disease has a support from patient’s constitution that is physical and mental makeup, which is representative of function of immune system. Therefore, homoeopathic medicine would vary accordingly from patient to patient. Here are names of a few homoeopathic medicines indicated for oral thrush -

Mouth - Thrush

Aethusa, Anantherum mur., Antimony-tart., Argentum-nit., Arsenicum alb., Asafetida,  Baptisia, Borax, Bryonia,  Butyric-ac., Candida parapsilosis, Carbolic-ac., Carbo-veg., Caulophyllum, Causticum, Chlorpromozinum, Hepar sulph., Hydrastis, Kali-brom., Kali-chloratum, Kali-iod., Kali-mur., Mercurius solubilis, Mercurius-corrosivus, Muriaticum-ac., Natrum-carb., Natrum-mur., Natrum-phos., Nitric-ac., Nux-vom., Phosphorus, Psorinum, Sarsaparilla, Sempervivum tectorum., Sepia, Staphysagria, Sulphuric-ac., Sulphur, Thuj occ.

Precaution - In case of infants and nursing mother infection passes back and forth so both mother and infant should be treated simultaneously. Breast should be cleaned thoroughly every time before and after feeding.

If a pacifier or a bottle for feeding is used, a solution of equal parts water and vinegar is used to wash nipples and pacifiers daily and dried in air to prevent fungus growth.

If a breast pump is used for certain reason, rinse the detachable parts that come in contact with milk in a vinegar and water solution.

A breast-feeding mother who has developed fungal infection should use un-synthetic disposable pads to prevent the fungus from spreading to clothes. Non-disposable pads and bras should be washed in hot water with bleach.

Adults or children who have oral thrush but are otherwise healthy should take unsweetened yogurt or acidophilus capsules or liquid which help to restore the normal bacterial flora in the body.

Persons with weakened immune systems as with HIV infection or using immunosuppressant treatment for some reason need special attention. Some allopathic antifungal medications may cause liver damage therefore liver function is needed to be monitored during treatment.

Good oral hygiene – Good oral hygiene has an important role in preventing growth and spread of candida in body.  One should brush and floss, at least twice a day better after every eating. Infected person should replace toothbrush frequently until infection clears up. Don't share toothbrushes. Avoid mouthwash or sprays — they can alter the normal flora in mouth.  

Dissolve 1/2 teaspoon of salt in 1 glass of warm water. Swish it and then spit it out, but don't swallow.

Prevention – To prevent development of Candida infection sugar and yeast containing food should be limited and mouth should be thoroughly washed after every eating.

Patient taking corticosteroid inhalers should rinse their mouth with water or brush teeth after taking inhaler as cortisones decrease the local immunity.

While taking antibiotics use fresh yogurt which contain Lactobacillus acidophilus or bifidobacteium to maintain intestinal flora.

Any vaginal yeast infection developed during pregnancy should be treated promptly.

Denture wearing persons and diabetics need a special mouth care. They should brush and floss teeth after every eating. Denture should be cleaned every night.

CASE

Mr. A G          28 years   male  CA      married        Hindu                vegetarian

Diagnosis – Oral Thrush (Candidasis).

For last more than 6 years the patient was suffering from sores on mucus membrane of mouth including tongue, the inner surface of cheeks and lips. Vesicular eruption burst to form raw ulcers covered with white material difficult to scrap and leave bleeding surface which is painfully sensitive to touch, eating or drinking anything. Mouth feels dry though moist on examination. Saliva dribbles during sleep. Has history of the similar suffering at the age of 12 years after Typhoid.

Lower limbs itching with red eruptions occur after bathing, during winters since 3 years. He also has decayed, brittle teeth, bilateral renal calculi and head pain from journey.

Appetite increased during oral infection. Thirst normal. He desires Chinese food. His perspiration is offensive and he is a chilly person. Always bath with warm water as cold bath causes chill. He sleeps on abdomen and gets dreams of office work. Anxiety about work, mutters after anger, fears high places. He feels better when alone.  He was lean, fair with smooth skin.

H e has a family history of oral infections, hypertension, renal calculi and diabetes.

14/11/09 Rx 1. Pulsatilla       200   two doses at 10 minutes.

                    2. Rubrum         30    two pills twice a day for 7 days.

23/11/09 No relief so took allopathic medicines which relieved him.

               Rx 1. Pulsatilla        200  two doses at 10 minutes stat.

                    2. Tuberculinum 200  two doses at 10 minutes on 8th day.

                    3. Rubrum          30    two pills twice a day for 15 days.

23/12/09 He was trouble free but got deep bluish ulcer on lower lip since 3 days. He feels itching all over after bathing. Cough from irritation in throat.

                 Rx 1. Phosphorus 30  two doses at 10 minutes stat.

                      2. P. L.          1M  two doses at 10 minutes on 8th day.

                      3. Rubrum      30   two pills twice a day for 15 days.

26/12/09 He has painless ulcer in side of lower lip.

                 Rx  Phosphorus    30   thrice a day for 3 days.

12/01/10 He was relieved but an ulcer has appeared under upper lip. Itching after bath recurred after medicines were over.

                  Rx 1. Phosphorus 200  two doses at 10 minutes stat.

                       2. P. L.           1M  two doses at 10 minutes on 8th day.

                       3. Rubrum        30   two pills twice a day for 30 days.

03/03/10 No itching. No oral ulcer or thrush. Mouth on examination was found clear. 

Phosphorus 200 was repeated on 03/03/10 and 22/05/10. A recurrence was reported on 19/06/10 so Phosphorus 1M one dose followed by rubrum was prescribed. Phosphorus 1M was repeated on 31/07/10, 16/09/, 16/10/10, and 10/11/10.

16/11/10 Thereafter no ulceration or thrush occurred but there was stomatitis from the next day of Phosphorus 1M, with indented tongue margins and white coated tongue with profuse salivation.

                    Rx  Merc.  Sol.        30   thrice a day for 4 days.

27/11/10 Patient reported relief after very first dose of Merc. sol.

                   Rx 1.  Merc. Sol.     200   two doses at 10 minutes interval.

                        2. Nihilum             30   two pills twice a day for 14 days.

Merc. sol. 200 was repeated on 13/12/2010 and Merc. sol. 1M one dose on 18/01/11 thereafter no recurrence occurred. Patient was advised to report if require.

Dr. M. K. Tyagi

D.H.M.S., Dip. N.I.H.

Research Officer, Sewa Mandir.

Mobile" 09829157926
Email: 1.sewamandir@usa.net, 2.manju_mkt2003@yahoo.co.in