Adult Oral Thrush: Symptoms, Causes, and Treatment Options - Internal Medicine

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Oral thrush, also known as oropharyngeal candidiasis, is a fungal infection caused primarily by the overgrowth of Candida species, particularly Candida albicans. This condition can manifest as white patches in the mouth, soreness, and difficulty swallowing, as you have described. It is not uncommon for adults, especially those with certain risk factors, to experience oral thrush.


Symptoms of Oral Thrush
The symptoms you are experiencing, such as the presence of white spots in your mouth, a tight sensation in your throat, and difficulty swallowing, are classic signs of oral thrush. Other symptoms may include:
- Redness or soreness in the mouth and throat
- Cracking at the corners of the mouth
- A cottony feeling in the mouth
- Loss of taste
- Pain while eating or swallowing

Causes of Oral Thrush
Several factors can contribute to the development of oral thrush:
1. Weakened Immune System: Conditions such as HIV/AIDS, cancer, or diabetes can compromise your immune system, making you more susceptible to infections.

2. Antibiotic Use: Antibiotics can disrupt the natural balance of bacteria in your mouth, allowing Candida to thrive.

3. Dry Mouth: Conditions that cause dry mouth, such as Sjögren's syndrome or certain medications, can increase the risk of thrush.

4. Hormonal Changes: Hormonal fluctuations, such as those occurring during pregnancy or due to birth control pills, can also play a role.

5. Smoking: Tobacco use can irritate the mucous membranes in the mouth, making thrush more likely.


Treatment Options
Treatment for oral thrush typically involves antifungal medications. Commonly prescribed medications include:
- Nystatin: An antifungal oral suspension that you can swish in your mouth and swallow.

- Fluconazole: An oral antifungal pill that may be prescribed for more severe cases or if nystatin is ineffective.

- Clotrimazole: Available as lozenges that dissolve in the mouth.

In addition to medication, maintaining good oral hygiene is crucial. This includes brushing your teeth at least twice a day, flossing daily, and using an antibacterial mouthwash. If you wear dentures, ensure they are cleaned thoroughly and removed at night.


When to See a Doctor
Given your history of recurrent oral thrush, it is advisable to consult a healthcare professional. Since you mentioned that your previous doctor suggested seeing a specialist, you might consider visiting an Ear, Nose, and Throat (ENT) specialist or an infectious disease doctor. They can provide a thorough examination and determine if there are underlying conditions contributing to your recurrent thrush.


Is Oral Thrush Normal?
While oral thrush can occur in healthy individuals, recurrent episodes, especially in adults, may indicate an underlying health issue that needs to be addressed. It is essential to investigate the cause of your recurrent infections, particularly since you have experienced dryness in your throat after previous episodes.

In summary, oral thrush is a treatable condition, but recurrent cases warrant further investigation to rule out any underlying health concerns. Seeking medical advice from the appropriate specialist will help you manage your symptoms effectively and prevent future occurrences.