Thrush in IBD Patients

Thrush, or oral candida, can be awful. It hurts to swallow, it feels like you’re choking, and it limits what you’re able to eat or drink (unless you prefer swallowing something that felt like tiny swords). There is also an attractive white mess of patchiness the comes with thrush.

How I know that thrush is coming

Your spit is thick, you can clear your throat 100 times, but it won’t feel clear. That’s my big uh-oh indicator to knowing thrush is coming for me. You can’t swallow comfortably and everything hurts to eat.

I’ll leave some foods to avoid based on previous GI recommendation and based on my own personal experience. Eating or drinking the wrong thing can actually irritate your infection more and feel like you’re swallowing parts of a cactus.

What thrush feels like

Thrush can be painful, irritating, and require (typically) a 5-10 day antifungal prescription, depending on what your doctor orders. For some reason, mine has begun to become like clockwork, monthly.

Through working with my GI, who knows how often I get it, we’ve come up with a system that works for both of us. Since our patient portal is so accessible, I just leave them a note, so the PA reads it and I’m able to get a script within a day, or if it’s over the weekend, a few days.

I’m so grateful that I have an understanding doctor that truly works with me when he knows how bad mine can get since I typically get it from the tip of my tongue to the bottom of my esophagus.

Symptoms of oral thrush

Thrush can cause a wide variety of symptoms in patients like pain and irritation while swallowing, feeling like you have phlegm in the back of your throat but you just can't get rid of it, and many more symptoms like fatigue, headache, and fever. Usually, mine show up with fevers, which cause me severe fatigue.

Your doctor may prescribe some “magic mouthwash” for you as well, which is very helpful. If you struggle with thrush often, I highly suggest you ask your doctor for the medicated kind, or you can make your own at home with just a few simple over the counter medications.

Why do I often get thrush?

Those most vulnerable to thrush: patients with compromised immune systems, older populations, infants as well.¹Prednisone may also be a factor in thrush, as well as weakened immunity, vaginal yeast infections, some medications, and dentures.

You can help prevent oral thrush by maintaining good oral health and washing/swishing your mouth out VERY well after using inhalers if you use them for another medical condition.²

Where does thrush appear and what does it look like?

While a lot of oral thrush appears in the back of the throat, it can sometimes be confused for strep by patients. It may also appear on the tongue, the insides of your cheeks, and even your gum lines.

On a personal note, thrush can be stinky & if you try to gargle with salt water or even just cough some of it up - it smells. It’s candida or yeast of the mouth. You may notice it when you try to spit some of the thickness out but may not notice the smell at all in some cases.

How is thrush treated?

Thrush is typically treated with an anti-fungal medication (often, the same medication that is used for vaginal yeast infections). Typical prescriptions will last from 5-10 days, depending on what your specialist provides you. Regular family physicians can prescribe this, but I go to my GI for this as it typically invades my esophagus.

Things to avoid while being treated for thrush:

• Soda or any carbonation - it will burn so awful you’ll want to cry
• Nothing acidic like orange juice or anything citrusy
• Sugary substances (this may only irritate it even worse) and high sugar fruits or juices
• Milk and cheese, as this can thicken the lining of thrush and actually make you feel even more restricted when you swallow
• Pizza sauce, marinara sauce, tomatoes

Things that can help with thrush:

• Yogurt
• Yogurt drinks - Chobani has some delicious yogurt drinks in many different flavors and I can’t stress enough how much I live on these during the weeks I have thrush. Sometimes it’s all I’m able to get into my body.
• There is also a very helpful resourceful diet that helps many patients who deal with chronic thrush (like myself) called the candida diet.³

You don’t have to go through the pain of thrush alone. So often many of us on steroids and inhalers deal with it, and it doesn’t get easier until you know what you should be avoiding and what you should be putting into your body to make your mouth and throat feel better. It took my years to learn that soda and natural sugars were making my mouth completely worse and so much more painful than it had to be.

If you struggle with thrush, talk to your doctor to discuss your symptoms and how often you’re getting it. Consider getting rid of the substances you’re putting into your body that may be making the thrush worse.

Have you experienced oral thrush or any other oral issues with Crohn's or UC?