Diagnosis

Diagnosis of thrush depends on the location and identifying whether there is an underlying cause.

If thrush is limited to your mouth

To diagnose oral thrush, your doctor or dentist may:

  • Examine your mouth to look at the lesions
  • Take a small scraping of the lesions to examine under a microscope
  • If needed, do a physical exam and certain blood tests to identify any possible underlying medical condition that may be the cause of oral thrush

If thrush is in your esophagus

To help diagnose thrush in your esophagus, your doctor may recommend any or all of these:

  • Biopsy. The tissue sample is cultured on a special medium to help determine which bacteria or fungi, if any, are causing your symptoms.
  • Endoscopic exam. In this procedure, your doctor examines your esophagus, stomach and upper part of your small intestine (duodenum) using a lighted, flexible tube with a camera on the tip (endoscope).
  • Physical exam. If needed, a physical exam and certain blood tests may be done to try to identify any possible underlying medical condition that could cause thrush in the esophagus.

Treatment

The goal of any oral thrush treatment is to stop the rapid spread of the fungus, but the best approach may depend on your age, your overall health and the cause of the infection. Eliminating underlying causes, when possible, can prevent recurrence.

  • Healthy adults and children. Your doctor may recommend antifungal medication. This comes in several forms, including lozenges, tablets, or a liquid that you swish in your mouth and then swallow. If these topical medications are not effective, medication may be given that works throughout your body.
  • Infants and nursing mothers. If you're breast-feeding and your infant has oral thrush, you and your baby could pass the infection back and forth. Your doctor may prescribe a mild antifungal medication for your baby and an antifungal cream for your breasts.
  • Adults with weakened immune systems. Most often your doctor will recommend antifungal medication.

Thrush may return even after it's been treated if the underlying cause, such as poorly disinfected dentures or inhaled steroid use, isn't addressed.

Lifestyle and home remedies

These suggestions may help during an outbreak of oral thrush:

  • Practice good oral hygiene. Brush and floss regularly. Replace your toothbrush often until your infection clears up. Don't share toothbrushes.
  • Disinfect dentures. Ask your dentist for the best way to disinfect your dentures to avoid reinfection.
  • Try warm saltwater rinses. Dissolve about 1/2 teaspoon (2.5 milliliters) of salt in 1 cup (237 milliliters) of warm water. Swish the rinse and then spit it out, but don't swallow.
  • Use nursing pads. If you're breast-feeding and develop a fungal infection, use pads to help prevent the fungus from spreading to your clothes. Look for pads that don't have a plastic barrier, which can encourage the growth of candida. Wear a clean bra every day. Ask your doctor about the best way to clean your breast nipples, bottle nipples, pacifiers and any detachable parts of a breast pump if you use one.

Preparing for your appointment

You're likely to start by seeing your family doctor or pediatrician. However, if you have an underlying condition that's contributing to the problem, you may be referred to a specialist for treatment.

Here's some information to help you get ready for your appointment.

What you can do

The doctor is likely to ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • When did you begin experiencing symptoms?
  • Have you recently taken antibiotics for an infection?
  • Do you have asthma? If so, do you use a steroid inhaler?
  • Do you have any long-term health conditions?
  • Do you have any other new symptoms of illness?

What to expect from your doctor

The doctor is likely to ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to spend more time on. Your doctor may ask:

  • When did you begin experiencing symptoms?
  • Have you recently taken antibiotics for an infection?
  • Do you have asthma? If so, do you use a steroid inhaler?
  • Do you have any long-term health conditions?
  • Do you have any other new symptoms of illness?
July 22, 2017
References
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  3. Kauffman CA. Clinical manifestations of oropharyngeal and esophageal candidiasis. https://www.uptodate.com/home. Accessed May 23, 2017.
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  10. Thrush and breastfeeding. La Leche League GB. https://www.laleche.org.uk/thrush/. Accessed May 23, 2017.
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