What to know about esophageal thrush
The food pipe is the tube that connects the mouth and throat to the stomach. Although anyone can develop esophageal thrush, it is more common in people with weakened immune systems, especially those with HIV or AIDS.
In this article, learn about the symptoms of esophageal thrush, as well as its causes and risk factors. We also cover treatment options and look at whether home remedies can help.
What is esophageal thrush?
For people with HIV or AIDS, esophageal thrush is more common.
Image credit: Samir, 2006
The fungus that causes esophageal thrush is called Candida. This type of fungus lives in the digestive tract and on the skin. It rarely causes problems. Sometimes, however, Candida can grow out of control and cause an infection.
Thrush likes to grow in warm, dark, and moist places, such as the mouth. Esophageal thrush is when the infection occurs further into the food pipe.
Similar infections in and around the vagina are common and are usually called yeast infections. Thrush is also more frequent in the mouth in babies and young children.
Esophageal thrush is much less common than these other types. Without treatment, the infection can spread deeper into the digestive system and even to the organs.
Causes and risk factors
Esophageal thrush develops when Candida on the skin or in the digestive tract, such as the mouth or throat, grows out of control.
It is more common in people whose immune systems are too weak to fight infections.
Some risk factors for a weak immune system include:
Some medications that can weaken the immune system include those that treat autoimmune diseases or prevent organ rejection after an organ transplant, including corticosteroids, such as prednisone.
Certain lifestyle factors may also make a person more vulnerable to esophageal thrush. These risk factors include:
- smoking tobacco
- wearing dentures
- having poor oral hygiene
- taking medications that cause a dry mouth
- taking antibiotics
Although esophageal thrush usually occurs in people with a weakened immune system, healthy people can also develop the condition.
A 2013 study reviewed the medical records of 88,125 Koreans who had undergone a procedure called esophagogastroduodenoscopy.
Out of all the study participants, 0.32 percent had an esophageal thrush infection. The researchers found that using certain medications, such as antibiotics or corticosteroids, or drinking large amounts of alcohol increased the risk of developing an infection.
Symptoms of esophageal thrush can include nausea, acid reflux, and pain when swallowing.
Other symptoms of esophageal thrush can include:
- pain when swallowing
- burning or itching in the throat or back of the mouth
- changes in taste
- acid reflux
- chest soreness
Esophageal thrush can spread quickly and may be severe. Without treatment, or if treatment fails, a person may develop:
- candidemia, a Candida infection of the blood
- Candida of the organs, such as the heart and lungs
- sepsis, which can be life-threatening
- weight loss and malnourishment due to swallowing problems
People with weakened immune systems are more likely to develop serious complications.
Having a weakened immune system may also make it more likely that the initial treatment will fail or that a person will have to try several different medications to find one that works.
People with esophageal thrush may also have thrush in the throat or mouth. If thrush is present in the mouth, and a person also has symptoms of esophageal thrush, a doctor may be able to diagnose the condition based on their symptoms alone.
In some cases, a doctor may need to take a sample of the patches in the mouth and send them to a lab to diagnose thrush. Further testing is often required if the patches resemble something else, such as oral herpes.
When the infection is deep and lower in the esophagus, a doctor may need to do an esophageal endoscopy for an accurate diagnosis.
An esophageal endoscopy involves a doctor inserting a long, thin, illuminated tube into the throat through the mouth, allowing them to see the esophagus.
Some doctors choose to treat the infection and see if symptoms get better in order to avoid doing an endoscopy.
A doctor may prescribe an antifungal medication to treat esophageal thrush.
Doctors prescribe an antifungal medication to treat esophageal thrush. These drugs are often in pill form. People with a severe infection may need to receive the medication intravenously.
The antifungal drug fluconazole, which can treat many types of thrush infections, is usually a doctor's first choice of treatment.
If a course of fluconazole does not work, or if a person cannot take fluconazole for any other reason, a doctor may prescribe voriconazole, itraconazole, or amphotericin B. Treatment usually lasts 14 to 21 days.
A person with a severe esophageal thrush infection may need to stay in the hospital for evaluation and treatment.
Certain over-the-counter remedies may help with other forms candidiasis, such as vaginal yeast infections or oral thrush.
Esophageal thrush, on the other hand, is a potentially life-threatening problem that can spread quickly. For this reason, people should not try to treat it without a doctor's prescription.
Homeopathic and home remedies are unlikely to cure the infection, and they may make it worse by delaying effective treatment and giving the thrush more time to grow.
A person may wish to use home remedies in conjunction with medical treatment to help the infection heal more quickly. Still, it is essential to speak to a doctor before trying these remedies.
Some home remedies include:
- Gentian violet: This is a dye made from coal tar. A person can apply it directly by swabbing it over thrush in the mouth, but they should not swallow it.
- Probiotic-rich foods: Foods that contain probiotics, such as yogurt or cottage cheese, may help the body recover. These foods contain healthful bacteria that may help prevent the growth of thrush.
- Probiotic supplements: Similarly to probiotic-rich foods, these supplements can help the body maintain its healthy bacteria. This may prevent a future thrush infection.
Esophageal thrush requires prompt medical care. People with problems swallowing, symptoms of an oral thrush infection or a history of thrush in the esophagus should see a doctor right away.
Improving oral hygiene, adopting a healthy lifestyle, and following a doctor's recommendations for strengthening the immune system may help prevent esophageal thrush from recurring.