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Thrush

Thrush – Causes, Diagnosis and its Treatment

 

Introduction

Thrush is an infection caused by a fungus called Candida albicans in the vagina or at times in mouth and surrounding areas. Thrush is associated with itching, irritation and swelling. It is commonly seen in women as Candida albicans fungus naturally exists in the vagina as well. Under normal conditions, the vaginal bacteria keep a check on the fungal growth and Candida remains in control. But due to multiple internal and external factors, this condition can be changed and Candida can start to multiply in the vagina, causing thrush. About 30% of women are known to suffer a bout of thrush some time in their lives, due to varying conditions. Although it is not a sexually transmissible disease, thrush can at times be onset and even transferred by sex.

Risk Factors

As thrush is developed due to a change in the natural flora of the vagina, it is indicative of a change in reproductive physiology or exposure to harmful external environment. Pre-pubescent girls and menopausal women don’t generally contract thrush and the condition is more common in women in their 20s and 30s. Thrush is also common in pregnant women or women with a severe condition of diabetes. Although the unborn baby of a pregnant woman is not at risk due to thrush, the corrective measures adopted to cure it can have varied side effects on the foetus.

Causes

Under natural conditions, the vaginal bacteria don’t permit Candida spp. to flourish explosively and develop into thrush. However, with altered vaginal flora Candida spp. can multiply at a rapid rate in warm, moist and unaired spaces. Although thrush appears suddenly and no apparent cause is established for it, there are causal factors which can lead to development of thrush –

  • Highlevel of diabetes: A woman suffering from a severe condition of diabetes is quite likely to develop blood sugar and hormonal compositions which encourages fungal and yeast growth, disturbing normal bacterial flora in the vagina.
  • Antibiotic course: If for a persistent health condition or disease, a woman is consuming a course of antibiotics; it can reduce the bacterial population in the vagina and allow for Candida spp. to flourish.
  • Lowered immunity: Due to treatments like chemotherapy for alleviating certain kinds of cancers, lowering in immunity may happen. This in turn can result in repeated or recurrent onset of vaginal thrush.
  • Hormonal replacement therapy: Although it is not completely linked with the onset of thrush, hormonal changes and imbalance can also affect the vaginal flora, leading to unchecked growth of Candida albicans.

Although sex is not known to cause or aggravate thrush, it can result in thrush being transferred from one partner to the other. It can also cause the symptoms of thrush to increase in terms of pain, itching and redness in the vaginal area.

Diagnosis

The symptoms of thrush are very similar to other STDs. It is the second most prevalent disease of the vaginal track and has a marked vaginal discharge to indicate its presence. The widely adopted diagnostic measures for thrush are –

  • The swab test: Thrush results in a creamy-white vaginal discharge which is generally odourless. An obstetrician can collect some of this discharge on a cotton swab and evaluate to check for cells of Candida spp. as other than Candida albicans, different strains of Candida can also cause thrush.
  • Surface symptoms:The most prominent symptom of thrush is creamy white lesions, redness and swelling which can be observed on the vagina.

In case of recurrence of thrush, swab test is considered unnecessary and based on the patient history as well as symptoms of discomfort, diagnosis is conducted for thrush.

Treatment for Thrush

Being a commonly observed reproductive condition, there are many corrective treatments available for thrush. Topical treatments like pessaries or anti-thrush creams are available both with prescription and OTC. The pessaries are to be inserted in the vagina with the help of an applicator and usually a single dosage is sufficient to clear a bout of thrush. An anti-vaginal cream is to be applied on and around the vagina, to manage itching and spread of thrush. Both of these topical treatments contain compounds like miconazole, econazole and clotrimazole. Oral medication in the form of tablets is also available to treat thrush. Fluconazole (single dosage) and itraconazole (2 doses in a day) are the tablets which are widely prescribed for thrush. Both oral and topical medications have little to no side effects. But as thrush is a condition which can also occur during pregnancy, caution must be taken before adopting any medication. It is advisable to consult a physician before selecting a treatment option, atleast for the first time thrush is contracted. In severe cases, a single dosage may not suffice, hence multiple applications of medicine and consumption of tablets may be necessary.