Thrush

[Alias]

Several months ago I was experiencing frequent discomfort in my upper chest, particularly at night, and when bending forward from a standing position. Initially I attributed this to heartburn and did not think too much about it. On my next rheumatologist visit I mentioned it to him. He looked in my throat and told me I had a fungal infection. I had no clue because it was not visible in my mouth or the forward portion of my tongue, but apparently it was quite obvious to him. Sure enough, a course of Nystatin seemed to knock it out pretty quickly. However, it has recurred and I am now on my third course of Nystatin. In the big picture, this is a very minor consequence of being immune suppressed, but from what I've read it can become quite serious if it's not treated. The treatment is no big deal, but this is something I'm evidently prone to when I am immune suppressed. Does anyone have any advice or experience to share?

[Debbie C]

Sorry I can't help you on this,I never heard of of thrush being like that. Did he say if there is something in particular that is causing it to keep reoccurring ? Is it definitely thrush ? Hope it goes away soon and you feel better.

[Dirty Don]

I had it once in the hospital...seems the nurses ignored it after they cleaned up my 'nuclear spill' as they called it: utterly black projectile vomiting. Anyway, wasn't until the generalist happened thru to check on me when she found out what was going on...immediately ordered a cup of 'whatever' and voila, done. But it was painful and a bit scary until the cuppa sulfa. Had all the same symptoms as you Alaska...went away quickly once treated. Best to you.

[Pete]

Hi Tom,

I was just wondering if you are taking bactrim as prophylaxis for pneumocystis pneumonia. (I've been on it MWF ever since I was dxed.) It appears to be in the same family of meds commonly used to treat thrush. Might be worth a conversation with your doc.

[Alias]

When this first cropped up, I was still taking Bactrim 3 x weekly, and I can't pinpoint any other medication changes that might explain it. In looking at the Mayo site it definitely suggests that a healthy adult immune system would quash this problem before it became noticeable, so I think it is just something I am going to be predisposed to as long as I am immune suppressed.

Regarding Bactrim, my doc discontinued it when I saw him in March. He thought it was no longer worth the risks of interaction with MTX, considering how well I am doing overall. :) (Knock on wood.)

Thanks for the reply.

[morningsunshine]

I've had a few bouts with thrush (and a yeast infection) in the last year. The worst is being starving from prednisone and not being able ot swallow from thrush!

The Nystatin seems to work pretty quickly, but it tastes awful!

One potential solution I've found: A month ago started making a serious effort to incorporate probiotics into my daily diet (yogurt, sauerkraut, kefir, etc) and haven't had any sort of fungal infection since. Just be careful if you're immunosuppressed--I've heard that the probiotic pills aren't great, which is why I'm going for the food option.

[Alias]

Interesting! I was taking probiotics for months, then discontinued them because I thought they might be contributing to stomach upset and I'd read some conflicting reports on whether they were a good idea or not. I was also making yogurt and fruit smoothies at breakfast pretty regularly, but then fell out of that habit. The giant tub of yogurt at Costco is now on my shopping list. In addition to the Nystatin (I agree - yuck) I've been doing salt water rinses several times a day, as recommended on the Mayo site. Anyway, maybe the yogurt will be just enough to keep things in balance and stave off recurrences of this minor annoyance. Thanks for the reply.

[drz]

Several months ago I was experiencing frequent discomfort in my upper chest, particularly at night, and when bending forward from a standing position. Initially I attributed this to heartburn and did not think too much about it. On my next rheumatologist visit I mentioned it to him. He looked in my throat and told me I had a fungal infection. I had no clue because it was not visible in my mouth or the forward portion of my tongue, but apparently it was quite obvious to him. Sure enough, a course of Nystatin seemed to knock it out pretty quickly. However, it has recurred and I am now on my third course of Nystatin. In the big picture, this is a very minor consequence of being immune suppressed, but from what I've read it can become quite serious if it's not treated. The treatment is no big deal, but this is something I'm evidently prone to when I am immune suppressed. Does anyone have any advice or experience to share?

I was told I had it once for same reasons. A suppressed immune system makes us vulnerable. I developed an allergic reaction to the Nystatin though but it seemed to go away quickly by itself. I think yogurt helps prevent it along with increased brushing of teeth and frequent sinus rinses too. Heavy use of alcohol is reported to be bad in terms of increasing the risk of thrush. So I think rinsing with a mouthwash often might be contraindicated.

I can't take Bactrim because of an sulfa allergy, plus I have diabetes so I have a higher risk for such problems related to suppressed immune system. I was told it often comes and goes in esophagus area and isn't serious problem there but if it gets into other areas of your body it can be real bad. It is just another one of those things us Weggies have to be vigilant about.

[Debbie C]

my endo. dr. told me to take probiotics and I have asked other drs. and they all agree they are good for you.I take ones that contain soy instead of milk since I became lactose intolerate and they don't upset my stomach.I am also on the smoothie kick every morning.
Drz,as far as the mouthwash you should get the one that say they contain no alcohol.
Hope things start working for you soon Tom.

[BookNut]

I did not have the symptoms you had. I think mine was mostly in my throat as a result of inhaling steroids. I took Clotrimozole which comes in a dissolvable tablet taken 5times a day. Not a bad taste at all. The only symptom I had of thrush was a stabbing feeling in my throat .... something between an itch and a mild pain. It always made my cough even worse.

My PCP has me take probiotic pills 3 times a day. She says to not bother with most of the probiotics on the shelves. In her opinion the only ones that are any good have at least 5 billion active cells and have to be kept refrigerated. Our local grocery store...the wonderful Wegmans...keeps it in the refrigerated section of their natural foods section. They work. I am the most regular person in the world! :rolleyes1:

[Debbie C]

Yea , the ones I take have 20 BILLION live cultures and have to be refrigerated. They are made from Natures Bounty called Ultra Strength Probiotic 10

[vdub]

Had it 3 or 4 months ago. Didn't know what it was and didn't go to the doctor for about a week. Finally, it got so painful I had to go to the doc. I was put on some sort of anti-fungal (can't remember what) and told to gargle warm salt water. The warm salt water is what seemed to bring almost immediate relief.