What causes esophageal thrush? What are the symptoms of esophageal thrush? What complications can occur with esophageal thrush.

Understanding Esophageal Thrush

Esophageal thrush is a fungal infection that affects the esophagus, or food pipe. This condition is also known as esophageal candidiasis. The esophagus is the tube that connects the mouth and throat to the stomach. While anyone can develop esophageal thrush, it is more common in people with weakened immune systems, particularly those with HIV or AIDS.

Causes and Risk Factors of Esophageal Thrush

The fungus that causes esophageal thrush is called Candida. This type of fungus naturally exists in the digestive tract and on the skin, but it can sometimes grow out of control and lead to an infection. Esophageal thrush develops when Candida on the skin or in the digestive system, such as the mouth or throat, proliferates.

Individuals with weakened immune systems are at a higher risk of developing esophageal thrush. Some risk factors for a weakened immune system include:

• HIV or AIDS
• Diabetes mellitus
• Cancer
• Certain medications, such as those used to treat autoimmune diseases or prevent organ rejection after a transplant, including corticosteroids like prednisone

Certain lifestyle factors can also increase the risk of esophageal thrush, including:

• Smoking tobacco
• Wearing dentures
• Having poor oral hygiene
• Taking medications that cause a dry mouth
• Taking antibiotics

Even healthy individuals can develop esophageal thrush, though it is less common. A 2013 study found that 0.32% of the 88,125 Koreans who underwent esophagogastroduodenoscopy had an esophageal thrush infection. The researchers also discovered that using certain medications, such as antibiotics or corticosteroids, or drinking large amounts of alcohol can increase the risk of developing an infection.

Symptoms of Esophageal Thrush

The primary symptom of esophageal thrush is dysphagia, which means difficulty in swallowing, as the infection involves the development of multiple white patches inside the esophagus. Other symptoms of esophageal thrush can include:

• Pain when swallowing
• Burning or itching in the throat or back of the mouth
• Changes in taste
• Nausea
• Acid reflux
• Chest soreness
• Fever

Complications of Esophageal Thrush

Esophageal thrush can spread quickly and may become severe. Without treatment, or if treatment fails, a person may develop:

• Candidemia, a Candida infection of the blood
• Candida infections 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 these 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.

Diagnosis of Esophageal Thrush

If a person has thrush in the throat or mouth and also has symptoms of esophageal thrush, a doctor may be able to diagnose the condition based on the 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 confirm the diagnosis. Further testing, such as an esophageal endoscopy, may be required if the patches resemble something else, such as oral herpes, or if the infection is deep and lower in the esophagus.

Treatment of Esophageal Thrush

Doctors prescribe antifungal medications to treat esophageal thrush. These drugs are often in pill form, but people with a severe infection may need to receive the medication intravenously. The antifungal drug of choice is typically fluconazole, which is taken for 14-21 days. In severe or resistant cases, other antifungal medications may be used, such as itraconazole or voriconazole.

Home Remedies and Prevention

While there are no proven home remedies for esophageal thrush, maintaining good oral hygiene and avoiding factors that can weaken the immune system, such as smoking and excessive alcohol consumption, may help prevent the condition. If a person has a weakened immune system, they should work closely with their healthcare provider to manage their underlying condition and reduce the risk of developing esophageal thrush.