Nasty Oral Thrush from Steroid Inhaler.

[COMPO56]

Hi there! I have adult related asthma. I was diagnosed with this about four years ago. I take capsules (Carbocisteine /Montelukast) to thin out the gunk on my lungs and I have two inhalers: a Blue reliever inhaler (Ventolin) and a Pink Forstair steroid inhaler that I use morning and night. It is the latter that is causing me problems. I can go months without any problems, but then I sometimes get severe Oral Thrush caused by the steroid in this inhaler. I have had this for the past week and it is the worse attack yet. Sore, red patches all over my tongue and a constricted throat.

Are there any fellow sufferers out there? Can anyone recommend a home remedy to alleviate this. It is really getting me down!

Thanks for any replies!

Seasons Greetings!

[Poobah]

Hello COMPO56. I always brush my teeth, gums & tongue - then swill/gargle with a mouth wash - twice a day. I have dry powder inhalers, if I don't thoroughly clean my mouth I get a sore throat. You can get scrappers to also clean your tongue. Flossing is also important.

If you have a wet inhaler then using a spacer may help as the mist is better inhaled.

And the next time you pick up your scrip from the pharmacy, ask the pharmacist to check your inhaler technique as this maybe part of the problem.

If all this doesn't work then your GP can prescribe anti- fungal treatment.

I'm no Einstein, but I think some folk are more likely to get thrush - maybe just more sensitive to steroids.

Good luck.

[GarryS]

When it happened to me the nurse gave me a prescription gargle to use. They say gargle with water after everytime you use the steroid inhaler to prevent thrush. Try a salt water gargle?

[Wheezycat]

Hi! I don’t get severe thrush, but it recurs regularly, say every three to four weeks or so. I monitor my mouth etc carefully, so the moment it starts I deal with it. I am on Symbicort 200/6, a dry powder inhaler. At first I tried home remedies, like salty water, and it may have slowed it down but not stopped it. When I take my inhaler I do the usual rinse-and-gargle routine after I have brushed my teeth. After a failed (due to poor instructions) attempt with prescribed anti thrush treatment, I have taken to using Oral Dactarin, and it has worked well.

However, I have now been told I cannot continue like this, as it isn’t good for me. So I am just in the process to changing to a metered dose inhaler, to be used with spacer. I then need to be careful to keep the spacer clean.

As a sign of times, my planned t/c call from the surgery pharmacist was cancelled twice, which affected my confidence, so I made a GP appointment instead. She felt unable to prescribe until stocks of medications had been checked, so just now I am just waiting. Fostair had been suggested, but I have no idea what I will get.

It seems that the state of your immune system can affect how often you get thrush, so these days, unlike my normal me, I take multivitamins and also Vitamin D with calcium. I got deficient in vit D a couple of years ago, but with this it is fine. Also increased oral thrush can be linked with diabetes, so that needs checking, if not already done.

[Singinglouder]

Interested that people clean teeth then rinse and gargle - I’ve always done it the other way around. Any particular reason for cleaning teeth first?

[Blue-Breeze in reply to Singinglouder]

I was told by rehab nurse to gargle and rinse after inhaler. She never mentioned anything about cleaning teeth beforehand.

[Wheezycat in reply to Singinglouder]

No, none at all. Just came naturally as it were.

[ChrissieMons]

I was told to clean my teeth, rinse several times then gargle once and swallow twice. Salt water gargles do help if you have thrush, but the rinse/gargle routine is supposed to prevent it. If you have an aerosol inhaler you can keep it in the bathroom, but that might not work for a powder one.

[Lorcas_15]

If you wish to benefit from the fluoride content of toothpaste clean teeth after rinsing/gargling with no further rinsing.

[strongmouse]

Having changed to a different inhaler I am finding the same with coated sore tongue. After a bit of on-line research I have started using an oregano mouthwash twice a day after using inhalers and brushing my teeth. Apparently the herb oregano has antiseptic properties. It is definitely making a difference.

The one I bought online was OregaWash (Zane). It is made in Greece and the ingredients are water, oregano flower oil and a plant mastic (gum). You put a one to two drops in a small amount of water. It leaves a tingling, burning sensation but apparently that is normal, and it is important not to rinse mouth out after using it.