Sore mouth!

[Pixix]

Newbie here. Quick question! My mouth is sore, not truly bad, but noticeable. I had oral thrush once, side effect of antibiotics, and am wondering if it’s starting again, or is this a known side effect of Pred, or alendronic acid or other marvellous tablets? I don’t want it to get bad...it was like a completely ulcerated mouth last time, and truly horrible. Is this a lovely addition, or is this a known PMR challenge, please? Due to start first taper tomorrow, but only 1mg down to 15mg. Sorry for pathetic question, but your info and knowledge much better than Google for hours!

[Jampad]

I have had thrush in my mouth several times since starting prednisolone. I use Corsydol mouth wash and then use the gel the pharmacist recommended. It clears up reasonably quickly, but keeps coming back.

[Pixix in reply to Jampad]

Thanks so much, I did think it may be the Pred. Will get some Corsydol and think I have gel but it may be out of date...will check and go to pharmacy if necessary!

[Hidden]

Hi Pixix

Yes, Pred can cause thrush & if you’ve also had it because of Antibiotics, l think you can be more predisposed to it.

A lot of us eat Live Natural Yogurt after we’ve taken our Pred, drinking water is also helpful.

Corsydol can be too harsh for a sore mouth caused by Thrush( it’s more Post Oral Surgery) have a word with the Pharmacist, explain you’ve had Thrush previously & are now on Prednisolone.

I’ve just had my Yogurt 😉

[Pixix in reply to Hidden]

Thanks so much. I loathe yoghurt...with a vengeance! I tried the Greek one to have with my Pred but didn’t even like that! I am on antibiotics for six months at the moment, too, so think the combo with Pred is too much, hence the thrush. I dug around in my medicines drawer and found the gel the doctor prescribed last time, just in date and unopened. It’s called Dektarin. Starting it now, and will get a new tube to take away with us in January. I like to be prepared and if Pred does this to folk then I’m definitely likely to get it. Thanks again, grateful for your help, S x

[PMRpro Ambassador]

Pred can predispose you to developing a sore mouth because of thrush. But I would be careful with Corsodyl - it will upset the bacterial balance in the mouth even more and that will allow further problems to develop. Thrush isn't bacterial, it is a yeast, so antibacterials don't help, you need specific treatment such as nystatin or clotrimazole.

medicinenet.com/thrush/arti...

[Pixix in reply to PMRpro]

Thanks very much. I’ve found Nystatin in my medicine drawer as well as Dektarin. The doctor thinks Dektarin is better, so trying that first as the Nystatin is 9 months out of date! Good news is that shows it’s a long time since I suffered from it, the azithromycin I take for six months of the year didn’t cause it in the last three winters, that’s why I asked about Pred this morning. Probably the two together! I seem to be predisposed to side effects from each drug and ending up taking more for the side effects...eg Omeprazole, then lansoprozole, now the mouth thrush stuff...and the weekly Alendronic Acid is causing stomach pains for half a day...but it’s only once a week. I have some probiotics that I will take once the mouth thrush is resolved...they do the same job as the live joghurt!! Onwards into battle! S xx

[Blearyeyed]

Not a pathetic question , as a sufferer if Mouth related symptoms from various Health issues I know how horrible this can be . I also have Recurrent Apthous Stomatis Syndrome and Dry Mouth to add to my Autoimmune related complaints .

Do you usually suffer from Dry Mouth as part of your condition as well?

If you feel it is Thrush coming on and it feels the same as before it may be worth taking the single dose Canasten pill for Thrush to know it on the head before your holiday.

I find I need to do this if I'm not given the antifungal treatment I usually get when I am on long term antibiotics . You have long term antibiotics as well as steroids don't you , so the mouth issues often happen because of that.

Drinking cool sparkling mineral water and green tea of any flavour helps improve mouth health. Drink more fluids generally on steroids and antibiotics.

Don't use very strong mouthwash and use a softer toothbrush , try a dry mouth toothpaste.

I occasionally use Corsodyl , original medicated form , but do rinse alot after it as it can sting and cause more inflammation if over used.

Eat probiotics yoghurt with your medications , ten minutes or so before to coat the stomach.

Eating probiotic yoghurt an hour after antibiotics help replenish good bacteria in the mouth and stomach after antibiotics have done there job . Leavecit coating the mouth for ten minutes before swilling to remove sugars.

Garlic capsules ( if allowed with other medications ) can help reduce recurrent Thrush and Mouth yeast issues. Extra Vitamin C and E and zinc also help get rid of mouth infections of all types .

Don't clean teeth straight after eating but swill and rinse your mouth with water or cold green tea instead to remove sugars but maintain the increase in saliva and natural bacteria removers.

Suck on a sharp sweet or saliva promoting losenge like Salivax , between meals to increase saliva production which helps keep the possibility of mouth infections at bay.

Buy some Buccal / Buccol Hydrocortisone Mini pills for treating ulcers over the counter and add them to your medicine bag for your holiday to help treat ulcers fast if some begin on your holiday.

Let's hope it's on the mend before your holiday , take care xx

[Pixix in reply to Blearyeyed]

Wonderful reply and help, many thanks for such a long reply it really is appreciated. See my comments above re yoghurt...but I will eat it if the probiotics tablets don’t work...I promise! I eat everything, not a fussy eater apart from yoghurt! Yes, you remembered, thanks, I’m on azithromycin for six months due to lung and allergy issues in the winter. I do get dry mouth and always have a glass of water nearby and sip it as I pass! I do have canestan as well in the cupboard, forgot about that. I will let everyone know how the Dektarin works now I know I’m not alone! I’ve never heard of Salivax, but will be buying it for sure. Thinking about it I do get dry mouth a lot now, always take flask of water in the car! I’m on 1000mg time release Vit C a day and the tablets my doctor prescribed have Vit E in them too. Green tea, yes, going to try that, too, thanks. Buccal, too. Fortunately we will be in the USA where they have so much available on the counters in the supermarkets! I’m so sorry to hear you have so many other ailments going on...never heard of that syndrome, off to Google it! Take care and many thanks for your help again, S xx

[Blearyeyed in reply to Pixix]

You can buy buccal tablets over the counter from the pharmacy in the UK if you discuss the symptoms and your recurring dry mouth them. I just order mine from one of the online chemists , they arrive next day.

[Pixix in reply to Blearyeyed]

All sorted...plus Salivix, ordered online. That syndrome you have is horrible...my father suffered from mouth ulcers most of his life...like huge gaping sore craters, awful pain, nothing much helped. It looks a bit like that’s what you have to put up with. Really sorry, sending hugs, S x

[Blearyeyed in reply to Pixix]

It was part of the reason I originally sent to the Behcets CoE , they had me for over a year and seemed to find everything but Behcets !!

It can occur though with the Ehlers Danlos because of its affect on the connective tissues , it's also part of the cause of my Dry Eye and Dry Mouth , and as you know from experience long term antibiotics don't help those Syndromes much either.

[Pixix in reply to Blearyeyed]

Wow, you have enough to put up with, for sure! Yes, I get dry eyes as well, but I have blepharitis, too...so shouldn’t be surprised...not that I pay any attention to it..whoops! Take care, S x

[SnazzyD]

Nothing pathetic about an uncomfortable mouth. Watch out with Corsodyl as it is very harsh on inflamed membranes and Chlorhexidine indiscriminate about killing off good bacteria. It can also stain your teeth. I use Curacept which is much milder but only when it is really needed because of wanting to keep my oral flora balanced. If it is thrush an antifungal medication is more specific.

[Pixix in reply to SnazzyD]

Thanks and yes although I feel it’s a bit wimpish I really hate mouth issues and it gets so sore. Thanks for your help...as others have commented too I’m not going to try corsodyl but first I will try the Dektarin gel. I’m sure it’s thrush as I’ve suffered before, but gave good access to my GP if it doesn’t work quickly and it’s our monthly ‘taper or not to taper and how much’ meeting next week, too. I feel blessed having such great help today, though...truly superb, thanks to you, too. Because the winter antibiotics haven’t caused the problem in the past three winters I felt it must be something else and as I’m on 16mg Pred in only my second month of PMR it was an easy guess this could be the culprit! S xx

[Iwillwin123]

Take this symptom very seriously. If you have PMR / GCA. This could well be a dormant VZV chicken pox virus getting reactivated and could well be the cause of the PMR/GCA as well .

My suggestion to you

1) Do a PCR analysis for VZV virus to see if it shows VZV traces . It may or may not show up there but is worth a try .

2) immediately start Valcivir a medication for VZV virus and check to see if sore mouth disappears . If it does , then you have nailed to problem .

[Pixix in reply to Iwillwin123]

Thanks for your messages. I appreciate your concern & have started using Daktarin gel. After only 4 ‘doses’ there is a noticeable improvement, so I think I’ve got this nailed. However, if it doesn’t clear very quickly, I will follow your guidelines, many thanks. I will check the active ingredients in Valcivir, too, & see if I have an equivalent in my cupboard.

[Iwillwin123]

In addition I forgot to mention - pCR analysis of SALIVA sample checking for VZV virus

[Iwillwin123]

If Valcivir works then you have nailed the problem .

[Pixix in reply to Iwillwin123]

Thought it rang a bell...I also have a large cold sore at the moment, though not on my lip, it’s at the base of my nose. It did not respond well to treatment as I missed the ‘tingle’ stage, it happened in the night! I’m a bit run down, & think my body is taking advantage of this right now! Thanks.

[Hidden]

I use Daktarin

[Pixix in reply to Hidden]

Thanks! After only 4 ‘doses’ there is a quick improvement, I’m impressed. Faster reaction than the ?Nystatin I used to use & not unpleasant to take. Appreciate your comment!

[Blearyeyed in reply to Pixix]

Thanks for the update on it ,,I will remember it in future xx

[Pixix in reply to Blearyeyed]

Update..although Daktarin worked quickly at first, it didn’t completely resolve it. Had my monthly meeting with my doctor last night and he believes that Nystatin is more relevant & works better in cases like this, where Pred is causing the oral thrush. Also, says if you are prone to it, it tends to repeat while on higher doses of Pred, but should be lessening as the tapering continues. Cheers, S xx

[Hidden in reply to Pixix]

Pixix, hope the Thrush is receding, do you eat Plain Live Yogurt after your Prednisolone, a lot of us do to try & keep the Thrush at bay!

[Pixix in reply to Hidden]

I hate yoghurt...in all forms. Tried Greek the other week yuk! I’m on my own with this and I will take it like a medicine for thrush but I tried hard and hated it the other week, sorry I’m not a fussy eater! I take my Pred at 3am with plain savoury biscuits and lanzoprozole and not getting any stomach pains now. Don’t even like the sweeter yoghurts with fruit. Somebody has to dislike the stuff! Thanks for trying to help, sorry if I sound difficult I don’t mean to be! Hope you are feeling a bit better, S xx

[Hidden in reply to Pixix]

No, no problem, l used to dislike plain, A Black Cherry 🍒 Full Fat Girl was I, actually l fancy that now 😉

Drink plenty of water to rinse your mouth that may help. My mouth was wrecked after Chemo took over a year to sort it out, think l had every treatment know to man 😛

Some of the others may have some tips 🤞🏻

[Pixix in reply to Hidden]

I haven’t found others who dislike all yoghurts except my husband! We used to be amazed at the amount of shelf space it takes up in supermarket s! When I have to I mix Demerara sugar (or did before my blood sugars rose!) into plain live yoghurt and eat it! I’ve had worse medicine! Sorry to hear you’ve been through the mill in other ways too...you mentioned chemo. I’m so sorry. That’s the trouble with being new to the forum you don’t know what others have put up with in the past! Taken care, S xx

[Hidden in reply to Pixix]

I keep bouncing back though 😉

[Blearyeyed in reply to Pixix]

Try using a yeast and fungus free diet while you have it as well , that's what I do , it does clear it up quicker although a bit annoying . It includes not eating rice , grapes , Marmite , anything with yeast , peanuts or any unroasted nuts , taking the skin of fruits like peaches and plums and washing your apples and no coffee unless it's instant ( basically keeping away from foods that contain mould or fungus spores) plus having a low sugar / no processed sugar diet and eating probiotic yoghurt before each meal. I do it for about a month. Adding a garlic supplement helps prevent fungus issues coming back especially on long term antibiotics but you do need to check you can take that if you are on any blood or heart condition medications.

Did he discuss Lichen Planus with you at all ?

[Pixix in reply to Blearyeyed]

No, we agreed we’d see if it clears up well now as I haven’t had oral thrush for four years and I’ve been in long term antibiotics each winter so we think it’s just the Pred. If it doesn’t stop I will put lichen planus on agenda for next monthly meeting, thanks. Thanks also for diet tips...my one sticking point is hating yoghurt in all forms but I have probiotic tablets. Apart from Christmas sweet stuff I haven’t had anything on your list in the past six weeks. I will be back to low sugar now the cake and mince pies have gone, too! S xx

[Blearyeyed in reply to Pixix]

It most likely is just Thrush caused by the combo of Pred and Antibiotics , the diet thing , garlic and drinking water or swilling the mouth with cold green tea after eating or tooth washing seems to have kept things under control for me. I usually only do the full Antifungal diet for a month , then stick just with low sugar and the regular mouth swilling and keeping saliva production up by using those Lozenges during the day or before a meal if my mouth is dry.

Just yet another of those annoying little adaptions that you seem to have to do occasionally as all these health things pop up .

Take care xx

[Pixix in reply to Blearyeyed]

The lozenges arrived in the mail today, I meant to mention that! I’m increasing my water intake too. I think the Pred probably pushes my resistance over the top but I have had oral thrush after IV antibiotics before now. Green tea being delivered by Sainsburys tomorrow pm! S xx

[Blearyeyed in reply to Pixix]

Yes being on steroids does push up any symptoms or issues you had because of previous or ongoing low immunity chronic conditions up a gear for sure .