That irritating itch
Your Health - Dr. Gita Mathai
Just like in the environment, fungi grow on our bodies in dark and moist. They usually have no effect on us but if they breach the skin or the mucous membranes in the mouth, anus, vagina, penis, and, in obese people in the skin folds in the axilla, the thighs and under the breast (in infants the diaper area), the resulting infection is called thrush, monilia or candida. The infection causes an intense desire to itch and scratch.
Candida in the mouth appears as curdy white patches. They appear to be stuck to the inside of the mouth.
In infants and young children, oral thrush is common. In breast-fed infants infection can occur spontaneously if the mother is on antibiotics. It can also occur if her hormonal profile changes and estrogen levels increase (hormone tablets). The infection can then pass back and forth between the mother and infant. It occurs more often in children who are on the bottle or suck pacifiers. Infants who are born preterm or underweight are also more prone to infection.
Vitamin B deficiency causes a red raspberry tongue, which burns and is very sensitive to hot and spicy food. This occurs in the elderly as their diet is often inadequate. It can also occur with antibiotic treatment as along with the bad bacteria the medication knocks off the "good bacteria" in the gut that synthesise vitamin B in our bodies.
People who use inhalers, rotacaps and nebulizers often do not rinse out the mouth after using them. The particles of medication can stick to the mouth and eventually monilia infection can occur.
Vulvo-vaginal candidiasis can occur in women of all ages. It is precipitated by antibiotic use. It can occur with urinary tract infections.
Men can develop candida on the tip of the penis or in the skin fold there. This is more likely to occur with diabetes. Although technically it is not a sexually transmitted disease, it can be passed back and forth between partners.
In overweight individuals, sweat accumulates in skin folds in the thigh, and under the breasts. This reacts with soap, providing a moist fertile area for monilia to thrive.
Monilia will disappear on its own once the precipitating factor is removed. (The diabetes controlled, the hormones corrected, the urinary tract infection treated, vitamin deficiency and diet corrected, bottle feeding stopped, pacifier thrown away, smoking stopped).
If you have monilia, consult a physician who can treat the precipitating cause. External applications of clotrimazole lotion to the mouth, cream to other parts of the body and pessaries for vulvo-vaginal candidiasis will usually get rid of the infection. Clotrimazole powder is available and can be used for the armpit and chest area. Sometimes the creams are combined with steroids. Although they appear to clear up the infection in record time, recurrences will occur as steroids provide a fertile ground for bacteria growth.
Bacteria of the lactobacillus family help to colonise the gut and vagina with friendly bacteria and prevent overgrowth of monilia and other fungi. A tablespoon of home-made curd on an empty stomach every day will usually do the trick.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
