Can You Avoid Thrush When Having COPD?

It was not until my mother started using regular inhalers for her COPD symptoms, that I found out what oral thrush was. As the caregiver, I first noticed an abrupt change in appetite in my mom, and she said that everything tasted different.

Understanding oral thrush

At first, I thought it was my mom being picky. She was able to independently care for her oral health and clean her dentures on her own.

It wasn’t until she was hospitalized after a fall that the nurses doing their full body check had her open her mouth and pointed out the white film, and patchy spots all over the inside of her mouth, throat, and had collected on her tongue. It is no wonder that everything tasted funny, and she had a lack of appetite.

I was educated on the causes of oral thrush and the ways to help prevent it. Some of the other symptoms of oral thrush can also be redness inside the mouth and throat, a painful sensation in the mouth similar to strep throat, and white thick patches focused on the tongue that can bleed. ¹

COPD and oral thrush

With COPD, the main culprit is the use of inhaled steroid medications. For most patients with COPD, the ability to inhale the medication directly into their lungs is difficult.²

For that reason, most of the medication that enters through the mouth does not get into the lungs where it is needed most. It is advised that you swish with water, or a hydrogen peroxide-based mouthwash, after each treatment of inhalers or nebulizer sessions.²

We did get into the habit of always swishing with water after each inhaled medication, as well as using a mild tongue scrapper at least once a day combined with mouthwash. My mom went from just a rescue inhaler used maybe once or twice a day to using the rescue inhaler 6-8 puffs a day, and 4 different nebulizer treatments daily near the end of her COPD battle.

Every time she would start to have altered taste, or dramatic change in appetite, I would focus on keeping an eye on the appearance of thrush. Most times, I would report the symptoms to her doctor and by virtual visit, he would look at her mouth, or see the close-up pictures of her mouth/tongue, then prescribe a round of antibiotics or Nystatin.

After a week of treatment, I would see an improvement. Only to have it come back a few months later.

Prevention and management

Other causes of thrush may be a weakened immune system, antibiotic use, combinations of medications/medication changes, poor oral hygiene, ill-fitting dentures, and stress.³

We found out the hard way that swishing with Listerine was not the answer to combating thrush. The high alcohol content in most mouthwashes burned her mouth so badly, that it made the pain worse.

We used non-alcohol-based mouthwashes and even used warm salt water to do a quick swish, gargle, and spit into the sink or cup. When you are out and about and you don’t have the comforts of home with you, you can at least swish with water to help rid your mouth of the excess medication that did not make it to your lungs.

Another helpful tool was to use a spacer between the rescue inhaler and her mouth. The spacer helps in creating a funnel to propel the medication far deep into your lungs.

Keeping thrush at bay is possible. I hope these tips are helpful to add to your tools to fight the additional symptoms of COPD.

Have you ever had oral thrush? What methods did you find effective in treating it? Let us know in the comments.