Disorders of the Gastrointestinal System, 2nd Edition
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Aphthous stomatitis, commonly re- ferred to as canker sores, causes burning, tingling, pain, and minimal swelling of the mucous membranes. Single or mul- tiple superficial ulcers with white centers and red borders appear, heal, and form at other sites. Healing generally occurs spontaneously within one to two weeks. Causes may be idiopathic or may include stress, fatigue, anxiety, vitamin B deficien - cies, nutritional deficits, toothpaste con - taining sodium laurel sulfate (SLS), mouth injuries such as from ill-fitting dentures, and fever (Mirowski, 2020). Stomatitis treatment focuses on symp- tom relief and prevention of future out- breaks. Medications used in treating stomatitis are antivirals such as acyclovir, corticosteroids to reduce swelling or in- flammation, pain-relieving analgesic gels such as lidocaine gels, and nonsteroidal anti- inflammatory drugs (NSAIDs) or ac - etaminophen as an analgesic. Avoiding salty and spicy foods or a food that is a known cause may also be recommended to reduce discomfort and prevent exac- erbation. Intravenous therapy may be in- dicated in extreme cases when patients cannot ingest adequate amounts of food and liquids or when a secondary bacte- rial infection is present. Current research also shows that immunomodulatory med- ications (e.g., cyclosporine and retinoids) may help manage chronic and severe cas- es (Mirowski, 2020). Candidiasis (Thrush) Thrush is an infection caused by the yeast (fungus) Candida albicans or an- other fungus in the Candida family. The infection causes cream- colored or white patches or lesions on the tongue, mouth, or pharynx surrounded by erythema. Per- sons at high risk for candidiasis include premature neonates, older adults, immu-
nosuppressed persons, persons with dia- betes, persons taking antibiotics, persons taking steroids for a long time, and per- sons with conditions that cause hyposal- ivation, especially inhaled corticosteroids (Kauffman, 2022). For infants with thrush, the oral mucosa is swabbed with nystatin between feedings; however, feedings can wash away medication. Nursing mothers should also be treated to avoid reinfec- tion and coinfection (Pampers, 2019). Infants who are six months older or old- er may be prescribed oral fluconazole. Older children and adults may rinse with and swallow antifungal solutions for treat- ment. Oral or intravenous (IV) medica- tions, such as fluconazole or clotrimazole, may be necessary in more severe cases. Good oral hygiene is crucial for prevent- ing and treating candidiasis (Cleveland Clinic, 2019). Figure 2. Thrush
Note . Heilman, J. (n.d.). Human tongue infected with oral candidiasis. Wikimedia Commons. https://commons.wiki- media.org/wiki/File:Human_tongue_infected_with_oral_ candidiasis.jpg. CC BY-SA 3.0.
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